Change Management Plan Essay.

Change Management Plan Essay.


Topic: Authorizing NPs to order cardiac and pulmonary rehabilitation services for Medicare patients. Develop a 1,050- to 1,400-word Change Management Plan using John Kotter\’s eight-step change model. Include the following in your plan; What current health policy issues exist that are of national concern that affect the NP? Authorizing NPs to order cardiac and pulmonary rehabilitation services for Medicare patients.Change Management Plan Essay.


What evidence is there to support the need to address the policy? Does the evidence indicate a sense of urgency regarding the issue? How is the policy issue represented in the media, and what type of influence does this have on you implementing change in this area? What are the ethical consequences if changes are not implemented? Identify stakeholders who will assist you in implementing the change, including opportunities for interprofessional relationships. Develop a plan for how and where you see the policy issue making an impact. Identify potential barriers that will hinder you from implementing change in this area and how you will face them to keep the change process progressing.Change Management Plan Essay. Create a strategy that will gain the support of your congressional representative or of one your senators and drive them to introduce legislation that will address the policy issue. How can you use Kurt Lewin\’s change management model to solidify change in this area?Change Management Plan Essay.

Change Management Plan

Authorizing NPs to Order Cardiac and Pulmonary Rehabilitation Services for Medicare Patients


The legislation proposed change is to allow NPs to order pulmonary and cardiac rehabilitation services for Medicare patients. This willincrease access of patients to cardiovascular rehabilitation services because evidence demonstrates that the increased access decreased deaths and hospital readmissions related to cardiovascular disease (Abreu et al., 2018). The policy will ensure that that nurse practitioners have the authority to order and refer patients for pulmonary and cardiac rehabilitation services. Increasing the access has direct access on patients with pulmonary and cardiac conditions because patients participating in pulmonary and cardiac rehabilitation services are at a reduced risk of readmissions and cardiovascular-related mortality after cardiac events like myocardial infarction (Abreu et al., 2018).Change Management Plan Essay.

Evidence Supporting theNeed to Address the Policy

Pulmonary and cardiac rehabilitation programs are aimed to improve the physical, social, and psychological function after patients qualify the diagnosis such as heart attack or procedure like coronary artery bypass surgery (Choo et al., 2018). Evidence shows that heart disease causes more than 610,000 deaths in the US every year. However, even though the evidence indicates that the pulmonary rehabilitation and cardiac rehabilitation programs can lower the rate of hospital readmission and death, only approximately 20% of qualifying patient access and receive cardiac rehabilitation (McMahon et al., 2017).Change Management Plan Essay. Participation rates in these programs are even lower for women and minority patients, as well as patients living outside metropolitan area or from low income urban locations. Additionally, only 3% of Medicare patient diagnosed with Chronic Obstructive Pulmonary Disease (COPD) are able to access pulmonary rehabilitation(McMahon et al., 2017).Change Management Plan Essay.

Nurse practitioners have the clinical training and education to provide timely and high-quality care to pulmonary and cardiac patients. NPs also act as the frontline healthcare providers within critical care settings such as hospitals and hospital clinics,intensive care units, emergency departments, urgent care centers, cardiac catheterization laboratories, and several other locations (Woo et al., 2017). Therefore, authorizing NPs to order and supervise pulmonary rehabilitation and cardiac rehabilitation services will allow NPs to be actively involved in their patient care from start to the end, leading to improved continuity of care and access to care for the patients.Change Management Plan Essay.

The Role of Media

The legislation has received wide media coverage from news media, social media, and print media as well. The legislation has also received support from advocacy groups and organizations such as American Heart Association.Media coverage of health issues plays an importantly role in helping the issue to be prioritized and be put in the public policy agenda. Therefore, wide media coverage for this legislation will help move the issue higher and facilitate quicker endorsement of the legislation.Change Management Plan Essay.

Ethical Consequences if Changes are not Implemented

The principle of justice advocated for equal treatment for everyone and fair, suitable, and equitable distribution of social goods. Healthcare is classified as a social good and thus medical services should be distributed fairly and equitably(Stone, 2018). Therefore, if the policy is not implemented, this will go against the ethical principle of justice because the legislation is likely to increase access to pulmonary and cardiac rehabilitation services regardless of the social status, income level, geographical location, race and ethnic background. The ethic principle of beneficence and nonmaleficencestresses the importance of supporting the provision of healthcare services to everybody securing fundamental protection of treatment (Stone, 2018). The acts of beneficence and nonmaleficence support increasing healthcare access and thus failure to implement the change is contrary to beneficence and nonmaleficence principles.Change Management Plan Essay.


The relevant stakeholders will include multidisciplinary stakeholders having expertise in cardiopulmonary rehabilitation, chronic heart failure, and COPD rehabilitation. These experts will accommodate the needs of chronically ill patients with respiratory and cardiovascular conditions. The specific stakeholders in the change program will include nurse educators, cardiologists, pulmonologists, exercise specialists, nutrition specialists, occupational specialists and mental health specialists (Jones et al., 2019). Additionally, the organizational leaders as well as advocacy groups and political leaders will be actively involved in implementing the change.Change Management Plan Essay.


The plan is to implement a cardiopulmonary rehabilitation program in the healthcare organization. The program will include exercise training sessions; Respiratory physical therapy and breathing techniques; Medical therapy assessment and optimization; Diet and nutritional counselling; and Psychological support and behavioral management. The program will target patients with severe cardiovascular and respiratory chronic conditions, and they have diagnoses such as COPD, chronic heart failure, and have undergone procedures such as coronary artery bypass surgery. The program will significantly improve the health outcomes of people with coexisting heart failure and COPD. The nurse practitioners should be able to order and refer patients for the cardiopulmonary rehabilitation services.Change Management Plan Essay.


Potential Barriers

The possible barriers include lack of support from the organizational management and resistance from the staff member who do not easily accept new ideas and changes due to time limitation and tight schedules. The staff in healthcare organizations normally face heavy workload and thus may lack time to devote changes and new initiatives. The organizational management may also not support the change because the extensive resources involves as well as the need for the legislation to be passed to support NPs to have the authority to order and refer patients for the cardiopulmonary rehabilitation services. These barriers can be addressed by convincing the organizational management regarding the importance of implementing the change and the organizational management recruiting more staff members to reduce heavy workload (Harper et al, 2017).Change Management Plan Essay.

Support fromCongressional Representative

The congressional representative will be contacted through a letter to request for a meeting, while highlighting the agenda of the proposed meeting. Additionally, it will be important to seek support from advocacy groups and organizations such as American Heart Association. The organizations and advocacy groups will persuade the congressional representatives and senators so support the policy issue and endorse it in the House.Change Management Plan Essay.

Kurt Lewin’s Change Management Model

The three stages of Lewin’s change management model include unfreezing, moving, and refreezing. The unfreezing phase entails creating awareness in the organization about the significance and benefits of the change and thus this phase helps in overcoming any resistance against the intended change(Wojciechowski et al., 2016). In the planned change, the organizational management, staff members as well as the political leaders and advocacy groups/organizations will be convinced about the importance of supporting the proposed cardiopulmonary rehabilitation program and to support the policy that allows NPs to order and supervise pulmonary and cardiac rehabilitation services to patients. Change champions and experts will be used to persuade the relevant stakeholders about the value of the proposed change. This will also include garnering the required resources and approaching political leaders to seek support.Change Management Plan Essay.

The second stage is known as “moving” and it is the process change where individuals and the organization adopt new ways in terms of the processes, policies, feelings, and behaviors(Wojciechowski et al., 2016). This phase will include implementing the proposed cardiopulmonary rehabilitation program in the healthcare organization and actively persuading political leaders to support and pass the policy that allows NPs to order and supervise pulmonary and cardiac rehabilitation services to patients.Change Management Plan Essay.

The third phase is known as refreezing and it entails the establishing and sustenance of the new change to ensure the implemented procedures and behaviors are integrated into the organizational say-to-day operations (Wojciechowski et al., 2016).Change Management Plan Essay.


Authorizing NPs to order and refer patients for pulmonary and cardiac rehabilitation services will increase access the appropriate rehabilitation care services to this patient population. Increasing the access to the rehabilitation services reduces risk of readmissions and cardiovascular-related mortality after cardiac events like heart attack. Therefore, support will be garnered from all the relevant stakeholders, including the political leaders to support the ratification of the health issue into policy.Change Management Plan Essay.




Abreu, A., Mendes, M., Dores, H., Silveira, C., Fontes, P., Teixeira, M., … &Morais, J. (2018). Mandatory criteria for cardiac rehabilitation programs: 2018 guidelines from the Portuguese Society of Cardiology. Revista Portuguesa de Cardiologia (English Edition), 37(5), 363-373.

Choo, C. C., Chew, P., Lai, S. M., Soo, S. C., Ho, C. S., Ho, R. C., & Wong, R. C. (2018). Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients. International journal of environmental research and public health, 15(6), 1095.

Harper M, Gallagher-Ford L, Warren J, Troseth M, Sinnott L &Thomas B. (2017). Evidence-Based Practice and U.S. Healthcare Outcomes. Journal for Nurses in Professional Development, 33(4), 170-179.

Jones, A. V., Evans, R. A., Man, W. D., Bolton, C. E., Breen, S., Doherty, P. J., Gardiner, N., Houchen-Wolloff, L., Hurst, J. R., Jolly, K., Maddocks, M., Quint, J. K., Revitt, O., Sherar, L. B., Taylor, R. S., Watt, A., Wingham, J., Yorke, J., & Singh, S. J. (2019). Outcome measures in a combined exercise rehabilitation programme for adults with COPD and chronic heart failure: A preliminary stakeholder consensus event. Chronic respiratory disease, 16, 1479973119867952.

McMahon, S. R., Ades, P. A., & Thompson, P. D. (2017). The role of cardiac rehabilitation in patients with heart disease. Trends in cardiovascular medicine, 27(6), 420–425.

Stone E. G. (2018). Evidence-Based Medicine and Bioethics: Implications for Health Care Organizations, Clinicians, and Patients. The Permanente Journal, 22, 18-030.

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. Online Journal of Issues in Nursing, 21(2).

Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health, 15(1), 63.

Change Management Plan Essay.