In 2010 The Future of Nursing: Leading Change, Advancing Health report identified the looming critical shortage of Registered Nurses (2010). Academic nursing leadership recognize the need to increase enrollment to meet the RN shortage threat but face a plethora of strategic and operational barriers and challenges that inherently define the complexity of nursing education. Faculty and clinical site shortages, complex curriculum requirements, faculty mentoring needs, changing higher education landscape, and the unique learning and socialization needs of a new generation of learners place an organizational burden on nursing programs and often portend discussions of program expansion.
When a Midwestern School of Nursing was provided financial support by university leadership to double their prelicensure program to meet the growing statewide shortage of professional nurses a methodical and coordinated approach was launched framed by Kotter’s Eight-Step Change Model and operationally guided by a quality improvement process.
Methods:
The project followed the eight steps of the Kotter model
(1) Establishing a sense of urgency: Leadership and faculty recognized the high stakes investment of the project and short timeline and agreed that an organized, planned, timely, and analytical project approach was required to achieve success.
(2) Creating the Guiding Coalition: The expansion project required a schema built upon best practices that identified shared goals, purpose, positive modeling behaviors, advocacy, reciprocity, networking, and leadership socialization. Building a shared governance foundation and culture was critical to the project success.
(3) Developing a Vison and strategy: Faculty champions/leaders built a framework that guided and coordinated communication and networking thereby formulating a united vision and best practice grand design for success
(4) Communicating the Change Vision: Using historical organizational communication models infused with new technological communication methods assured “just in Time’ ongoing project data/information was provided to internal and external stakeholders
(5) Empowering Broad Based Action: Utilizing a Quality improvement project approach key expansion metrics were defined, data collected, and root cause analysis conducted to determine and communicate all necessary actions.
(6) Generating Short Term Wins & (7) Consolidating Gains and Producing more Change:
Each project team assigned to a project metric developed QI Gantt charts identifying the metric tasks, duration to complete, start/stop time, and predecessors were displayed in a common area of the School of Nursing. As tasks were completed charts were updated illustrating progress, success, and change
(8) Anchoring New Approaches in the Culture:
Recognizing the cultural change resulting from growth faculty champions developed a formal culture committee embedding the cultural mission, vision and goals into the Lifelong Learning Standing committee. This has assured that challenges and barriers to continued program excellence, positive student outcomes, and faculty satisfaction would be monitored, prioritized, and sustained to assure a flexible and responsive School of Nursing ecosystem.
Results: The program expansion has been completed with enrollment meeting the 800 target, 32 new faculty hired, and process and procedures developed to support and sustain new programming paradigm.
Conclusion: The successful expansion project required a schema built upon faculty development that identified shared goals, purpose, positive modeling behaviors, advocacy, reciprocity, networking, and socialization.