Change Management CHANGE AND CHANGE PROCESS Objectives 1. Explain why nurses have the opportunity to be change agents. 2. Describe how different theorists explain change. 3. Discuss how the change process is similar to the nursing process. 4. Differentiate among change strategies. 5. Discuss how to handle resistance to change. 6. Describe the nurse's role in change. Change Change: Is essential for adaptation and growth Is the process of making something different from what it was Is a continually unfolding process rather than an either/or event Change: Can be threatening May cause a grief reaction even when planned Produces new opportunities Change agents Change agents: Work to bring about change Are role models for others Stimulate the need for change and help shape its success Nurse as change agent : Nurses facilitate change Must be proactive in shaping the future Opportunities exist now for nurses, especially in management positions Change process • Same path as nursing process Assessment – Planning – Implementation – Evaluation – Change Theories -Lewin -Lippitt -Havelock -Rogers -Prochaska & DiClemente Assessment • • Identify the problem or the opportunity Ask the right questions – Where are we now? – What is unique about us? – What can we do that is different? – What is the driving stimulus in our organization? – What prevents us from moving? – What kind of change is required? Collect data Identify all driving and restraining forces Assess political climate Assess costs and benefits Analyze data Planning Determine who, how, and when Include organization/system members Plan resources required to make the change and establish feedback mechanisms Implementation and evaluation Implementation : Plans are put into action. Evaluation: Evaluate effectiveness Stabilize the change - Akin to Lewin's moving stage Methods to change individuals Methods to change groups Energizer role is still needed to reinforce Change Strategies Power-Coercive Strategies: Empirical–Rational Model: -Based on the application of power by legitimate authority, economic sanctions, or political clout Revolves around knowledge Assumption is that people are rational and will follow their rational self-interest Normative–Reeducative Strategies Assumption that people act in accordance with social norms and values Power = Skill in interpersonal relationships Effective in reducing resistance, stimulating creativity Resistance to Change If no resistance, change may not be significant enough Forces changes agent to: Reasons for Resistance to Change: Lack of trust Vested interest in status quo Fear of failure Loss of stature or income Clarify Misunderstanding Keep interest high Establish reason for change Belief that change is unnecessary or that it will not improve the situation Six Responses to Change Innovators love change Early adopters still receptive to change Early majority prefer the status quo Late majority resistant, then accept Laggards openly antagonistic Rejecters actively oppose, may sabotage Managing Resistance to Change Talk to those who oppose the change. Clarify information. Be open to revisions. Present negative consequences of resistance. Emphasize positive consequences. Keep resisters involved Maintain climate of trust, support, confidence Divert attention Nurse’s Role in Change Change not always initiated from top management level Staff nurses can initiate change Mandatory skill for nurses Cultivate and master characters of successful change agents Engage strategies for accessing power Assist in other ways Planning Information sharing Managing the transition Change has become the norm Thank You
