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Assessment 3: Change Proposal

Kathy Ergle

Capella University

NURS-FPX 6218: Leading the Future of Health Care

Prof. Donna Ryan

November 23, 2022

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Change Proposal

A change regarding healthcare is successful when health organizations and professionals

identify the required change and get a chance to influence it. Other significant factors that

contribute to a successful change are the preparedness of professionals, recognizing of the

benefits and value of the change, and knowing its health outcomes (Nilsen et al., 2020). A change

proposal plays a vital role in the identification of change, its value, benefits, and outcomes. In

this assessment, I will draft a change proposal, soliciting the support of executive leaders for

health-related change in the Jordan Community.

Summary

Benefits and Implication

The major health issues in the Jordan community were related to imbalanced

socioeconomic status, water contamination, and poor air quality (JordanMN, 2021). Due to

economic differences, several people were included in a low-income population. Such a

population has to face several health disparities like difficulty in dealing with the cost of

healthcare services, lack of regular hospital visits due to costly health insurance, and lack of

health access due to expensive management of chronic health conditions (Capella University,

n.d.). Poor economic status is linked with several other aspects of the community such as

education, healthcare access, living standards, and safety (Lago et al., 2018). The poor conditions

of water and air in the community also contribute to several health conditions including cholera,

diarrhea, asthma, respiratory disease, and chronic obstructive pulmonary disorder (Manisalidis et

al., 2020). And such conditions are difficult to manage for people, especially those belonging to

low economic status.

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Keeping all the issues of the community in view, the proposed change is the use of

telehealth services and the initiative of free medical camps every six months. The goals of the

change include spreading awareness about safety measures, access to affordable healthcare, and

free medical check-ups for the poor population (Haque et al., 2022; Pathak et al., 2019).

Telehealth services have several direct benefits as they will provide the community with easy

access to low-cost healthcare. Low-income people will be able to get affordable healthcare

through online visits (Kichloo et al., 2020). Moreover, the people affected by waterborne health

conditions and air pollution will get treatment and safety awareness through telehealth services.

Free medical camps will be arranged every six months to support the low-income population

who cannot buy costly health insurance. Moreover, they will be directed to get affordable health

insurance under the Affordable Care Act (ACA) (Isola & Reddivari, 2021). The health disparities

in the Jordan community will be addressed by the combination of telehealth and free medical

camps. The change will improve the overall health of the community by improving the existing

health disparities.

Pathak et al., (2019) conducted a study in India, where 60% of the population does not

have access to basic healthcare, to check the effectiveness of the medical camps to address the

health access issue. They found the intervention beneficial for the population’s health and

suggested similar interventions should be followed in the future. Moreover, Haque et al., (2022)

conducted a study based on questionnaires to find the use of telehealth services in different

populations. They found that low-income people were one of the populations who were mostly

associated with the use of telehealth services.

The agreement of all stakeholders is essential for the approval of the proposed change

(Boaz et al., 2018). Making them agree to the change is not an easy job. Stakeholders include

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patients and funders or payers as well. Patients can feel hesitant to utilize new arrangements due

to misconceptions (Mahmoud et al., 2022). On the other hand, private funders and payers need to

know about the profit and benefits of the change because they have to offer financial support. To

avoid the risk of stakeholders jumping to unfounded conclusions, presentations should be

arranged that will focus on the direct benefits of the proposed change. Moreover, the community

can acknowledge the benefits through pamphlets and awareness campaigns (Seymour, 2018).

Potential Barriers to Change

Although telehealth services are beneficial and easy to access, several barriers can be

faced while the implementation of the change. As the Jordan community contains people from

different ethnicities, cultural and language barriers may affect the services. Moreover, people can

feel hesitant to use online consultations due to misconceptions, privacy issues, or hearing issues

(Mao et al., 2022; Žagar et al., 2019). According to Busso et al. (2022), people can also feel

hesitant to use telehealth services due to a lack of technology knowledge, mistrust of online

services, and behavioral biases. Another barrier that can hinder the proposed change is the

availability of the internet and knowledge of technology for telehealth services at the user level.

The resistance to the use of telehealth services and medical camps can be due to cultural

diversity and privacy-related misconceptions (Žagar et al., 2019; Zhang et al., 2020). A lack of

cultural competence in telehealth providers reduces patient satisfaction and hinders the effective

use of the initiative (Hilty et al., 2020). At the organizational level, the lack of cultural or lingual

competence and technical challenges can create resistance to telehealth change. The study by

Žagar et al., (2019) analyzed the barriers to medical camps and found several factors contributing

to the hindrance. Two of them were cultural diversity and language barriers. Kalicki et al., (2021)

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presented research that showed two major barriers to telehealth services e.g., video meetings

internet issues, and unavailability to support technology use.

Change Drivers

Drivers of change are factors or people that contribute to the development and

implementation of a change. In this case, the potential drivers of change are health professionals,

volunteers, management, and the involvement of stakeholders in decision-making. My vision for

change is the provision of affordable healthcare and the improvement of health conditions in the

Jordan community by removing health disparities.

Change Model

The change model used here is the Complex Adaptive System (CAS) which takes a

healthcare change as a dynamic system. It integrates agents or changes drivers from different

areas and integrates them under one context where the drivers collaborate by adapting each

other’s actions (Gomersall, 2018). The expected outcomes are a reduction in health disparities,

improved healthcare access, and improvement in cost-related health issues. The time expected

for the change is almost 60 days. The plan will be evaluated every fifteen days through surveys.

The reason behind keeping the evaluation period fifteen days is to get an idea of the early

success of the project. The purpose of the evaluation will be to check the effectiveness and

progress of the proposed change. Approval to change, collection of financial and human

resources, technological arrangements, and preparation of awareness campaigns, presentations,

and medical camps are included in this time framework. Communication with stakeholders

(patients, payers, professionals) is crucial for the successful implementation of the change. It can

be done through presentations for stakeholders, and seminars for the target population focused on

the need and requirement for the mitigation of resistance. The conflict among competing

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interests will be resolved by training health professionals to get the technological expertise

needed for telehealth. They will be trained to practice cultural and lingual competency. Also,

informing the community about the benefits of telehealth services will reduce the conflict

(Bhaskar et al., 2020).

Stakeholder Communications

Strategies for Stakeholders

The strategies to help stakeholders understand the proposed changes will include

presentations and training sessions. The presentation will be arranged for all the stakeholders,

including payers, nurses, management, and other involved professionals while the training

sessions will be conducted for nurses and the providers who will execute telehealth technology.

For community members, seminars will be arranged to enhance their knowledge of technology

and clear misconceptions about telehealth services. The changes will be evaluated through

surveys and the dissemination of questionnaires among nurses and community members because

it is imperative to know both sides of perceptions for effective evaluation of the project (Gaur et

al., 2020). The key stakeholders for the change will be the hospital management, the target

population of the Jordan Community, health professionals, and financial supporters.

Influence of Stakeholders

The overall influence of the stakeholders on the community is that change cannot be

implemented without their involvement. Health professionals need to be trained in telehealth

services (Haleem et al., 2021). Financial supporters will provide funds to arrange seminars and

medical camps, install telehealth systems, and other campaigns. The management will organize

the system and allocate financial and human resources as per requirements.

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Data for Decision Makers

The data and information provided to the decision makers will include demographic data

of the community, potential benefits and risks of the proposed change, the time required for the

implementation, and expenses needed for the whole change proposal.

Effect of Changes on Organization

The changes will also affect the healthcare organization. For example, the proper

allocation of financial resources will help reduce the financial burden on the hospital related to

the emergency department (Radinmanesh et al., 2021). Moreover, the training of healthcare

providers will help the professionals keep a work-life balance by not wasting time on technical

issues (Haleem et al., 2021).

Buy-In Engagement of Stakeholders

Presentation and training sessions for stakeholders (nurses, payers, and professionals)

will engage them in the project. Moreover, financial incentives for best-performing health

providers can also increase their buy-in (Martin et al., 2020).

Budget Associated with the Proposed Change

A project manager will be leading the budget-related change in the organization. The

major budget will be required for telehealth implementation and salaries. The startup cost will

include software installment and equipment purchase ($50,000). Then, the cost will be required

for its maintenance ($10,000) (Horiachko, 2022). Medical camps in the first year will cost

$12,000 to the hospital. Travel and other costs will add $3,900 to the total expenses of the

proposed change (Guiding Light Orphans, n.d.). The budget information will be provided to the

stakeholders to inform them of the details of the changed proposal and the purpose of the

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required money. Moreover, the documents of the change proposal along with its financial

expenditures will be signed by all major stakeholders involved in funding and decision-making.

Conclusion

The change proposal for improving health disparities in the Jordan Community is crucial

as it affects the community’s overall quality of life. The implementation of telehealth services

and free medical camps will improve the community’s health condition. There might be potential

barriers to the change, but they can be minimized using certain strategies. The involvement of

stakeholders is imperative for the successful implementation of the change.

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References

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https://www.bestplaces.net/health/city/minnesota/jordan

Bhaskar, S., Bradley, S., Chattu, V. K., Adisesh, A., Nurtazina, A., Kyrykbayeva, S., Sakhamuri,

S., Moguilner, S., Pandya, S., Schroeder, S., Banach, M., & Ray, D. (2020). Telemedicine

as the new outpatient clinic gone digital: Position paper from the pandemic health system

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Boaz, A., Hanney, S., Borst, R., O’Shea, A., & Kok, M. (2018). How to engage stakeholders in

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Busso, M., Gonzalez, M. P., & Scartascini, C. (2022). On the demand for telemedicine: Evidence

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primer for authors. Journal of Korean Medical Science, 35(45).

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Gomersall, T. (2018). Complex adaptive systems: A new approach for understanding health

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Guiding Light Orphans. (n.d.). Medical camps. GuidingLightOrphans. Retrieved November 22,

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Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare:

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https://doi.org/10.1016/j.sintl.2021.100117

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Shaima, S. N., Chowdhury, S., Matin, K. F., Karim, I. J., Ahmed, M. T., Hossain, S. Z.,

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clinical outcomes and administrative approaches. MHealth, 20(6), 20–20.

https://doi.org/10.21037/mhealth.2019.10.04

Horiachko, A. (2022, May 4). Cost of telemedicine system: Is it a worthy investment? Softermii.

https://www.softermii.com/blog/cost-of-telemedicine

Isola, S., & Reddivari, A. K. R. (2021). Affordable Care Act. PubMed; StatPearls Publishing.

https://pubmed.ncbi.nlm.nih.gov/31747174/

JordanMN. (2021). Jordan 2021 drinking water report. Jordanmn.gov. https://jordanmn.gov/wp-

content/uploads/2022/04/Jordan-2021-Drinking-Water-Report.pdf

Kalicki, A. V., Moody, K. A., Franzosa, E., Gliatto, P. M., & Ornstein, K. A. (2021). Barriers to

telehealth access among homebound older adults. Journal of the American Geriatrics

Society, 69(9). https://doi.org/10.1111/jgs.17163

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Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala,

R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current

COVID-19 pandemic, and the future: A narrative review and perspectives moving

forward in the USA. Family Medicine and Community Health, 8(3), e0005

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(2018). Socioeconomic status, health inequalities and non-communicable diseases: A

systematic review. Journal of Public Health, 26(1), 1–14. https://doi.org/10.1007/s10389-

017-0850-z

Mahmoud, K., Jaramillo, C., & Barteit, S. (2022). Telemedicine in low- and middle-income

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Appendix A: Grant Proposal

Need Proposal

The main issue identified in the Jordan Community is the existence of socioeconomic

differences, and poor water, and air quality that cause different health conditions in the

community (Best Places, n.d.; JordanMN, 2021). The issue is affecting the Jordan community,

especially the low-income population. The proposed change for the community is aimed at

providing cost-effective healthcare and awareness to the community through telehealth services

and free medical camps. The potential barriers could be a lack of telehealth awareness among the

community, technical issues, misconceptions, and hesitance to the use of telehealth. The need for

change was defined through a windshield survey. Further efforts can be added to the change for

addressing the problem.

Program Description

The reason behind the implementation of telehealth is its economic viability for the

organization and the community. Moreover, the services will help the organization reach more

patients in the community regardless of their cultural and socioeconomic backgrounds. Free

medical camps after six months will provide free check-ups for low-income populations in the

community. The change will involve all the stakeholders like health organizations, professionals,

community members, nurses, project managers, and payers. The project will take 60 days to

implement.

Goals and Objectives

The goals of the proposed initiative are:

 Provision of cost-effective healthcare to patients, especially low-income

population

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 Free medical checkups for the low-income population

 Making healthcare access easy for more patients

 Improving cost management for chronic diseases

Program Evaluation

A survey team will be developed to evaluate the program. The team will include members

from Jordan Community for better evaluation. The survey will be conducted every fifteen days,

in the beginning, to check the improvement in the community’s health after the implementation

of the change. After that, the evaluation time will be increased to a period of thirty days. The

survey will be led by disseminating questionnaires and taking interviews with community

members and health providers. The evaluation reports will be presented to the supervisor. Key

stakeholders including funders will be given copies of the reports to inform them about the

progress of the plan.

Summary

The change is important to the community because it will improve the existing health

disparities due to socioeconomic differences and low quality of water and air. The primary

objective of the plan is easy to access to affordable or free healthcare while the funding

organization also aims to improve health coverage at affordable prices. That is why both

objectives are well aligned with each other. The financial support of the funders is essential as

the hospital and Jordan community are not very stable financially. In the end, I would thank the

funding agencies for considering and supporting the initiative financially.

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Table

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Categories Startup 1st Year
Other Sources

of Revenue Justification
Salary and Wages $80,000 $100,00

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Hospital Revenue
and Government
Funds

Salaries will be given
to professionals and
providers for the
change services.

 Professionals $47,000 $52,000
 Project Manager $7,000 $8,000
 Support Staff $26,000 $30,000
 Other $10,000

Fringe Benefits These incentives are
significant to raise
the morale of
workers.

 Incentives $500 Private Payers
 Health Insurance $20,000 $20,000

Telehealth Cost $50,000 $10,000 Funds from
Government and
Private Payers

The initiative of
telehealth needs the
installation of
software equipment,
and maintenance
expenses.

(Software, Equipment)

Medical Camps $6,000 $12,000 Private Payers Free medical camps
will require surgical
supplies, free
medicines, and other
materials.

(Surgical Supplies,
Others)

Travel $200 $400 Hospital Revenue Medical camps have
to be arranged in
different areas of the
community.

(For medical camps)

Miscellaneous $3,500 $3,500 Hospital Revenue Training, awareness
campaigns, and
seminars are essential
for the proposed
change.

(Training, Awareness
Campaigns, Seminars)

Total Expenses $159,700 $146,40

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