LA+1B

Nursing 4131: Nurse Influencing Change Learning Activity 1B
 * LA 1B - May 9th, 2012 **

1. Clearly articulate what the nature of your change is


 * To implement a pilot project for Telehealth or e-Net technology to support provision of home care for the adult/older adult population

2. Collect data to support your decision to create a change

> ======Complete literature review. ====== > ======Information about target population. ====== > ======What does the home care team do? ====== > ======What is the need for home health services? Is there an unmet need? ====== > ======Perceptions, attitudes, and knowledge about using technology for healthcare services in both the target population and healthcare providers ====== > ======What types of services are there to teach health care providers how to use Telehealth technology? ====== > ======Examples of similar health initiatives in other health authorities. ====== Excellent analysis of the data collection required! 3. Use Lewin’s Change Theory to guide what steps you will follow in pursuing your change project.
 * How is Telehealth used in home care and healthcare in general.
 * Has Telehealth been used in the adult/older adult population?
 * What were the results of the studies?
 * <span style="font-family: 'Times New Roman',serif;">What were the strengths and barriers?
 * <span style="font-family: 'Times New Roman',serif;">Did client education increase?
 * <span style="font-family: 'Times New Roman',serif;">Did clients receive care sooner and more frequently?
 * <span style="font-family: 'Times New Roman',serif;">Did patient confidence and autonomy increase?
 * <span style="font-family: 'Times New Roman',serif;">What were the adoption rates for Telehealth and e-Net technology?
 * <span style="font-family: 'Times New Roman',serif;">Did the changes cause any distress to the clients?
 * <span style="font-family: 'Times New Roman',serif;">Who are they?
 * <span style="font-family: 'Times New Roman',serif;">Are there equal amount of female/male clients?
 * <span style="font-family: 'Times New Roman',serif;">Where do they live?
 * <span style="font-family: 'Times New Roman',serif;">What is the socioeconomic status?
 * <span style="font-family: 'Times New Roman',serif;">How are their senses eg. vision, hearing?
 * <span style="font-family: 'Times New Roman',serif;">Do they have support from family members?
 * <span style="font-family: 'Times New Roman',serif;">Currently, do they have problems with travelling to health clinics?
 * <span style="font-family: 'Times New Roman',serif;">Do they have a source of internet access?
 * <span style="font-family: 'Times New Roman',serif;">What services do they provide?
 * <span style="font-family: 'Times New Roman',serif;">Is it feasible to provide some care using Telehealth or e-Net technology?
 * <span style="font-family: 'Times New Roman',serif;">How many clients does a home health nurse visit on an average day?
 * <span style="font-family: 'Times New Roman',serif;">What is the average travel time between clients?
 * <span style="font-family: 'Times New Roman',serif;">Is there a wait list?
 * <span style="font-family: 'Times New Roman',serif;">Is safety being compromised because of lack of services?
 * <span style="font-family: 'Times New Roman',serif;">How comfortable are adult/older adults and health care providers with learning to use Telehealth technology?
 * <span style="font-family: 'Times New Roman',serif;">Is there a lack of confidence?
 * <span style="font-family: 'Times New Roman',serif;">Misconceptions?
 * <span style="font-family: 'Times New Roman',serif;">Ready and motivated to learn?
 * <span style="font-family: 'Times New Roman',serif;">Do they understand why this change is necessary?
 * Also consider the acceptance among home health nurses for the use of this technology
 * <span style="font-family: 'Times New Roman',serif;">How long will it take to learn?
 * <span style="font-family: 'Times New Roman',serif;">Is it a simple or difficult process?
 * <span style="font-family: 'Times New Roman',serif;">What their procedure was and what was their finding?
 * <span style="font-family: 'Times New Roman',serif;">Was it effective in providing more effective care?
 * <span style="font-family: 'Times New Roman',serif;">Did they make further recommendations?

> ======<span style="font-family: 'Times New Roman',serif;">Decide if change is needed: ====== > ======<span style="font-family: 'Times New Roman',serif;">Communicate awareness: ====== > ======<span style="font-family: 'Times New Roman',serif;">Identify who will be affected: ======
 * <span style="font-family: 'Times New Roman',serif;">Unfreezing: when the change agent convinces members of the group to change. People become discontented and aware of a need to change.
 * <span style="font-family: 'Times New Roman',serif;">Identify the problem: a need to increase the effectiveness (efficiency, productivity, accessibility, etc.) of home health nursing care.
 * <span style="font-family: 'Times New Roman',serif;">Consider the need/demand for improved home health services (refer to 4th point, question 3)
 * <span style="font-family: 'Times New Roman',serif;">Consider the predicted effectiveness of pilot project through literature review and similar projects in neighbouring health authorities
 * <span style="font-family: 'Times New Roman',serif;">Consider the compatibility of the target population (adult/older adult) with Telehealth technology through literature search.
 * <span style="font-family: 'Times New Roman',serif;">Consider all factors related to change (these are mentioned in question 3)
 * <span style="font-family: 'Times New Roman',serif;">Inform involved parties of plan for Telehealth pilot project
 * <span style="font-family: 'Times New Roman',serif;">Explain why project is needed
 * <span style="font-family: 'Times New Roman',serif;">Describe how they may be affected
 * <span style="font-family: 'Times New Roman',serif;">Adult/older adult population in Vancouver community
 * <span style="font-family: 'Times New Roman',serif;">Home health team (health care providers normally working with the target adult/older adult population)
 * <span style="font-family: 'Times New Roman',serif;">Management level staff
 * <span style="font-family: 'Times New Roman',serif;">Technical support staff
 * <span style="font-family: 'Times New Roman',serif;">Government (providing funding)

<span style="font-family: 'Times New Roman',serif;">4. Determine how you might share your vision for change and engage your stakeholders


 * <span style="font-family: 'Times New Roman',serif;">We could present the need for Telehealth as our community’s problem. E.g. it is each of our responsibility to ensure that our growing adult population receives quality care
 * <span style="font-family: 'Times New Roman',serif;">Provide a real life case study of a client that could benefit from Telehealth. Provide evidence of this need with statistical evidence.
 * <span style="font-family: 'Times New Roman',serif;">Show stakeholders a ‘before’ and ‘after’ video/presentation to demonstrate the potential gains from Telehealth

<span style="font-family: 'Times New Roman',serif;">5. Apply Lewin’s Force Field Analysis to your project and identify potential strategies to shift the equilibrium in a favourable direction

> ======<span style="font-family: 'Times New Roman',serif;">Driving forces also include: ======
 * <span style="font-family: 'Times New Roman',serif;">Emphasize that most of the disadvantages/drawbacks are temporary and will yield a long term benefit, a more sustainable healthcare system for clients and staff.
 * <span style="font-family: 'Times New Roman',serif;">Cost effective home health care
 * <span style="font-family: 'Times New Roman',serif;">Increase accessibility
 * <span style="font-family: 'Times New Roman',serif;">Patient education and empowerment
 * <span style="font-family: 'Times New Roman',serif;">• Address disadvantages (restraining forces) and offer solutions (if possible):
 * <span style="font-family: 'Times New Roman',serif;">Difficult to set up and learn technology but there will be specialized staff hired to provide training. Also for staff, reinforce that they are capable of embracing changes in technology and have demonstrated this in their work.
 * <span style="font-family: 'Times New Roman',serif;">High cost of equipment and technical support but in the long term, it will yield a positive return on investment
 * Are there adequate fiscal and human resources at your disposal or will this restrict the scope of the program?
 * Excellent work! You have covered all the bases in great detail. I look forward to what you will produce with the next LA!