Lewin 3 Stages Of Planning Change

Implementing change among all organizations is necessary to achieve success; within the health care industry change is constant and it is the role of management teams to assess, plan, implement and evaluate change to ensure satisfaction. Considering this among the other aspects of running a successful organization it is essential to ensure that there is minimal resistance and familiarity to change. Demands of the consumers and staff as well as regulations are continuously changing. The responsibility of managers is to successfully lead these inevitable changes.

Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz, Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a change of this nature. The use of Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track.

“ The ADKAR model of change includes Awareness of the need for change, the Desire to support the change campaign, Knowledge of how to make this successful, the Ability to implement new strategies, Reinforcement of change implementation, and periodic re-evaluation (Hait,2006). These four elements promote evidenced- based practice change and the commitment from nurses to participate in professional activities.”(Robert & Pape, 2011, p. 43) A APRN’s we will have to be agents of change to provide the best care for our patients. When we identify a issue or concern we must have the ability to address it

The problem in this scenario is the challenges faced with trying to implement a new clinical pathway. This particular clinical pathway trying to be implemented is concerning ventilator-dependent patients who are discharged to home with home health care needs. These patients tend to have multiple health care needs beyond the ventilator and the new clinical pathway will establish a smooth transition from hospital to home, allowing for all the patient’s needs to be met. The challenges arise when trying to get all areas of the health care team to get involved. This especially includes the physicians that seem reluctant to follow a nurse’s guidelines. Not only are the physicians reluctant, the home health care representative will not be available to attend team meetings for a while. The new clinical pathway is due to be started in one month, so there is little time to get all parties on board.

This plan will take 10 weeks to accomplish. Week 1, flyers will be made and distributed, so that all staff is aware of the changes being implemented and can plan to make this change. It will also give staff an opportunity to voice any concerns related to the changes and fill out the initial survey which is in Appendix B. This week will also be used to gather any resource materials needed to help with implementation of skills. Week 2 will be used for coordinating instruction and teaching with unit managers. Weeks 3 & 4 will be used to review the process of shift change report and how communication occurs between nurses, from nurse to patient and from nurse to physician. Staff interdisciplinary interactions will also be reviewed to find weaknesses in communication and teamwork. Week 5 will be used to review incident reports, to determine the gaps and what the staff needs to know to make incident reporting more effective and efficient. Week 6 will be used to arrange teaching times. This week will also be used to find teaching facilitators to teach the rest of the

Implementing a change project is a challenging step of the Capstone Change Project. This paper focuses on steps that must be taken to implement a change, strategies to ensure the success, involved stakeholders and their roles, educational requirements, safety issues, ethical considerations, and external or internal regulations’ effects on the process. It also include the change theory, nursing theory, and evidence based practice influences on the implementation process.

I agree with you the nurse that is seeking to implement a change must be able to reach across to all stakeholders. These stakeholders come from different walks of life and the challenge here will be knowing their educational background in order to deliver a message that is not intricate to grasp. You have to also remember that people remember only 10 percent what they read, but they remember 40 percent what they hear and see. Thank you for you thoughts.

It is very true that lack of communication and not being honest with your staff can lead to frustration. It will be more appreciative if the manager will come and recognize that some of the new things are new for him/her to instead of just making it mandatory without any preparation. We understand that many times policies and procedures are coming from higher levels, but discussing with the ones which will be affected will have a better outcome in terms of accepting new changes. "The person who has to deliver the often unpleasant news determines whether to call the unit and leave a brief note on the assignment sheet or go to the nurse to talk directly about the change".

The healthcare field is constantly changing and frequent practices and procedures are reviewed and updated based on evidence-based practice (EBP). Research and EBP guides us in identifying areas that need improvement or revision. Whether it be new practices, procedures, protocols, or equipment, nurses are expected to be able to adapt to change. At Sacred Heart hospital, a new intravenous pump (IVP) will be introduced hospital-wide. The purpose of this paper is to describe what leadership style, change theory, and collaborative practice will be utilized in implementing the new IVP and how healthcare economics plays a role in its implementation.

In contrast, Eden and Ackerman (1998) take on a utilitarian approach to stakeholder analysis, with the aim of identifying stakeholders who be persuaded and support actively the strategy and intent of the organization that is prioritizing them. The stakeholders in the institution play a major role as they hold varying degrees of power and interest in the institution. In order to be successful with a proposed project, it is important to identify the stakeholders and to understand their attitudes concerning their expectation and acceptance of the project. Routinely, while the procedures are in progress in the operating rooms, updated information is exchanged among health care providers and family members via nurse liaisons. With the installation of new technology, the access to updated information can be accomplished in a faster, timely, and professional manner. Some of the benefits include the need for less staff members that can be economical to the institution and increased patients and relatives' satisfaction.

The physicians will have the role as the promoter; they need to make sure the patients have this information, and they understand what they are reading. The physicians have to be on board and encourage all the staff to support this process change to continue to grow and meet the needs of our patients. The providers are pivotal to this process change because they have the power to help the process along or hinder it. The providers would have a great interest in this project to ensure we are utilizing evidence-based practice and meeting our patient’s needs.

Thanks for the post, I definitely agree with some of your points. The triage point about why it is taking so long to implement the changes. Often times what is seen with good implementation is that there is robust training that is provided to the people that will be using the new tool. Unfortunately that is not always the case. As it can be seen in this case, the nurses are not familiar with the process and so they cannot reap all of the benefits of the shortcuts. Project teams should always consider that the employees need ample time and input on how the new tool should work, because they will be the ones who are using the tool in the long term. Also great point about the triaging of the patients to reduce the waiting in line.

Prior to implementing the standardized procedure, as nurse manager I would confirm with the State Board of Nursing and Nurse Practice Act whether a new procedure adheres to the nursing scope of practice in my state. Meaning a nurse manager should be aware if the nursing professionals are permitted to undertake newly suggested actions and processes in compliance with their professional license guidelines. I would also verify with the healthcare facility whether a new procedure lies within policy regulations. Then a nurse manager should be very clear what exactly the new procedure encompasses and what it asks for and steps required to complete the procedure correctly (Board of Registered Nursing, 2011). Evidence-based practice and nursing research

The nursing staff will have the most important role in this process change. The nurses are the ones who see the patients first. The nurses will need to be onboard and understand that this process change will help us give our patients the knowledge they need as well as increasing their satisfaction. Each nurse will be responsible for maintaining the educational materials while making sure the information is accessible to our patients. An important part of this process change is to make sure the staff is onboard and the patients are receiving the information. The nurses will be able to influence and hold each other accountable for this process change. The nursing staff has the best interest of the patients and want to provide the best care they can. The nurses have the power to either bring this project along or they can hinder this

In addition, Lewin recognized that change is almost always met with resistance. More importantly, he identified the behaviors and environments that stimulate resistance. Thus, careful consideration of behavioral and environmental impacts must occur in the Unfreezing stage of Lewin’s Unfreezing-Changing-Refreezing Model prior to implementing the change. This will prepare the leaders of the organization to meet the resistance with the correct leadership and management style.