The Negative Impact of Diabetes on Pregnancy

As previously stated, the preconception counselling is very important for diabetic women since it provides information about serious complications of diabetes for women during and after pregnancy. According to Eaton (2014), the change process in the healthcare industry is problematic and usually underestimated by sponsors and managers. The proposed solution of raising awareness among pregnant women requires the evaluation and dissemination plan. This plan will be focused on diabetic women, medical and healthcare professionals and other stakeholders. Thus, the plan implies a change that will impact stakeholders perspectives, views, values, and operations.

In order to achieve the proposed change, this plan proposes to use several methods and variables. However, implementation of change is also a difficult task. According to Atkinson (2014), 80-90% of today’s change initiatives fail with having good planning but bad implementation. Thus, the author emphasizes the importance of motivated agents of change whose main aim would be to lead, motivate and execute goals of change at every level. He also defines several critical success factors of change, such as a need in a charismatic change leader, a strong organisational culture, a need of seeing change as a systematic and systemic process. Eaton (2014) defines three major stages in any change, such as preparation, implementation, and embedding. According to him, preparation aims to set down the objectives and finds the resources for a change. Implementation is a physical process of making a change itself. In addition, embedding is a transition of structures and values to desired ones. In addition, the change strongly depends on key players, such as clients or sponsors, catalysts of change, and implementers (Atkinson, 2014). Finally, it is important to manage expectations of change members and undertake balanced risks assessment.

This paper suggests using following methods in the process of implementation of change:

  1. Survey of staff attitudes and contributors to job satisfaction and dissatisfaction before and after initiating change.
  2. Obtain turnover rates before and after initiating change.
  3. Compare patient discharge surveys before the change and after initiation of change.

In addition, it is necessary to define the variables that will be measured when evaluating the project outcome. Among these variables will be:

  1. Staff attitudes and perceptions.
  2. Patient attitudes and perceptions.
  3. A rate of nursing staff turnover.

The main aim of the change is to increase an awareness of diabetic women about the control over the amount of glucose in the blood and a level of stress during pregnancy. The complexity of this change also interrelates with an intricate nature of the healthcare sector. There are several steps that need to be done in order to increase the awareness and execute the change. First, it is necessary to form a team with passionate agents of change and a strong and charismatic leader. This team would be responsible for all future operations and execution of change. Secondly, there is a need in a creation of a map of stakeholders that clearly shows all levels of involved organisations, businesses, and other people.

Obviously, there will be different types of information’s delivery on organisational levels. The proposed change requires a transition from a current position on the issue to another, a possible rapid change in healthcare structures, systems and stakeholders’ values. According to Chreim, Williams, and Coller (2012), the change in the healthcare sector is complex because of its pluralistic nature. It is based on “the presence of divergent objectives and multiple actors linked through fluid power arrangements” (Chreim, Williams, & Coller, 2012, p. 216). Thus, with defining of stakeholders, it will be necessary to outline goals that the team wants to achieve from each organisational level. Potentially, there will be two types of people affected by this change. First, the pregnant women that need to be informed about this issue. And secondly, doctors, nurses, paramedical and other staff that also need to be informed about the importance of delivery of information on this topic.

Apparently, the most powerful and complex level would be the healthcare sector itself. The most important organisation that can promote information in this field is American Diabetes Association. Thus, in order to raise the awareness about the impact of diabetes on pregnancy, the ADA should publish guidelines on this topic and take care of their distribution and performance. In order to raise public awareness, information about this topic should be published and displayed in all types of mass media, such as newspapers, television, magazines. In order to track the status of change, the team of agents of change should collect and analyse information about the process of change execution. The information should be collected from both pregnant women and healthcare practitioners. The team can use surveys, and questionnaires to collect the data.

According to Grol, Wensing, Eccles, and Davis (2013), there are three types of evolutional observations, such as observational evaluation, process evaluation, and economic evaluation. All these types assess the effectiveness of a change process. The authors underline that observational evaluation consists of descriptive and comparative evaluations that include different methods, such as objectives, study population, designs, measurements, analysis, causal effects, and generalizability. The main aim of observational evaluation is to explore the factors pertaining to the executed change. Process evaluation usually applies to the implementation strategy and evaluates the effect that this strategy has on change. This type of evaluation includes analysis and measurements of a composition and size of target groups, motivation for participation, professional status, and other factors. Lastly, the economic evaluation considers economic consequences and costs of the change. It includes different types of analysis, such as cost-minimization, cost-effectiveness, cost-utility, cost-benefit (Grol et al., 2013).

Finally, the dissemination plan should include answers to such questions as why, what, to whom, how and when the change would be applicable. This paper aims to raise awareness about the negative impact of diabetes on pregnancy and how this impact can be mitigated. This topic is important because the increased awareness will reduce the number of negative effects on pregnant women and contribute to a healthier American society. This change aims to provide information for pregnant women, doctors, nurses, paramedical and other staff. This paper proposes to create a team with a charismatic leader and agents of change who will plan, evaluate, and execute the change. This team can be found on the basis of American Diabetes Association or in close cooperation with it. The planning process includes the construction of stakeholders map, a collection of data on communication. The realisation phase contains many practical actions pertaining to an increase of awareness about this issue, such as promotion on mass media channels, providing of guidelines for a healthcare industry. The evaluation phase will include different observational techniques that were discussed above.


Atkinson, P. (2014). How to implement change effectively. Management Services, 58(3), 33.

Chreim, S., Williams, B. E., & Coller, K. E. (2012). Radical change in healthcare organization: Mapping transition between templates, enabling factors, and implementation processes. Journal of Health Organization and Management, 26(2), 215-236.

Eaton, M. (2014). Embedding change in the healthcare sector. Perspectives in Public Health, 134(1), 12.

Grol, R., Wensing, M., Eccles, M., & Davis, D. (2013). Theories on implementation of change in healthcare. Oxford, UK: John Wiley & Sons, Ltd.

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