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Theory, Risk, and Quality Management in Healthcare Facilities


Risk management approaches were incorporated into the health sector following the increased malpractice crises. Hospitals were encountering increased compensation demands and more plaintiff verdicts leading to financial loss. Hospitals were faced with a decline in crucial specialists as well as higher insurance rates. Thus, risk management can be referred to as the process of generating and executing decisions that will help in the prevention of negative scenarios and reduce the effects of such scenarios (McCallin & Frankson, 2010).

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Change management project

A project plan is essential to produce a successful project and should cover all events that should be accomplished to attain the project’s objectives, with every task given a working timeframe (Guo, 2015). The project structure should list all the tasks related to establishing the project and deciding on its layout. The roles may include coming up with the project meetings schedule and creating high-level and detailed project plans. Coming up with written objectives and maintaining a risk log is necessary for patient safety practices.

Traditionally, health care sector handled risks in a reactive way. Every department worked autonomously to accomplish its missions and tackle its problems. This absence of central reporting led to divergent, replicative efforts and extravagant use of funds. Significant trends and patterns were omitted since departments never shared critical information with each other. Besides, turbulent economic periods made health care sector to seek a greater perspective on handling risks (Cummings, Fraser, & Tarlier, 2009). Legal reforms were initiated to respond to react to raging economic times. Since then, there has been a switch from reactive risk management to strategic risk management.

Consultation and Redesign

Consultation and redesign entail actions about restructuring the process or patient pathway or events leading to a change process. Such actions include generating new means of working, patient pathways and building new operational procedures. Developing new ways of operations leads to efficacy and team motivation. Identifying and agreeing priority areas for evaluation. Engaging departments and support systems to give their inputs to the project.

Implementation and Evaluation

This stage details actions necessary to implement the new process, patient pathway or means of working and assessing its success. This section involves generating training manuals and a training schedule. Building an implementation plan Crafting an evaluation tool During the implementation process, understanding the risks involved is necessary to help in planning on how to limit its effect. Good communication is important to assist ensure that everyone involved in the change process feel valued (Thornlow & Merwin, 2009). This can be achieved through meetings with the team members and involving everyone in decision- making process.

Relationship between Theory and Change Management

Change management is defined as transitioning individuals, entities and projects from one state to another. The advantage of change management is that it assists to increase quality and ensure patient safety. In a bid to manage change and execute change models, it is necessary to evade applying irrelevant methods and try to concentrate on a proper plan of action. Change management requires the nurse administrator to adopt one of the many effective management theories or models (Simpson, 2004). According to Lewin’s the change management theory, change process is guided by various models that include unfreezing, the change and refreezing. Nurse leaders should follow the three faces to change the status quo and come up with plans to sustain the change.

Unfreezing is the initial stage of the process of change. Unfreezing entails the preparation of the change. The key here is to make team members realize why the status quo needs to be changed, and the benefits of that change can bring. Change is the stage where the actual transition occurs. Refreezing is the process of integrating, absorbing and implementing change by the team members. This is the moment to get moving by dividing the ultimate goal into small and achievable parts (Thornlow & Merwin, 2009).

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Tools and techniques for effective change management

Tools involve a range of components and techniques that assist nurse administrators to recognize the need for change, plan, communicate and sustain change. Tools help to define what needs to be changed by surveying the organization to identify the immediate state (Simpson, 2004). Nurse administrators should ensure there is sufficient support from top management. Efficient communication and involving staff in the change process is essential to smooth transition Understanding and dealing with resistance to change is a major skill for nurse administrators since resistance is expected response to change process.

The tools/techniques should assist in defining goals or clear expression of the need to initiate change. For instance, unfavorable economic times compelled health care sector to take a wider dimension on managing risks Establishing the change agents and people who can act as ambassadors for change. Identify and embrace what supports the change as well as build ways to maintain that change (Guo, 2015). Correcting to reduce the impact of an event and preventing similar occurrences.

The Role of Nurse Administrators in Risk and Quality Management

Nurse administrators should ensure safety of patients as well as that of employees and minimize losses to incurred through the litigation (Guo, 2015). Nurse administrators should possess skills to detect, evaluate and avert risks before they occur. Creating awareness and empowerment both hospital-wide and department based on training and education. Nurse administrators serve as a resource or adviser of events happening in the hospital. By facilitating education, nurse administrators ensure improved patient safety and quality (Thornlow & Merwin, 2009). Delegation entails transferring the responsibility for tackling a task to another person but remaining accountable for the entire process. Nurse administrators should possess skills to delegate to avoid legal burdens linked to an ineffective delegation. Failure to delegate forces nurse administrators to perform duties such as patient care thus hindering them from accomplishing tasks that cannot be delegated. Staffing and ensuring proper staffing levels on nursing units. Staffing is one of the critical challenges in risk management. Nurse administrators must ensure the right staffing mix and numbers.

Nurse leaders formulate and declare organization’s goals. Besides, they serve as the team leaders thus; they should come up with defined goals to lead the way in the organization. Nurse leaders should describe the organization’s scope, components, and means of operation. This helps the entire team to understand their environment and what is expected from them as individuals and as group members. Nurse leaders should delegate roles and responsibilities for implementation and execution. Nurse leaders offer guarantees of confidentiality and cushion from retaliation for those who reveal delicate information.

The role of theory, risk and quality management, and evidence-based practice in supporting change management

Risk and quality management practices lead to improved ability to understand and prevent risk (Cummings et al., 2009). Evidence-based practices lead to improved adherence to quality services. Evidence-based practices promote the safety culture hence ensuring patient satisfaction. By creating a new path that is patient safety-oriented, a risk quality approach can lead to high-quality health care (McCallin & Frankson, 2010). The presence of regulatory compliance ensures that laws and regulations that control the health sector are respected. Leads to improved identification of processes that may cause adverse effects if not intervened.

Evidence-based practices ensure that there are more interventions aimed at minimizing the chances of recurrence. Risk and quality management practices help identify opportunities for improvement in the health sector. Additionally, such practices help develop a system of policies that enable the health sector to do its business in line with the prevailing regulatory standards (Reimers & Miller, 2014).


Change management project can seem discouraging because the process is not always clearly defined since less literature is discussed within the health sector.

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Nonetheless, the main aspects examined in this paper set out the processes of managing change, which are the significant elements of successful projects. By adopting these processes, change can be easily monitored, and issues detected at an early level, thus providing time to come up with a plan.


Cummings, G., Fraser, K., & Tarlier, D. (2009). Implementing advanced nurse practitioner roles in acute care: an evaluation of organizational change. The Journal of Nursing Administration, 33(3), 139-45.

Guo, L. (2015). Implementation of a risk management plan in a hospital operating room. International Journal Of Nursing Sciences, 2(4), 348-354.

McCallin, A., & Frankson, C. (2010). The role of the charge nurse manager: a descriptive exploratory study. Journal Of Nursing Management, 18(3), 319-325.

Reimers, M., & Miller, C. (2014). Clinical Nurse Specialist as Change Agent. Clinical Nurse Specialist, 28(4), 224-230.

Simpson, R. (2004). Managing the three ‘P’s to improve patient safety: nursing administration’s role in managing information technology. International Journal Of Medical Informatics, 73(7-8), 559-561.

Thornlow, D., & Merwin, E. (2009). Managing to improve quality. Health Care Management Review, 34(3), 262-272.

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