Identified Change
Patient classification systems (PCS) tools are designed to dictate safe and appropriate staffing levels. PCS were developed in the 1970’s partly in response to the Health Maintenance Organizational act of 1973 aimed at controlling health care costs (Hoven, 2004). Hospital organizations began the institution of PCS tools to accurately measure staffing needs and to flex staff according to patient care needs and continuous fluctuations in patient census. The challenge was to find a tool which accurately reflected patient acuity based on a defined patient population and apply that tool to determine a safe nurse to patient ratio.
CHOC Children’s Hospital in Orange California utilizes a PCS. CHOC Children’s has utilized this tool since the …show more content…
Havelock recognized the need to address restraining forces, active involvement by the change agent, and careful attention to planning change. Havelock’s theory of change incorporates six stages for change to occur. The first stage is relationship development with a system in need of change. It represents contemplation away from the status quo. The second stage is a diagnosis by the change agent to find the needed areas of change. The third stage is acquiring knowledge which is the process of information gathering and solution preparation. The fourth stage is selecting a pathway best suited for dissemination of information. The fifth stage is establishing acceptance to change and overcome the restraining forces. The sixth stage is maintenance and separation (Tyson, 2010). Havelock’s Theory is closely aligned with the change process at CHOC Children’s. A shared governance approach is used as are established teams for monthly meetings to address such issues. Havelock’s theory incorporates the change agent as an integral part of the change process as does CHOC