NR 534 Week 6 Assignment: Planned Change: Leadership of
Reduction in Workforce
You are the CNO of your current healthcare organization and have been told that the current
organizational structure of the nursing department is "top heavy," resulting in financial loss for the
institution in the last fiscal year. You've been instructed to restructure the department to flatten the
line to reduce expenses. You must decide how you will do it and how you will implement the change.
Describe the decision-making framework or model you will choose and the rationale for choosing it.
Of the three change models—PDSA, Kotter, or Rogers—which would you choose to use and why?
What makes the other two less useful? What influence did your leadership profile have on your
choices?
The first step in making changes in a healthcare system is identifying where there is a problem. Financial
burden in a healthcare system can be detrimental to an organization and must be addressed
immediately. In order to implement change as the CNO, one must figure out what approach to the
change is the most beneficial.
In this given scenario, I personally believe the PDSA model is most fitting. This model follows a four step
process: plan, do, study and act. The model is used for examining and implementing interventions for
systems-based process improvement identified through a systematic process (Polancich et. al, 2017). The
first step is “plan”, with this the CNO must identify the causes to the current problem. Why is there
financial loss? How can expenses be reduced? What changes need to be made? The next step is “do”:
This is where the CNO will implement a potential solution to the problem. What type of organizational
structure may work better for this institution? Once implemented, this model will then “study” the
results and how well they worked or where changes need to be made. Finally, the CNO will the “act” and
adopt the solution(s) if the results need to be changed or modified.
The Kotter’s change model is a little more in-depth and a lengthier process as this involves 8 steps to
change. This process is modeled upon change taking time and not being a quick and simple process,
which can become a problem in this situation due to financial loss occurring. Additionally, the Rogers
model could be utilized, however, it more is dependent upon the participation level and on the behavior
of individuals.
Reference:
Polancich, S., Coiner, S., Barber, R., Poe, T., Roussel, L., Williams, K., … Miltner, R. (2017). Applying the
PDSA Framework to Examine the Use of the Clinical Nurse Leader to Evaluate Pressure Ulcer Reporting.
Journal of Nursing Care Quality, 32(4), 293–300. https://doi.org/10.1097/NCQ.0000000000000251
Reduction in Workforce
You are the CNO of your current healthcare organization and have been told that the current
organizational structure of the nursing department is "top heavy," resulting in financial loss for the
institution in the last fiscal year. You've been instructed to restructure the department to flatten the
line to reduce expenses. You must decide how you will do it and how you will implement the change.
Describe the decision-making framework or model you will choose and the rationale for choosing it.
Of the three change models—PDSA, Kotter, or Rogers—which would you choose to use and why?
What makes the other two less useful? What influence did your leadership profile have on your
choices?
The first step in making changes in a healthcare system is identifying where there is a problem. Financial
burden in a healthcare system can be detrimental to an organization and must be addressed
immediately. In order to implement change as the CNO, one must figure out what approach to the
change is the most beneficial.
In this given scenario, I personally believe the PDSA model is most fitting. This model follows a four step
process: plan, do, study and act. The model is used for examining and implementing interventions for
systems-based process improvement identified through a systematic process (Polancich et. al, 2017). The
first step is “plan”, with this the CNO must identify the causes to the current problem. Why is there
financial loss? How can expenses be reduced? What changes need to be made? The next step is “do”:
This is where the CNO will implement a potential solution to the problem. What type of organizational
structure may work better for this institution? Once implemented, this model will then “study” the
results and how well they worked or where changes need to be made. Finally, the CNO will the “act” and
adopt the solution(s) if the results need to be changed or modified.
The Kotter’s change model is a little more in-depth and a lengthier process as this involves 8 steps to
change. This process is modeled upon change taking time and not being a quick and simple process,
which can become a problem in this situation due to financial loss occurring. Additionally, the Rogers
model could be utilized, however, it more is dependent upon the participation level and on the behavior
of individuals.
Reference:
Polancich, S., Coiner, S., Barber, R., Poe, T., Roussel, L., Williams, K., … Miltner, R. (2017). Applying the
PDSA Framework to Examine the Use of the Clinical Nurse Leader to Evaluate Pressure Ulcer Reporting.
Journal of Nursing Care Quality, 32(4), 293–300. https://doi.org/10.1097/NCQ.0000000000000251
