Trans-Theoretical Model

The roles of the leadership in the clinics are essential to the success or unsuccessful implementation of change. The attitude of the leadership carries weight on how well the rest of the staff receives the change. Leaders on the clinic level have to accept changes whether good or bad and expect staff to challenge them. Leaders have to be strong and accept the change themselves and to support upper management. There are problems dealing with changes when issues arise between created civilian and military personnel. These issues are not easily dealt with and when changes are ensuing within a facility this causes undue stress within the organization. This is one reason that leadership needs to bring forth and implement changes within an organization as all one team because staff is well suited at picking up any rift

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.

Understand the principles of change management in health and social care or children and young people’s settings. 01.1 01.2 01.3 01.4

“ 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

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.

Change is a hard concept for most, but change in the hospital setting can be beneficial for both staff and patients. According to Mclean (2011), “Every change begins with an ending” (p.79). How people respond to change can make the process easy or hard depending on how the change is presented.

Change Theory, introduced by Kurt Lewin, states that change in an institution is necessary but can only be achieved by the whole organization not just individuals. (Bishop, 2011,p.357). Lewin believed that change is a three-step process, which includes: unfreeze, change and refreeze (Connelly, n.d.). Implementing Just Culture into an existing work environment by utilizing those three steps will be beneficial. The first step, as described by Lewin, is to unfreeze, which involves leadership teams stating the reason for the change. The leadership team needs to teach the healthcare

Stonehouse, D. (2012). Change management: a tool for support workers. British Journal Of Healthcare Assistants, 6(10),

The meaning of a change agent is basically 2-fold; to accomplish change themselves and to also encourage the capacity to change in others (Stefancyk, Hancock, & Meadows, 2013). The nurse change agent needs to recognize the question, include the right population, intervention, compare to other groups, and expected outcomes (Eads & Maruzzella, 2016). The first example would have to be years ago when I worked on the surgical step-down unit. The nursing staff on the floor were inundated with our nurse to patient ratio, which was usually 7:1. In the surgical step-down unit, we would give hourly pain medications, multiple antibiotics, do extensive wound care, as well as ambulating patients three times a day. We had an RN patient flow coordinator that would help with bed assignments and discharges. The entire floor petitioned to do away with that position and give us another clinical nurse at the bedside instead. With the lower nurse to patient ratio, we would be able to manage our own discharges and properly take care of our patients. We fought and won and went from 7:1 to 5:1 with one nurse having 6:1 for the day. Another example was in the ICU, where I witnessed our nurse leaders advocating to change our policy on alcohol withdrawal. Our ICU has a 24-hour intensivist and as nurses, we would have to get written orders for each patient experiencing DT’s. Nationally there is a Clinical Institute Withdrawal Assessment (CIWA), that my nurse leaders wanted to initiate. Basically, it would allow the doctor to initiate the CIWA protocol and give the nurses a guideline to follow when treating alcohol withdrawal patients. It was passed due to the efforts of management and the involvement of the intensivists. We now have a standard to follow without having to call the doctor for each medication order.

Health care is in a constant state of change. Health care organizations must recognize that change is needed to improve the quality and safety of patient care, retain employees, and restructure the organizational chart to maintain their viability. When changes are carefully and deliberately thought through using the knowledge and skill of leaders, this is considered planned change. The change agent plays a major role in the outcome of the change; whether the change is successful or unsuccessful (Marquis & Huston, 2012). The purpose of this paper is to identify a deficiency within a department of a healthcare organization. A description of the planned change to address the deficiency will be

The healthcare system is a constantly changing field. Change is a part of life and a part of change is learning how to cope with the new environment. Doctors, nurses, social workers, and managers are continuously educating themselves, staying updated on current events, attending seminars, learning about new technology, pharmaceutical breakthroughs and broadening their knowledge in their area of work. In this field, healthcare professionals have to be wiling to adapt and accept change. For the patients, it is the responsibility of healthcare providers to make the environment as stable as possible to accommodate patients well-being, however, the staff should be willing to accept an unpredictable environment. Sound Shore

It is very stressful for an adolescent to manage any disease. This is the population that strives to find their identity in society, and when they have to deal with a disease such as type 2 diabetes that requires changes in diet and lifestyle, it is a battle especially when you are an immigrant to a country that speaks a different language. Their parents lack the resources to get them help. There are many programs across the nation that are geared to educating English speaking adolescents that have type 2 diabetes and help them to get educated and improve their care. Prochaska's trans-theoretical model of behavior changes is founded on stages of change, and categorizes segments of population based on where they are in the process of change. Principles and processes are practical to start movement through the stages of change. Intervention is modified to specific needs and allow programs to be interactive and broadly applicable for treatment of an entire population (Proschaska, n.d.). Will the introduction of adequate, cultural sensitive educational programs geared towards diabetes type 2 prevention in immigrant Latino

With our main research question we aim at exploring the importance of effective change management and the characteristics of a successful change management program in a hospital. The main research question can be formulated as: To what extend is change management necessary and how can it most efficiently be implemented in a hospital?

1. Diagnose the problem. 2. Assess the motivation and capacity for change. 3. Assess the resources and motivation of the change agent. This includes the change agent’s commitment to change, power, and stamina. 4. Choose progressive change objects. In this step, action plans are developed and strategies are established. 5. The role of the change agents should be selected and clearly understood by all parties so that expectations are clear. Examples of roles are: cheerleader, facilitator, and expert. 6. Maintain the change. Communication, feedback, and group coordination are essential elements in this step

The second step in the change theory is the transition stage. Once people are unfrozen, the problem now shifts to how to keep them going. This is now the actual change process a stage that is characterized by confusion as people try to change from the old to new ways. This stage is further characterized by fear because people tend to be unsure and is the hardest step in the whole process (Schein, 1995). During transition, new behaviors are developed, values and attitudes. It is achieved through development techniques and change in existing organizational structures. People undergoing this stage need to be given ample time to adapt to new ways. Of uttermost importance during this stage is support. Support is offered in terms of coaching and training as well as acceptance that mistakes will be part of the transition process (Smith, 2001).