Paper
Wednesday, July 21, 2004
This presentation is part of : Public Policy
Using Evidence-Based Thinking to Facilitate Change: The Role of Leadership
Greta Cummings, RN, PhD, University of Alberta, Faculty of Nursing, Edmonton, AB, Canada and Marianne P. McLennan, BScN, MEd, Quality Improvement, Vancouver Island Health Authority, Nanaimo, BC, Canada.
Learning Objective #1: Describe how evidence-based thinking can inform the implementation of change initiatives
Learning Objective #2: Identify the role and structure of an advanced nurse practitioner (ANP) that contributes to creating an Evidence-Based nursing culture
Background: One key role of healthcare leadership is to facilitate change in the workplace in order to continually improve quality of care and to meet fiscal realities. Using evidence based thinking supports the implementation of change and the engagement of key stakeholders.

Objective: To implement ANP roles in a traditional medically oriented tertiary oncology centre using research findings from a study on organizational change (Cummings, Fraser & Tarlier, 2003) and a framework for implementing policy change (Lomas, 2000).

Design: Single case study implementation and analysis. Using Lomas (2000) framework for implementing research findings into practice at the policy level, the authors initiated a change strategy that would enhance the collaborative work of multidisciplinary oncology tumour groups by integrating the role of an advanced nurse practitioner into their functioning.

Method: Key stakeholders (front-line nurses, managers, academic nurse representatives) were recruited to participate on an ANP Advisory Committee to craft an EB role description and develop a three-year implementation strategy.

Findings: Necessary corporate, medical staff and front line nurse support were achieved by focusing on policy approaches that aligned with their values and influenced their beliefs, while addressing questions of competency, standards of practice, fiscal savings, medical and nursing workload, and ongoing multidisciplinary teamwork.

Conclusions: Focusing on the organizational culture, stakeholder values and beliefs and the concepts of “what is in it for me" were essential ingredients to facilitate change.

Cummings, G., Fraser, K. & Tarlier, D. (2003). Implementing advanced nurse practitioner roles in acute care: An evaluation of organizational change. Journal of Nursing Administration. 33(3): 139-45.

Lomas, J. (2000). Connecting Research and Policy. http://www.isuma.net/v01n01/lomas/lomas_e.shtml

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Sigma Theta Tau International
July 21, 2004