Promoting shared decision-making in patient-centered care is a chance for nurses and patients to establish trustful relationships and exchange necessary information. Planning and implementation of change cannot be ignored by project developers. This paper will focus on goals for improvement, measuring change, needed resources, the timeframe of implementation, mechanisms of data collection, and the theoretical background.
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Goals and Change Measurement
The goals of this project are to improve the quality of patient-centered care and achieve positive health outcomes by training nurses how to apply shared decision-making. In modern nursing practice, there are many methods to change the manner of caregiving or to increase nurses’ motivation for cooperation. Each idea has its aims and specific characteristics, and shared decision-making is one such practice with a focus that covers several aspects of collaboration between patient and medical staff for faster recovery and greater patient satisfaction (Shay & Lafata, 2015). The measurement of change should be organized in three main stages.
First, the goals and outcomes of the proposed intervention should be compared. Second, the level of patient satisfaction with the care and services provided must be evaluated. Finally, the overall progress of patient-centered care in a particular hospital should be discussed based on the views of the medical staff.
Nurses need to improve their knowledge about shared decision-making practices and involve patients in discussions through the identification of required resources. First, supplies and equipment have to be discussed, including the material needed for nursing work with patients, training courses, and presentations. Paper and pencils are obligatory for lecture notes and questionnaires for nurses and patients before and after the intervention. A quiet, comfortable, and well-illuminated room must be selected for training courses. A projector for two presentations needs to be installed for the period of the training courses. Several people should be ready to perform specific roles:
- an educator teaches nurses and explains the characteristics of shared decision-making;
- a researcher gathers information and the opinions of participants before and after the intervention;
- ten nurses take courses, develop necessary skills, and use them in practice;
- 50 patients share their health data and their opinions about the quality of care to compare intervention outcomes.
Completing the intervention is expected to take about three months. One week is necessary for selecting participants, inviting them to participate in the project, and providing them with the necessary information. One week is for a pre-intervention phase with questionnaires being addressed to nurses and patients. Two months should be spent on the intervention, including a course with eight lectures and two presentations, five practical assignments, and three personal evaluations. During the second to last week, a researcher will develop new questionnaires for nurses and patients to gather information for measuring change and analyzing the outcomes. A final week is for final evaluations and conclusions about the value of the improvement.
Data Collection Mechanisms
This project will be based on a quasi-experimental design with a qualitative questionnaire as the main data collection instrument. Two groups of people will be asked to answer a list of questions before and after the intervention. Nurses’ opinions will define the level of their knowledge, readiness to use shared decision-making, and professional skills. Patients’ answers that are gathered from questionnaires will identify the level of care before and after the intervention and explain the effects of change. After informed consent is obtained from each potential participant, questionnaires will be created in written form and offered to participants. All personal information about patients and nurses should remain anonymous, and confidentiality must be ensured.
Change and Leadership Theories
There are two theories to be applied to this project. From the change perspective, Kotter’s theory will be used as it focuses not only on the change process itself, but also on the people who stand behind the change. In this case, the intervention of learning about shared decision-making has to be properly introduced to all direct stakeholders, and Kotter’s theory helps to take all the necessary steps (Chappell et al., 2016):
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- create a sense of its urgency;
- build a group of people;
- develop a strategic vision;
- get everyone involved;
- remove all potential barriers before the intervention;
- underline recent achievements;
- promote activities;
- complete the change.
From the point of view of leadership, cognitive resource theory should be used. This theory was developed by Fred Fiedler and Joe Garcia in 1987 as an element of situational and contingency approaches to promoting analytical and logical thinking without stress and anxiety (Soans, 2018). Change leaders should consider the importance of such factors as intelligence, experience, and communication. Leaders make decisions while focusing on the abilities of the team, stress management, positive attitudes, and multiple but simple tasks. Shared decision-making consists of several steps to be rationally taken and explained. In this situation, the selected theories promote an understanding of how to prepare people for change and organize it properly.
In general, this project plan demonstrates the researcher’s readiness for a new intervention in a local hospital. Nurses and patients should develop professional skills to communicate and exchange information that is critical for health care. Shared decision-making is a good practice all nurses must be aware of, and this intervention plan explains how to implement this concept in a particular setting.
Chappell, S., Pescud, M., Waterworth, P., Shilton, T., Roche, D., Ledger, M.,… Rosenberg, M. (2016). Exploring the process of implementing healthy workplace initiatives: Mapping to Kotter’s leading change model. Journal of Occupational and Environmental Medicine, 58(10), 341-348.
Shay, L. A., & Lafata, J. E. (2015). Where is the evidence? A systematic review of shared decision making in patient outcomes. Medical Decision Making, 35(1), 114-131.
Soans, S. T. (2018). Let our flowers bloom. Indian Pediatrics, 55(4), 281-283.