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Volume 45, Number 2, pp 61-62
Copyright B 2015 Wolters Kluwer Health, Inc. All rights reserved.
T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N
MAGNET A PERSPECTIVES
Lessons From Unplanned Change
Cole Edmonson, DNP, RN, FACHE, NEA-BC
The article focuses on the concept of unplanned change
in a large tertiary facility in Texas related to the 1st
Ebola patient to be diagnosed in the United States. The
chief nurse executive relates the general reactions, im-
pacts, and challenges faced in this unprecedented event.
Much like the Aspen tree, we may appear as
individuals, but in truth we are all connected as one
great organization, profession, community, and
world. Our connectedness is our strength, allowing
us to weather the storms that are brought upon us.
As a 2-time MagnetA-designated facility, 1 of ap-
proximately 400 worldwide, Texas Health Presbyterian
Hospital Dallas for many years has been extremely
proud of its innovations in clinical nursing care and
leadership. Our focus on professional practice environ-
ments and clinical leadership has been unwavering, as
has our commitment to be leaders in our community.
Author Affiliation: Chief
Nursing Officer, Texas Health
Presbyterian Hospital Dallas, and
Robert Wood Johnson Foundation
Executive Nurse Fellow.
The author declares no
conflicts of interest.
Correspondence: Dr Edmonson,
Texas Health Presbyterian Hospital, 8200 Walnut
Hill Ln, Dallas, TX 75231 (Coleedmonson@
Being Magnet means being on the frontlines of
change with the ability to embrace complexity and
demonstrate plasticity, while remaining focused on
humanity. Over the years, we have demonstrated
this with programs and research including our Sexual
Assault Nurse Examiners care and training program,
international research on maternal-infant bonding,
and the resuscitation quality improvement programV
all firsts in the world and our community.
Planned Versus Unplanned Change
Innovation, research, and sharing are part of the
DNA of this hospital. These examples, however, rep-
resent outcome-focused change based on careful plan-
ning and evaluation. Preparing for, and learning from,
unplanned change is a completely different experience
that challenges organizations in unique ways including
their resilience and hardiness.
In an unplanned change scenario, it is important
to keep the elements of planned change front of mind:
planning, testing, evaluating, revising, implementing,
refining, and ultimately deploying in a more controlled
With the luxury of time and calm gone, un-
planned change can take on a dizzying pace. But in
that time, the amount of learning that occurs can be
tremendous if captured properly for later review,
processed for key lessons, and disseminated.
Recently, we were presented with an extremely
challenging situation where
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