DQ: Do you foresee any issues with the proposed implementation of your project? DQ: Do you foresee any issues with the proposed implementation of your project?

The only issue I see with the proposed implementation of my project is allowing both nurses and patients the time to get used to the implemented process. Most organizational change initiatives fail because we apply strategies that are not tailored for the structure of the concerned organization. I work at the VA in Lancaster and our structure is a healthy one. Changing a healthy structure requires trust, clarity, and integrity. Employees are accountable for what they do. If they need skills, they can get trained or ask support to their managers. Anyone in the organization, not only managers, is likely to ask questions like: “When will you be ready?” or “Have you tested the quality of your realization?” Everyone is accountable to their colleagues. Here are the guidelines to follow to identify the most appropriate change approach. It decomposes the movement from the current state to the future state in five steps (Cavarec, 2014):

  • Formulate change
  • Plan change
  • Implement change
  • Manage transition
  • Sustain change

Threats to sustainability may be identified both at the beginning of a project and when it is ready for implementation. The National Health Service Sustainability Model is reviewed as one example to help identify issues that affect long-term success of quality improvement projects. Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles (Silver et al., 2016).

Investments in new clinical practices do not stop with their developers; enormous effort and resources are directed to introducing new clinical knowledge to healthcare organizations. These investments include mobilizing human resources through the establishment of knowledge brokers, evidence-based practice committees or teams and identifying opinion leaders and champions who will support the practice excellence (Virani et al., 2009).

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Implementing the evidence-based practice of early ambulation in post-surgical patients can be associated with several challenges. Implementing the evidence-based practice of early ambulation in post-surgical patients requires addressing issues such as resistance to change, resource allocation, staff training, and workflow modifications. These issues need to be anticipated and managed to ensure successful implementation. Healthcare organizations often need more support from healthcare providers, who may be comfortable with traditional practices or skeptical about the benefits of early ambulation. Ensuring that staff members receive appropriate education and training is essential to facilitate the practice change.

Employing change management principles is vital to create and sustain readiness for change. Communicate the benefits of early ambulation to all stakeholders, emphasizing patient outcomes, reduced complications, and improved recovery times. Leadership support and involvement are crucial in providing necessary resources and fostering a culture of change. A multidisciplinary team comprising representatives from different departments involved in post-surgical care(Lavin & Ida,2022). This team can collaborate to develop protocols, guidelines, and training programs for early ambulation.

Reviewing recent research studies, systematic reviews, and clinical practice guidelines to gather evidence supporting the benefits of early ambulation in post-surgical patients to ensure that the change is based on current evidence (Bramer,2018). This will provide a foundation for the implementation plan.

Bramer, W. M., de Jonge, G. B., Rethlefsen, M. L., Mast, F., & Kleijnen, J. (2018). A systematic approach to searching: an efficient and complete method to develop literature searches. Journal of the Medical Library Association : JMLA, 106(4), 531–541. https://doi.org/10.5195/jmla.2018.283

Lavin, J. M., & Ida, J. B. (2022). Quality Improvement Methodology. Otolaryngologic clinics of North America55(6), 1301–1310. https://doi.org/10.1016/j.otc.2022.07.008

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