AACN Roadmap for Implementing Change
Change is a fact of life, and that can be a good thing. Taking something learned—such as new evidence-based care practices—and introducing it
in our workplace to enhance patient care and to improve outcomes is a change for the better. However, change is often a difficult process. The
AACN Roadmap for Implementing Change is a tool intended to assist you in sharing and implementing new learning and practices in your unit
and hospital. This Roadmap serves as guide to assess your unit’s level of readiness for change and to identify strategies for implementation. It is
best used once you and your team have determined a specific practice or area to change.
Action Steps
Supporting Resources
Key Stakeholders
Unit and Staff Assessment
Assess your unit’s structure and readiness to
support change.
 Change Readiness Assessment
 Unit leadership (may include managers,
charge nurses, council chairs, Clinical Nurse
Specialist, Nurse Educator)
 Staff nurse(s)
 Interprofessional team members (as
determined by the change initiative)
Assess current knowledge of problem, practice or
procedure.
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Unit Gap Analysis
Survey Monkey survey
Informal discussion
Performance improvement (PI) data
Discussion at journal club
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Nursing staff member(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Practitioner(s)
Quality improvement team(s)
Physician(s)
Other members of a multidisciplinary team
(as determined by the change initiative)
Action Steps
Evaluate results of assessments.
Supporting Resources
 Discussion at unit council meeting
 Discussion with unit leadership (Nurse
Manager, Clinical Nurse Specialist,
Physician Director)
 Engage PI or Quality departments
Key Stakeholders
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Nursing staff member(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Practitioner(s)
Quality improvement team(s)
Physician(s)
Other members of multidisciplinary team
(as determined by the change initiative)
Email blast (see sample)
Posting flyers
Material to hospital or unit journal club
Huddle (see sample script)
Newsletter write-up (see sample)
Telling peers
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Unit staff nurse(s)
Clinical Nurse Specialist
Nurse Educator
Physician(s)
 All “Low” level resources
 PowerPoint teaching presentation (see
sample)
 “Lunch & Learn”
 Staff meeting
 Poster presentation
 Competency Day
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Nurse Educator
Advanced Practice Nurse(s)
Nurse Manager
Unit staff nurse(s)
Physician(s)
Determine Change Strategies
Readiness Level: Low
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Raise awareness, advocacy.
Readiness Level: Medium
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Provide education.
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Action Steps
Readiness Level: High
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Implement the change initiative.
Supporting Resources
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All “Low” and “Medium” level resources
Forming or participating in a committee
Evidence-based project initiation
Identification of a leadership champion
Interprofessional taskforce
Plan rollout
Key Stakeholders
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Nurse Educator
Advanced Practice Nurse(s)
Nurse Manager
Unit staff nurse(s)
Physician(s)
Multidisciplinary team leader(s)
Measure Success
Evaluate efforts: Awareness and advocacy level.
 Monitoring dialogue
 Discussion at a future staff meeting or
huddle
 Quality improvement team(s)
 Staff nurse(s)
Evaluate efforts: Education level.
 Knowledge checks
 Competency validation
 Assessment of the use of audit tools
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Quality improvement team(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Educator
Evaluate efforts: Implementing change level.
 Compliance audits
 Quality indicators (i.e., patient
outcomes)
 Satisfaction: staff, patient, team
 Length of stay
 Cost
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Quality improvement team(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Educator
Unit quality team member(s)
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Action Steps
Evaluate efforts: Sustained change over time.
Supporting Resources
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Regular monitoring of outcomes
Reporting outcomes to unit leadership
Continual auditing for compliance
Re-educating as needed
Key Stakeholders
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Quality improvement team(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Educator
Unit quality team member(s)
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Quality improvement team(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Educator
Unit quality team member(s)
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Quality improvement team(s)
Nurse Manager
Clinical Nurse Specialist
Nurse Educator
Unit quality team member(s)
Disseminate Findings
Share learning.
 Discussion at organizational critical care
team meetings
 Sharing with other units and/or
organizational practice councils
 Hospital newsletter
 Poster presentation or educational
session at local or national professional
meetings
 Submission of findings for publication
Celebrate Success
Determine meaningful recognition.
 Scaling the recognition for the level of
success
 Evaluating recognition mechanisms
 Involving staff in selecting recognition
methods
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Action Steps
Tell AACN your story.
Supporting Resources
 Submitting a poster or abstract for
presentation at NTI
 Submitting a manuscript for publication
to Critical Care Nurse or AJCC
 Sending an email to practice@aacn.org
Key Stakeholders
 All members of the team
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Copyright © 2013 American Association of Critical-Care Nurses