Proposed plan for change improves or maintains patient safety

How will you, as an agent of change, use Kurt Lewin’s Lewin’s three-step change model to implement a change in school practice? Use these questions as a guide.

1. Unfreezing
2. Gather data, diagnose the problem
3. Examine the status quo. Where are we now? What do we do now?
4. Decide if the change is needed. What can be done differently?
5. Who is for us? (Driving forces)
6. What can prevent us? (Restraining forces)
7. Moving
8. Develop a plan. Look in the literature (Who, Where, What, When, How)

Who will it affect? Where will the change be implemented? What is needed (resources)? When will it occur? How will it be implemented?

1. Set goals and determine outcome criteria
2. What resources are needed?
3. Identify and include everyone affected by the change (Stakeholders)
4. Put Plan in Motion – PILOT STUDY
5. Provide support and encouragement (How?)
6. Evaluate (How?)
7. Modify if needed
8. Refreezing
9. Stabilize the change

Plan for change must include: 

Identifying involved stakeholders  

• Patient
• Nurses
• Social work?
• Recreational therapist
• Psychologist

Creation of all materials needed for the project

• Questionnaire
• Survey
• Board games
• Card games
• Art supplies
• Music

Timeline for implementation 

• 1 week?

Plan of evaluation

• Questionnaire
• Survey
• Compare day 1 answers today 7 answers

Rubric

1. The topic is identified for improvement and is patient-centered (Patient-Centered Care)-
2. The plan includes an interdisciplinary approach for change (Teamwork and Collaboration) –
3. The proposed plan for change is applicable and supported within the literature (Evidence-Based – Practice)-
4. Proposed plan for change improves or maintains patient safety (Safety)-
5. The proposed plan for change is supported by data and enhanced by technology (Informatics)
6. The proposed plan for change is based upon a model of quality improvement (Quality Improvement)-
7. Change Project is created and presented for members of the healthcare profession (Professionalism)–

The process of change can be a tricky one, especially when it has to do with the trauma and stress of a sudden illness or hospital stay. It has been argued that ‘play is not used to escape from, but to confront and cope with, the dangers and difficulties of a life that is not always easy’ ( Tonkin & Whitaker, 2016)  One area that we noticed was in need of some improvement was patient interaction. During our daytime clinical hours, we saw a significant amount of patients who had no visitors. The need to work and/or take care of children can lead to a significant amount of time for a hospitalized patient to be alone. Some patients didn’t seem to have a problem with this, others were edgy, demanding, and exhibiting what could be manifestations of dissatisfaction and anxiety. This project focuses on a way to combat the feeling of being alone and refocus that energy into play.

A hospital in and of itself can cause someone anxiety. A loss of control and autonomy can be a significant shock to the system of an adult. The way a hospital function makes it difficult to protect patients from stress. Sharing a room or being witness to another patient’s possible decline can put someone in a highly anxious state ( Caraballo, Dharmarajan, & Krumholz, 2019). The number of people coming in and out of the room and the sheer amount of information can be an unwelcome stressor to someone used to being in control of their own life and privacy.

A hospital stay can require a significant amount of patience on the part of the person who is already sick and possibly scared. Add to this, especially in this age of COVID-19, a lack of any sort of distraction from visitors. We saw this first hand just due to a family needing to work and being unavailable to visit, now there is an actual visitor ban in place, leaving anxious patients to fend for themselves for the entire duration of their stay. What if there was someone whose job was to simply be there and to distract the patient with play