As I prepare to roll out my project to staff some of the biggest challenges I believe I will meet is with the reluctance to change.  Much of the way things are done currently are instilled as habits and due to the lack of monitoring, staff have found a way to implement methods of treatments that are the easy way.  For example, it is noted in the the scenario that it appears much of the patient satisfaction scores are going on monitored.  It’s easy to ignore because no one has required it be addressed.  When I approach a team of individuals and start requesting the various changes that I’m looking to initiate, I expect to be met with resistance.

The first change that I am wanting to address is the number of patients leaving without being seen.  I will be requiring the staff to follow a new policy  involving the PCT to obtain vitals in the waiting room and laying eyes on every pt, every 30 minutes.  Any changes will need to be reported to the triage nurse.  Both of these require additional time and effort from the staff to ensure its being done correctly and that nothing is being missed.  Along with this policy being put in place, I will be tracking how the changes are affecting the LWBS as well as patient satisfaction scores and sharing them throughout the department.

It is my hope that in my “pep rally” I will be able to get the staff excited about the opportunity to improve and grow, not only as a facility but as individuals.  Throughout the change process of this project I think it would also be important to identify a way for individuals to recognize one another for accomplishments.  This recognition of a job well done will assist with building our team and our teams bond.

While I know there will be many more obstacles and challenges to this project, (including potential delays to progress to a new addition or running out of fund), without the support of the team to make this project work, it will be difficult to prove that we can have a positive impact on patient care , no matter how much more waiting room space we have or how many cool gadgets we put in it.


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