Change Theories in Nursing
Ngozi Oguejiofo has been writing on a freelance basis since 2009 and most of her writings are focused on health. She is currently a registered nurse. She is interested in teaching, and writes articles focused on student nurses for various online publications. By Ngozi Oguejiofo, eHow Contributor
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Change means making something different from the way it was originally. Change may be planned or unplanned. Unplanned changes bring about unpredictable outcomes, while planned change is a sequence of events implemented to achieve established goals.
In nursing a change agent is a person who brings about changes that impact nursing services. The change agent may be a nurse leader, staff nurse or someone who works with nurses. Change theories are used to bring about planned change in nursing. Nurses and nurse leaders must have knowledge of change theories and select the right change theory as all the available change theories in nursing do not fit all nursing change situations.
“Dosimeter” is Copyrighted by Flickr user: …eagan under the Creative Commons Attribution license. Lewin’s Change Theory
Kurt Lewin’s change theory is widely used in nursing and involves three stages: the unfreezing stage, moving stage, and refreezing stage. Lewin’s theory depends on the presence of driving and resistant forces. The driving forces are the change agents who push employees in the direction of change. The resistant forces are employees or nurses who do not want the proposed change. For this theory to be successful, the driving force must dominate the resistant force. Rogers’ Change Theory
Everette Rogers modified Lewin’s change theory and created a five-stage theory of his own. The five stages are awareness, interest, evaluation, implementation and adoption. This theory is applied to long-term change
projects. It is successful when nurses who ignored the proposed change earlier adopt it because of what they hear from nurses who adopted it initially. Spradley’s Change Theory
This is an eight-step process for planned change based on Lewin’s theory of change. It makes provision for constant evaluation of the change process to ensure its success. The steps are: recognize the symptoms, diagnose the problem, analyze alternative solutions, select the change, plan the change, implement the change, evaluate the change and stabilize the change. Other Theories
Reddin’s, Lippitt’s and Havelock’s theories are based on Lewin’s theory and can be used to implement planned change. The first two have seven stages, while the third has six. Real Life Application
An article titled “Managing change in the nursing handover from traditional to bedside handover—a case study from Mauritius” details the use of Lewin’s and Spradley’s theories to implement a change in the process of handover reports between nurses. The driving force in this case was dissatisfaction with the traditional handover method, while the resistant forces were a fear of accountability, lack of confidence and fear that this change would lead to more work. Evaluation of the implemented change showed that the new process was successfully implemented.
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Change Theory: The Motivation it gives to Health Care Nursing Change theory and healthcare
Nursing is a field that requires a good deal of adaptation by an individual due to its many changes and fundamental processes. An issue in change that is a certainty is that there are going to be reactions to it but one can manage it in order to ensure the projection planned will fall into the correct place (Beitler 2005). While one can enter into the field of nursing
with their own idea of what skills are going to be necessary; as well as with many opinions on how various situations should be handled, there always needs to be a good deal of preparedness for any type of change that might take place suddenly, or over time. Furthermore, the area of communication is a key essential, especially if motivating others towards a new direction, is the path that is underway.
Without proper communication in this field of work, there are going to be roadblocks preventing a smooth transition from one way of doing things to a transformation into an improved interpretation of how the work is and should be carried out. There are many different theories for change out there, some more pronounced than others, but one of the best was Lewin’s action research model for change. What this model actually utilizes is a self reflective type of summation, which often surrounds social situations (Infed Encyclopedia 2006). Action research focuses on the participants own thoughts that are formed, again in a reflective manner. This supposedly helps to draw upon a better comprehension of their own practices, so that improved care can be given to others.
Kurt Lewin is the theorist responsible for coining this type of mentality, “action research”, and through his model, motivation and change in the work place flow rather smoothly, especially in the atmosphere of health care nursing. The reason this theory works so well is it involves an action of planning and fact gathering before proceeding on to the next phase of action. It ensures that all participants are comprehending what is expected of them correctly, and keeps a strong focal point in the area of communication, which again is a necessity in nursing.
The main points to keep in mind when going through any form of an organizational change process, or a minute change is that, through change theory is that, learning moves from one individual to the next, then on to the group unit and finally the whole organization. It can be interpreted as a systematic process at times but now works in ways that provide almost immediate new actions taking place.
The basic idea is to “unfreeze” current methods, so that new ideas and implemented changes can be fixated and put into place and then to “freeze” these new procedures so that they will stick, and those affected by them can learn and become accustomed to the new process involving their work (Rouda 1995).
Strategic planning is a necessity when change is taking place within a group environment. In this way, proper feedback can be given to the top people in the organization. Also, interaction in the planning process for change is essential as well as it gives a hands on feel of how the new methods are going to affect individuals own behaviors (such as if they are going to be favorable of it or not). Often times there can be resistance to change because it is new and questionable but by working together and having communication amongst the group participants, all the kinks can appropriately be worked out for the better. The transition then flows more fluidly than if there were not any type of change theories utilized at all.
Furthermore, Lewin’s theory alone shows that action research is definitely a fundamental process when working in the areas involving human resources (a2zpsychology.com 2006). Lewin’s classical methods implemented change through educational programs in order to promote changes efficiently. This was then carried over into the group atmosphere. The reason this theory works well in nursing is because this field is group oriented. It is compatible with the nursing philosophy and promotes change far better than any other theory when utilized correctly. It helps in the initiating, and implementation of change, which is what any good organization strives for.
Health care nursing changes
In conclusion, change takes place in all organizations. It can promote better group interaction if all the necessary communication tools are utilized. Health care nursing is changing all the time and it is simply a circumstance that every good nurse needs to be prepared for. Change management process
The change management process is the sequence of steps or activities that a change management team or project leader would follow to apply change management to a project or change. Based on Prosci’s research of the most effective and commonly applied change, most change management processes contain the following three phases: Phase 1 – Preparing for change (Preparation, assessment and strategy development) Phase 2 – Managing change (Detailed planning and change management implementation) Phase 3 – Reinforcing change (Data gathering, corrective action and recognition) These phases result in the following approach as shown below in Figure 1.
Figure 1 – Change Management Process (the Change Management Toolkit and Change Management Pilot show you how to apply the process))
It is important to note what change management is and what change management is not, as defined by the majority of research participants. Change management is not a stand-alone process for designing a business solution. Change management is the processes, tools and techniques for managing the people-side of change. Change management is not a process improvement method.
Change management is a method for reducing and managing resistance to change when implementing process, technology or organizational change. Change management is not a stand-alone technique for improving organizational performance. Change management is a necessary component for any organizational performance improvement process to succeed, including programs like: Six Sigma, Business Process Reengineering, Total Quality Management, Organizational Development, Restructuring and continuous process improvement. Change management is about managing change to realize business results.
Assessments are tools used by a change management team or project leader to assess the organization’s readiness to change. Readiness assessments can include organizational assessments, culture and history assessments, employee assessments, sponsor assessments and change assessments. Each tool provides the project team with insights into the challenges and opportunities they may face during the change process. Assess the scope of the change, including: How big is this change? How many people are affected? Is it a gradual or radical change? Assess the readiness of the organization impacted by the change, including: What is the value- system and background of the impacted groups? How much change is already going on? What type of resistance can be expected? Assess the strengths of your change management team.
Assess the change sponsors and take the first steps to enable them to effectively lead the change process.
Communication and communication planning
Many managers assume that if they communicate clearly with their employees, their job is done. However, there are many reasons why employees may not hear or understand what their managers are saying the first time around. In fact, you may have heard that messages need to be repeated 6 to 7 times before they are cemented into the minds of employees. That is because each employee’s readiness to hear depends on many factors. Effective communicators carefully consider three components: the audience, what is said and when it is said. For example, the first step in managing change is building awareness around the need for change and creating a desire among employees.
Therefore, initial communications are typically designed to create awareness around the business reasons for change and the risk of not changing. Likewise, at each step in the process, communications should be designed to share the right messages at the right time. Communication planning, therefore, begins with a careful analysis of the audiences, key messages and the timing for those messages. The change management team or project leaders must design a communication plan that addresses the needs of front-line employees, supervisors and executives. Each audience has particular needs for information based on their role in the implementation of the change.
Coaching and manager training for change management
Supervisors will play a key role in managing change. Ultimately, the direct supervisor has more influence over an employee’s motivation to change than any other person at work. Unfortunately, supervisors as a group can be the most difficult to convince of the need for change and can be a source of resistance.
It is vital for the change management team and executive sponsors to gain the support of supervisors and to build change leadership. Individual change management activities should be used to help these supervisors through the change process. Once managers and supervisors are on board, the change management team must prepare a coaching strategy. They will need to provide training for supervisors including how to use individual change management tools with their employees.
Training and training development
Training is the cornerstone for building knowledge about the change and the required skills. Project team members will develop training requirements based on the skills, knowledge and behaviors necessary to implement the change. These training requirements will be the starting point for the training group or the project team to develop training programs.
Sponsor activities and sponsor roadmaps
Business leaders and executives play a critical sponsor role in change management. The change management team must develop a plan for sponsor activities and help key business leaders carry out these plans. Sponsorship should be viewed as the most important success factor. Avoid confusing the notion of sponsorship with support. The CEO of the company may support your project, but that is not the same as sponsoring your initiative.
Sponsorship involves active and visible participation by senior business leaders throughout the process. Unfortunately many executives do not know what this sponsorship looks like. A change agent’s or project leader’s role includes helping senior executives do the right things to sponsor the project.
Resistance from employees and managers is normal. Persistent resistance, however, can threaten a project. The change management team needs to identify, understand and manage resistance throughout the organization. Resistance management is the processes and tools used by managers and executives with the support of the project team to manage employee resistance.
Data collection, feedback analysis and corrective action
Employee involvement is a necessary and integral part of managing change.
Managing change is not a one way street. Feedback from employees is a key element of the change management process. Analysis and corrective action based on this feedback provides a robust cycle for implementing change.
Celebrating and recognizing success
Early successes and long-term wins must be recognized and celebrated. Individual and group recognition is also a necessary component of change management in order to cement and reinforce the change in the organization. The final step in the change management process is the after-action review. It is at this point that you can stand back from the entire program, evaluate successes and failures, and identify process changes for the next project. This is part of the ongoing, continuous improvement of change management for your organization and ultimately leads to change competency.
These eight elements comprise the areas or components of a change management program. Along with the change management process, they create a system for managing change. Good project managers apply these components effectively to ensure project success, avoid the loss of valued employees, and minimize the negative impact of the change on productivity and a company’s customers.
Cite this Change Management – Theories and Components
Change Management – Theories and Components. (2016, May 11). Retrieved from https://graduateway.com/change-management-theories-and-components/