Lippit’s Change Theory
Candace Creese
Wilmington University
Lippitt’s, Watson and Wesley-1958
• The Seven phases of change elaborated on
Lewin's Three Step Change Theory
• The seven step theory is to focus on the role
as a change agent throughout the evolution of
change
• The key to change is having the right person to
be the voice of change and the support for the
change; empowering the process.
Lewin’s Three Step Change Theory
The process of changing the behaviors of an
individuals resistance to a change in any
situation.
– Unfreeze- shifting the “push-pull” relationship of
opposing forces to status quo.
– Movement- the status quo is the equilibrium and
this step is to increase the level of equilibrium.
– Refreezing- after the implementation of change,
this step is necessary to make the change “stick”
Seven Phases of Change
These phases shift the change process to include the role of a change
agent through the evolution of the change.
• Phase 1:Diagnose the problem
• Phase 2:Assess the motivation and capacity for change
• Phase 3:Assess the resources and motivation of the change
agent(commitment the change, power, and stamina)
• Phase 4:Define progressive stages of change
• Phase 5:Ensure the role and responsibility of the change agent is
clear and understood (communicator, facilitator, and subject matter
expert.
• Phase 6:Maintain the change through communication, feedback,
and group coordination
• Phase 7:Gradually remove the change agent from the relationship,
as the change becomes part of an organizational culture.
Research
Psychiatric nurses were asked to self-reflection on orientation
of action toward change
– Results yielded an outcome that nurses were either
enthusiastic, hesitant, or withdrawn about changing practices to
patient-centered care on the admission unit of a psychiatric
hospital.
Chief executive officers of hospitals were surveyed on the
process of change at their facilities to reduce cost and
maintain quality care within the organization.
– With the economic crisis we are in today, many hospitals are
facing the same concern. Although the research yielded some
limitations with the research, it showed the need for the change
process to relieve the financial burden on hospitals to maintain
high quality care on a budget.
Research
It has been used to enhance scope of practice in
nurses at a time when there is a workforce
shortage in the healthcare profession. The
need to ensure organizational readiness for
change to broaden practice roles.
– Public health nurses seem to take on larger roles
and responsibilities because of the heavy work
load to meet the needs of ill population,
workforce demands and expectations.
Nursing Practice
• Nursing leadership and management is the effective
“change agent” needed for the evolvement of change
in the nursing profession. Lippitt’s phases can be used
in nursing practice especially with the advancement in
technology, the nature of healthcare organizations, and
professional standards. The style, policies, procedures,
relationships with subordinates and behaviors of a
nurse manager have to be evaluated to suit the new
breed of nurses. Although we experience change
everyday, nurses have a difficult time embracing
“planned” change. Nursing leadership must be a
person who is influential to support and encourage
success is the process of change.
Nurse Leadership and Management
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Phase 1:Envolving all parties involved in the change that will occur (scheduling,
charting, standards for practice, etc.)
Phase 2:Discussing the pro’s and con’s and the process of the change, conducting
small group activities to assess the motivation of the participants. (this can
predetermine the possible confrontation or conflict involved and allow the change
agent to modify the approach of the change.
Phase 3: the manager must have the desire to improve the situation and the
approach to the process. (open mindedness and personal acceptance of the
change)
Phase 4:detailed planning, timetables and deadlines must be addressed, and
designating responsibilities to implement the change that will occur.
Phase 5:handeling personal conflicts and confrontation, from employees, about
the change.
Phase 6: Providing communication and feedback
Phase 7: this phase is when the change is implemented and the procedures and
policies are written to assure compliance with the change, and a termination date
for the change agent is determined. The change agent will remain available for
advice and reinforcement of the change but will turn over the responsibility of the
change to the employees or participants.
My Practice
• As nurses we often experience continual change especially as the
profession of nursing advances. The change to computerized charting was
met with resistance by many nurses, as we strived to validate how the
process would falter; to justify keeping things the way they are. The
change was a smooth success and as I reflect back, I can recall the phases.
P1: Every employee was notified of the change and how it would affect them.
P2: Each unit had a meeting to discuss how they felt about the change
P3: It was evident that the change agent (for me was my manager and educator)
was dedicated to the change being successful.
P4: Responsibilities were designated to staff to be “super users”, well educated
about the system to support the staff in the change.
P5: My manager addressed all concerns of the nurses on the unit and advocated
for the system to be personalized to our unit to enhance functionality for the
population of patients we care for.
P6: Continually surveying the staff to see what we do/do not like about the
system and adjusting screens and tabs to make the charting easier.
P7: For the first six weeks we had tech support and the builders of the program
on hand , on every unit. Now they are reachable by telephone if help is
needed.