The organization offers quaternary care to women and neonates from across the state, many of whom are at-risk and socio-economically disadvantaged women and children. In current facilities, babies with Level IV care needs are separated from their mothers. The alignment of maternity and newborn care in a single facility while continuing to provide high quality outcomes centralizes the needs of the family and is an organizational strategic priority. Moving maternity care from the adult to a pediatric hospital, however, results in major practice change. This transition heightens fear around whether child-bearing women, a vulnerable population, will be safe.
This project is a part of the Maternal Child Health Nurse Leadership Academy (MCHNLA), presented by Sigma Theta Tau International Honor Society of Nursing (Sigma) in partnership with Johnson & Johnson. Personal leadership growth was accomplished through the development of a strategic plan, informed by a change readiness assessment. The purpose of the change readiness assessment was to assess the readiness, willingness and ability of team members to undertake this change and to advance mutual trust among the internal community. Findings contributed to specific strategies that will be operationalized in advance of the transition.
Purpose:
The purpose of this project was to develop a strategic plan for the transition of maternity care into a pediatric hospital.
Methods:
Activities to complete an environmental assessment, conducted between March 2018 and April 2019, included a key stakeholder analysis, a SWOT analysis, a review of 2018 employee engagement survey results. Monthly Maternity Services team member focus groups began in November 2018.
An additional step, the change readiness assessment, a 21-question valid and reliable tool, was completed using an online survey format during March and April 2019. Recruitment for voluntary participation of team members and medical providers of maternity and pediatric care occurred via email. The results of the change readiness assessment are pending. Four questions on the change readiness assessment directly correlated to the employee engagement survey and will be compared for longitudinal evaluation.
Upon completion of the change readiness assessment, key strategies will be created. Repeat use of the change readiness assessment to evaluate strategy effectiveness is planned.
Results:
Strategy for care delivery models emerged from key stakeholder analysis and SWOT analysis. Remaining strategies will be complete pending the results of the change readiness assessment.
Conclusions:
- Involving key stakeholders early is important.
- External forces such as state legislature and professional organizations influence organizational strategy and timeline, yet may be outside the control of a change leader.
- Moving too fast or too slow through change are both risks; project delays are hard to manage amidst expectations.
- Strategic planning informed by change readiness is expected to be more effective in addressing obstacles and resistance to transition.