What activities and strategies have been utilized in this field to promote Culture Change?
Implementation of Culture Changes in Field Level has utilized several strategies such as Resident Choices, Individualized Care, Physical Environment Changes, and Staff empowerment.
What barriers and limitations have been acted against the spread of Culture Change?
One of the barriers to spread of culture change is workload of the caregiver. The staff describe adaptive challenges arising from case-mix and staffing ratio implications of culture change. Another limitation is physical environment where researchers identify challenges related to the adaptive work required to identify a balance between making the environment personalized and home-like while at the same time maximizing resident function.
Who are the key players in this field and how do their interests differ?
The players in Culture Change include the staff, the residents, and the management. The staff are interested in creating home-like living environments for the residents who seek quality of care. The management are interested in making decisions to empower their staff to effectively respond to resident needs.
In what ways do advocates', managers', and regulators' perspectives of Culture Change align and diverge?
Both advocates and regulators of Culture change claim that Culture change will support efficiency of their efforts to create more positive impacts in practice. Managers have reported improved occupancy rates and reduced staff turnovers.
Who should be responsible for managing tradeoffs between different approaches to care?
Leadership of the nursing homes should responsible for managing the tradeoffs. The management should address the different interests of the staff and the residents. Addressing these needs would entail aligning the needs of the two groups to ensure that the residents get the quality of care they need while ensuring the staff are motivated to provide such care.
What do you see as the future of the Culture Change Movement?
Care processes continue to focus on quality-improvement efforts. Over time, Culture Change movement will be related to these efforts and will influence selected outcomes. For instance, staff turnover rates to depression rates among the residents will be the new focus for the change interventions.
Organization Culture Change
What might motivate an organizational leader to want to adopt Culture Change?
One of the motivations for leaders to implement Culture Change is empowerment of the staff which would result to reduced employee turnovers. This has the potential of saving the nursing homes from incurring high hiring and training costs.
What should a leader take into consideration when deciding whether to adopt Culture Change?
In order to ensure that Culture Change creates the desired outcomes, the leaders should consider the impact on the staff. For instance, adoption of Culture Change should recognize the possible effects on the staff including resistance, motivation and empowerment. Additionally, the cost of implementation is an essential factor to be considered.
How can you explain that staff resistance is often a barrier to implementation and yet staff turnover appears to decrease after implementation?
Despite the high resistance of staff, turnover rates are reducing because of fear of job loss. The number of qualified nurses with a degree are increasing in the labor market implying high competition. Additionally, poor communication and engagement of the staff causes significant resistance to implementing culture change.
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