Organizational Culture and Readiness Discussion

My evidence-based practice (EBP) project is “Decreasing maternal mortality in opioid-addicted mothers with holistic community involvement.”  In this paper, I examine my organization’s readiness for change, identify stakeholders and project teams, and propose technologies for implementing the intervention.

The Organization’s Culture

The organization where I plan to implement the EBP project is a small community hospital where I work. The hospital’s mission is to build an environment where community members can access quality and affordable to restore health and general well-being. We serve a community designated as underserved. My organization seeks to promote holistic health. It also aims to increase accessibility to healthcare services.  Organizational Culture and Readiness Discussion To achieve better health for all, we focus on prevention and treatment. Besides, we embody core values, such as acceptance, diversity and inclusion, accountability, teamwork and collaboration, and respect. Over the years, the hospital has provided health services through a team effort involving physicians, nurses, other healthcare professionals, associates, and the community.  The interdisciplinary collaboration has enabled the community hospital to provide tailored and need-specific services. The organization’s culture supports any practice change aimed at improving an individual’s or community’s holistic health, such as decreasing opioid-related deaths.  It also upholds prevention and care for vulnerable groups, including mothers with opioid addiction. Overall, I would conclude the community hospital’s culture will support the EBP project.

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Organizational Readiness Tool and Assessment

               Assessing an organization’s readiness to change is crucial in the implementation phase. Implementers are urged to determine how prepared their organizations’ s are for the intervention of interest. To assess the community hospital’s readiness for the EBP project for decreasing the mortality of pregnant women with opioid addiction, I choose the Organizational Readiness for Change Assessment (ORCA). ORCA is an evidence-based tool for measuring an organization’s preparedness for a new intervention or technology.  It has 74 items testing the organization on four domains individual psychological and structural, and organization’s psychological and structural (Crittendon et al., 2020). The tool was used to assess the community hospital. Organizational Culture and Readiness Discussion

The survey results the community hospital is ready for the EBP project implementation but there is a need to improve individual and organizational abilities. The members of the staff and the hospital’s leadership recognize that maternal mortality is a significant issue among pregnant women with opioid use disorder (OUD)  and demonstrate commitment to reducing the deaths. Also, the structure to support the implementation is available, as evidenced by a supportive organizational culture and management. However, the staff requires training. Furthermore, the community hospital will need resources to support the project to fruition.

Strategies To  Facilitate The Readiness Of The Organization

               Having established organizational readiness, the next step is defining improvement strategies. The interventions for improving preparedness should be targeted to the stage of readiness and the affected stakeholders. One way of determining the extent to which individuals or an organization are ready to change is by applying the transtheoretical model. The framework postulates that people or organizations in transition can be in pre-contemplation, contemplation, or preparation phases. The plan for promoting change readiness should consider these levels (Vax et al., 2021). The assessment indicated that my community hospital is in the contemplation stage. There is widespread awareness about maternal mortality in pregnant women battling OUD. However, the staff lack knowledge and skills for reducing the deaths. Likewise, the leadership requires an understanding of the project’s feasibility before allocating resources. The staff will need training. The project proponent should also conduct a feasibility study to illustrate why the hospital requires prioritizing the intervention against other competing projects. Communication will also help address any concerns the staff or the leaders might have about the EBP project. These interventions can promote organizational readiness and project outcomes. Organizational Culture and Readiness Discussion

The Degree To Which The Organizational Culture Will Support And Sustain An Evidence-Based Practice Change

The community’s hospital culture will support and sustain the evidence-based practice intervention.  The organization’s readiness assessment of the hospital’s collaborative culture and commitment to prevention and health promotion will drive the implementation and sustainability of the project. However, a lack of knowledge and skills in implementing the EBP intervention for decreasing mortality in mothers with OUD might be a barrier. Also, the failure of the management to support the project due to not understanding the feasibility of the proposed intervention could impede the implementation (Vax et al., 2021). Utilizing the identifying strengths to implement the project while addressing the barriers can improve the implementation process and the long-term outcomes.

Health Care Process And Systems Recommended For Improving Quality, Safety, And Cost-Effectiveness

I would propose a holistic perspective to caring for mothers in antepartum, intrapartum, and postpartum. I recommend comprehensive care for mothers with OUD that comprises risk assessment, brief interventions, and referral for therapy or advanced mental health treatment. These process measures will ensure that mothers with addiction are attended in time to promote maternal health outcomes and prevent opioid-related deaths. The community hospital also needs to normalize OUD risk assessment and care for all mothers attending the facility by making a procedural policy (Hoyland et al., 2022). The policy will form the structure to support and sustain the EBP change to enhance care quality, safety, and cost-effectiveness. Organizational Culture and Readiness Discussion

The Stakeholders And Team Members For The Project

The stakeholders that will be involved in the EBP project are the nurses, physicians, mothers with opioid addiction, and hospital management.  These stakeholders include people who the intervention will affect. For instance, introducing the intervention will influence the clinical workflows, affecting how nurses and physicians care for mothers with OUD.  The project will also impact the strategic direction of the community hospital. The management would want to know how the intervention aligns with its healthcare goals. The patients who comprise the antepartum, intrapartum, and postpartum women with OUD will be affected by the recommended intervention. Engaging these stakeholders will determine the project’s success.

The project team will include the nurse lead, physician representative, the chief of operations, and quality assurance representatives. This team will be responsible for the EBP project implementation. The nurse leader will lead and manage the project. They will communicate the practice change purpose and ensure the team is prepared for the project. The physician representative will inform the team about the best clinical practices for addiction. The chief of operations and the quality assurance group will assess the intervention’s impact on workflows and quality of care. Organizational Culture and Readiness Discussion

Information And Communication Technologies Needed For The Implementation

Telehealth, particularly mHealth is a novel information and communication technology required for the implementation of the EBP project for decreasing opioid-related mortality.  mHealth solutions address access barriers by enabling remote care. Healthcare providers can educate, send reminders, and follow up on addicted mothers undergoing maintenance treatment through digital technologies. The community hospital can integrate the mHealth application into the existing electronic healthcare records (EHR) system. The technology used will promote accessibility and compliance with the intervention.

How Technology Will Help Improve Nursing Practice And Care Delivery For The Targeted Individuals And Populations

The mHealth application will enhance nursing practice and care delivery for mothers with opioid addiction. The mHealth solution will improve access to care for mothers who might not travel to community hospitals for consultation. It will also enable nurses to provide patient education and conduct follow-ups to ensure medication adherence and behavioral change (Raynor et al., 2023). Overall, mobile health technology will promote care accessibility and quality. Organizational Culture and Readiness Discussion

Conclusion

               The EBP project for reducing opioid-related deaths in mothers with opioid addiction will need collaborative culture and management support. Engaging the stakeholders will ease the implementation and sustain the intervention. Lastly, utilizing mHealth to improve access to care and intervention outcomes would be helpful.

References

Crittendon, D. R., Cunningham, A., Payton, C., Mills, G., Kelly, S., LaNoue, M., & Arenson, C. (2020). Organizational readiness to change: Quality improvement in family medicine residency. PRiMER, 4(14), 1-6. https://doi.org/10.22454/primer.2020.441200.

Hoyland, S. A., Schuchert, A., & Mamen, A. (2022). A holistic perspective on continuing care for substance use and dependence: Results and implications from an in-depth study of a Norwegian continuing care establishment. Nordic Studies on Alcohol and Drugs, 39(5),469-584. https://doi.org/10.1177/14550725221099702.

Raynor, P.,  Corbett, C.,  West, D., Johnston, D., Eichelberger, K.,  Litwin, A., Guille, C., & Prinz, R. (2023). Leveraging digital technology to support pregnant and early parenting women in recovery from addictive substances: A scoping review.  International Journal of Environmental Research and Public Health, 20(4457), 1-14. https://doi.org/10.3390/ijerph20054457.

Vax, S., Gidugu, V., Farkas, M.,  & Drainoni, M. L. (2021). Ready to roll: Strategies and actions to enhance organizational readiness for implementation in community mental health. Implementation Research and Practice, 2, 1-11.https://doi.org/10.1177/2633489520988254. Organizational Culture and Readiness Discussion

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Appendix A: APA Writing Checklist

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☒ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and the format is correct throughout.

☒  The title page is present. APA format is applied correctly. There are no errors.

☒ The introduction is present. APA format is applied correctly. There are no errors.

☒ Topic is well defined.

☒ A strong thesis statement is included in the introduction of the paper.

☒ The thesis statement is consistently threaded throughout the paper and included in the conclusion. Organizational Culture and Readiness Discussion

☒ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☒ All sources are cited. APA style and format are correctly applied and are free from error.

☒ Sources are completely and correctly documented on a References page, as appropriate to the assignment and APA style, and the format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and are usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries. Organizational Culture and Readiness Discussion

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

***I work in a small community hospital with an accepting culture ***

In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. Organizational Culture and Readiness Discussion

In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed. (Decreasing maternal mortality in opioid addicted mothers with holistic community involvement)

You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Organizational Culture and Readiness Discussion
Propose strategies to better facilitate the readiness of the organization.
Discuss the degree to which the organizational culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources.
Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders.
Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document, located in Class Resources, for an overview of the evidence-based practice project proposal assignments. Organizational Culture and Readiness Discussion

You are required to cite a minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist,” located in Class Resources, to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies: Organizational Culture and Readiness Discussion

MBA-MSN; MSN

3.1: Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.

3.3: Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations. Organizational Culture and Readiness Discussion