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401213 Benefits of Electronic Medical Record and Leadership Style Assessment 2 Answer

401213 LClinical eadership and Professional Relationships Spring 2020

Essay: Critical reflection Scenario-Based Essay

Type of CollaborationIndividual
Submission:Refer to section 2.5 of the LG- General Submission Requirements
Length:1,500 words
Curriculum Mode:

Aim: This assessment provides the student the opportunity to apply and evaluate leadership styles in a scenario involving a change process.


A recent state-wide quality improvement project has shown that an electronic medical record system improves com- munication between health care providers and many aspects the individual patient’s care. In order to share this knowledge, the state organisation has shared the results on a quality improvement website.

The Local Health District that you work for has recently had some critical incidents where communication has been cited as a root cause. These critical incidents occur in the context of a general increase of minor communication incidents over the last three years.

The Local Health district’s executive team including the senior Nurse Leaders have reviewed the information on the state’s quality improvement website.

The Nurse Leader of the two hundred bed hospital you work in calls the Nurse Unit Managers for a meeting and advises of the general trending increase in communication errors. The Nurse Leader advises that the computer hardware and systems will be available for installation in two months and that there is an expectation that all wards will have adopted the electronic medical record system within six months.

Discuss how an effective Nurse Unit Manager would lead this change to address this important patient safety issue. The essay will need to:

  • Discuss reasons, using support from the literature, to adopt the fully electronic medication system
  • Use Lewin’s model to outline a plan of change that includes milestones and timeframes
  • Choose and apply a leadership style to the plan of change.
  • Critically evaluate the choice and compare with at least one other leadership style
  • Describe two aspects of potential resistance and discuss how the resistance might be addressed.



Due to decision-making capacity, knowledge, and leadership role, nursing leaders are front liners of transitioning healthcare information systems. They affect the design, development, reception, and implementation of new changes with the organization to achieve a high-quality result. Nursing leadership plays a crucial role in creating the organizational culture allowing the flow of data efficiently and accurately.  The efforts of nursing leadership can impact the transition through education and collaborative effort from the colleagues.  The essay emphasizes on the benefits of the electronic medical record and how, as a nurse unit manager, showing suitable leadership quality change within the organization can be introduced. The model of change is based on Lewin's theory. Appropriate application of the leadership style for the plan of action is discussed with critical analysis and comparison with another leadership style.


Electronic medical records are the automated collection of the medical information system that collects, stores, and redirects the patient information. Medical electronic records are meant to create a legible and organized patient recording and to provide easy access to clinical details on specific conditions.  Electronic medical record system improves the patient outcomes and safety through improved management and reduction in medical errors. Electronic medical record system also helps in avoiding unnecessary investigations through improved communication and interaction among the primary healthcare providers. They ensure effective communication between physicians, nurses, and medical staff with the patient (Manca, 2015)

EMR also demonstrate to improve the working efficiency of healthcare professionals by reducing the time requires to pull patient charts. It enhances access to comprehensive patient data hence helping in the management of prescription, patient appointments, and scheduling by providing remote access to patient's records. Electronic medical records systems capture point of care data to improve the practice thorough quality projects, educational researches, and practice level interventions. With the participation of nursing leadership, the electronic medical record can improve the documentation and care of the patient within the hospital premises. Electronic medical records system organizes investigations reports, streamline treatment information, and enhance the decision support system (Schopf et al., 2019).


Kurt Lewin, a pioneer in the field of organization and group dynamics, theorized the three stages model of change. These three stages are unfreezing-change-freezing. The model requires the leader to acquire new knowledge with the displacement of current knowledge. The concept of the model is to identify the forces both negative and positive to either diminish or strengthen them for bringing the change (Hussain et al., 2018).

The first stage is the unfreezing, involves methods through which nurse unit manager assist employees in letting go of their previous behavior by overcoming the resistance and conformity. This is the stage of disequilibrium where disruption of current status occurs (Cummings et al., 2015). The milestones for the phase are the agreement of nurses on technology replacement, Funds arranged for technology updates like computers, printers, scanners, etc. The timeframe for this step will be around 4-6 weeks for complete implementation.

The second stage is the stage of movement or change. This is the stage where perception, through and feeling are changed in a processed manner. The milestone for this stage is the formation of a supportive technical team which will provide fresh perspective and confidence. The number of nurses who completed training; the number of computers installed can be an apt parameter for the milestone. The timeframe required for the implementation of this step is 2-3 weeks. 

In the third step, known as refreezing, change is adopted as a permanent habit. This phase is to ensure that the change implemented creates a new equilibrium with the highest level of performance. The milestones are improvement in medical errors, better patient management. This stage may take up to 4-6 weeks.


Leadership in a complex ecosystem like a 200-bed hospital demands adaptive and innovative methodology for the plan of change and implementation of the electronic medical record. The leader can inspire others to accept and establish the change through becoming an active part of the change. Empowering others to create the change within the organization ensures the shift at a faster pace. Due to increased rapid technological shifts, the healthcare industry demands leadership, which is agile and capable of empowering changes. The transformational leadership style enables changes within the organization's culture by engaging the employees themselves as an integral part of the change (Choi et al., 2016)

As a transformational leader, nurse unit manager can promote better training and a higher level of employee satisfaction (Fischer, 2016). To prepare a robust system, employee feedback is essential, especially when the changes occurring are complex and require constant knowledge up-gradation.  The four I's of the transformation leadership are much-oriented action required for forwarding movement in building new culture within the organization: these include, idealization, intellectual stimulation, inspirational motivation, and individual consideration. The change is conceptualized when the Nurse Unit Manager, as a transformational leader, creates a plan to address all the dimensions. 

Another leadership that can be used is the laissez-Faire, where the leader does not interfere and let things progress at their own pace and course. Although this type of leadership allows employees to work freely, the persuasion of a leader is relatively passive. Through literature, it is evident that the success of the plan of change depends on complex and multidimensional interactions between the individuals and the organizational environment, hence the participation of the leader is the critical driving force. Absence of which in the laissez-Faire style of leadership avert the responsibility and decision-making ability required for the implementation of complex processes like electronic medical record systems.  In general, organizations that promote collaboration and trust with autonomy and flexibility being encouraged and are more likely to succeed (Ismail Taiwo, 2019). The strategies adopted by a transaction leader include mentoring employees, open discussion, sharing responsibility and collaborative efforts. The transformational leader acts as a role model instilling confidence in subordinated to handle the change with trust and effective communication, which is required for implementing new change in line.


The electronic medical record had been considered as a critical factor contributing to improve patient quality and care; however, adoption continuously face resistance causing huge lag. Successful technological projects in healthcare are rare and require a through problem diagnosis for accelerating innovations implementations. One aspect of the potential resistance is the workflow disruption. In a busy hospital with a constant flow of patients, maintaining records, and taking the extra time for EMR can be difficult. Also, typing every detail may cause concentration disruption as skills may be required for assessment and simultaneously taking notes (Niazkhani et al., 2020). Additional skill requirement could be too demanding from the viewpoint of the nurses, which are already overburdened with excessive workload.

 Another potential resistance is the absence of computer skills (Williams et al., 2017). To use EMR, nurses must require interface knowledge, which is mostly not found even in the adept computer users. In daily routine, highly demanding computer skills, along with handling patients could be complex. Converting prescription on to the EMR as well as patient information requires perfection and precision in terms of using computer and typing skills. Human factors may include lack of skills or technological capabilities. 

An effective way of communication as a leader from the unit nurse in charge can change the perception (Gyamfi et al., 2017). Another method through which resistances can be addressed is the introduction of educator theme. Educator includes younger members of the team comparatively well versed and confrontable with the technology. They can be motivated to encourage their teammates for better productivity. Hence challenges in the implementation can be achieved through team efforts. These barriers can be addressed by feedbacks and listening to the concerns (De Benedictis et al., 2020). Leaders must understand the organizational processes and the human resource element for the motivation of change adaption. Nurse unit manager can encourage employee to take educational training to gain the complete standardized familiarity with the system with time.


Change in the healthcare sector is inevitable and moving at rapid pace as hospitals are implementing rigorous technological techniques like ICD 10, EMR, and EHR. Despite increasing popularity and efficiency of electronic medical records, compliance with long term usage is still questionable. To continue the effect in the future as a permanent part of the change, the nurse unit manager as a leader needs to constantly check, motivate, and provide training conduction. In term of implementation, a leader may face certain resistance or barriers which can be dealt with motivation and persuasion. To increase the reliability of change nurse unit manager, need to engage the higher hierarchy for defined EMR policy strategies focussing on financial support, training, technical support staff, and flexibility.

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