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Barriers to Change in Health Care (with detailed speakers notes)
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Barriers To Change in Health Cate
Gayle A. Mitchell, PMP
Medication Errors
• Dose Omission• Overdose/multiple dose• Under Dose• Wrong Product Strength• Expired Order• Incorrect Documentation • Wrong Product• Wrong Rate of
Administration
• Wrong Time• Wrong Patient• Wrong Duration• Monitoring Error• Wrong Form of Product• Expired Product• Incorrect Route• Nocsomial Infections• Improper Labeling
Educate Before You Medicate
A Prescription for Change
• Identify the organizational change
• Articulate the case for organizational transformation in health care
A Prescription for Change
• Detect organizational/individual barriers
• Recognize influencing factors• Address motivational theories to assist
change
A Prescription for ChangeMotivational Theories to Assist Change
• Machiavelli’s Commentary on Change• Motivation Theories
– Need Motivation – Maslow– Two-Factor Theory - Herzberg– ERG Theory - Alderfer– Acquired Needs Theory - McClellan– Reinforcement Theory- B.F. Skinner– Expectancy Theory – Vroom and Tolman
A Prescription for Change• Technology is not the sole panacea
• The human factors of change– Culture
– Alignment
– Controls
– Accountability
A Prescription for Change• Common Barriers to Change
– Fear of the Unknown– Lack of Knowledge and Understanding– Lack of Strategic Vision, Leadership and
Communications– Absent Engagement of Stakeholders– No Roadmap – Idiosyncrasies of Individual Participants– No Progress Measurements– Failure to Recognize Successes
• Overcoming Resistance to Change– Reasonable Initial Hypotheses– Organizational Readiness– Clear vision– Sense of urgency– Committed leadership– Transparent Communications – Conflict Resolution Strategies– Reinforcement
A Prescription for Change
A Prescription For Change
• What is Six Sigma?– Overview– DMAIC– Kaizen
Six Sigma
A Prescription For Change
• Why Six Sigma for this change effort?– Disruptive innovation drivers– Alignment with complex systems management– Targets 99.99975% error-free conditions– Standardizes critical incident reporting– Documented previous success
Six Sigma
A Prescription for ChangeConclusion
ReferencesBuck, C. (2001). Application of six sigma to reduce medical errors. Quality Congress.ASQ's ...Annual Quality Congress Proceedings, , 739-242. Retrieved from http://search.proquest.com/docview/214394036?accountid=458
Cherry, K. (n.d.). Theories of Motivation - Major Theories of Motivation. Psychology - Complete Guide to Psychology for Students, Educators & Enthusiasts. Retrieved September 21, 2013, from http://psychology.about.com/od/psychologytopics/tp/theories-of-motivation.htm
Frey, B., Buettiker, V., Hug, M. I., Waldvogel, K., Gessler, P., Ghelfi, D., . . . Baenziger, O. (2002). Does critical incident reporting contribute to medication error prevention? European Journal of Pediatrics, 161(11), 594-9. doi:http://dx.doi.org/10.1007/s00431-002-1055-0
Groen, P., Mahootian, F., & Goldstein, D. (2008, April 19). Medical Informatics: Emerging Technologies, ‘Open’ EHR Systems, and Ethics in the 21st Century. Shepherd University. Retrieved September 21, 2013, from www.shepherd.edu/surc/cosi/Me...s%2004
Jordan, S. (2011). Signposting the causes of medication errors. International Nursing Review, 58(1), 45-46. doi:10.1111/j.1466-7657.2010.00867.x
ReferencesKellert, S. H. (1993). In the wake of chaos: Unpredictable Order in Dynamical Systems. Chicago: University of Chicago Press.
Machiavelli, N., & Donno, D. J. (2003). IV. The Prince (Bantam Classic reissue. ed., p. 21). New York: Bantam Dell.
Steel, P., & König, C. J. (2006). Integrating Theories of Motivation. Academy Of Management Review, 31(4), 889-913. doi:10.5465/AMR.2006.22527462
Study: Errors continue as leading cause of death in hospitals. (2006). OR Manager, 22(5), 32. Retrieved from http://search.proquest.com/docview/213088793?accountid=458