NUR 514 Describe an organizational change model that can be used in a dynamic health care environment

Healthcare organizations and settings implement changes for different reasons, key among them being improvement of the quality of services that they offer. Change management is essential to allow these entities attain set goals and overcome challenges, necessitating the need for utilizing an appropriate theory or approach. Mahmood (2018) asserts that several change models exist for healthcare settings, including Kotter’s model, Lewin’s change model and balanced scorecard. The dynamic health care environment requires stakeholders to use Lewin’s change model to manage changes or new way of doing things.

Lewin’s change model is a three-step process that evaluates two critical areas; organization’s transformation and challenging the status quo to attain expected transformation. The model entails stakeholders following these processes; unfreezing, change, and refreezing (Nilsen et al., 2020). In unfreezing, the change agent or management informs employees of the need for change and creates urgency as well as vision based on areas that require transformation. The second phase is to implement new ways of doing things by sharing knowledge and through effective leadership (Hussain et al., 2018). The third stage is to embed the changes as part of the organizational culture and practices by sustained application and corrective measures where necessary.

The model advances that the management of organizational change needs one to understand each stage and having a visionary leadership styles like use of servant leadership model, transformational leadership and even contingency or situational leadership. Lewin’s change model emphasizes the role of stakeholders; especially nurses as change champions committed to improving overall care delivery in their practice settings (Nilsen et al., 2020). The model asserts that stakeholders play a critical role in organizational change by ensuring that they lead in championing for and implementing new ways of doing things. Stakeholders also share information and provide resources to attain the suggested change to the highest level.

References

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s

change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Mahmood, T. (2018). What models of change can be used to implement change in postgraduate

medical education? Advances in Medical Education and Practice, 9, 175. DOI: 10.2147/AMEP.S160626

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of

successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC health services research, 20(1), 1-8. https://doi.org/10.1186/s12913-020-4999-8.

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Change is always happening to health care with so many technological advancements and evidence-based practices being developed to better patient safety and care. There are different models organizations can utilize for change, one being the ADKAR Change Management Model (Giva Inc, 2021). The acronym is as follows:

A: Awareness- The first stage in this model is that the organization has an awareness that change needs to be made; change made in order to keep the organization moving forward in a positive direction. This awareness can be observed by those who work within the organization and also those who are consumers of the organization.

D: Desire- The second stage in this model is that there is a desire for the change the organization has been made aware of. This part of the model can be tricky because it takes all parts of the team to have the desire for the change. In health care, many of us have encountered changes that were not desired by those on the floor, however, administration put it into place. On the other side, there have been desires for change on the floor; however, the administration does not have the desire to initiate the change. When all parties don’t share the desire the change, implementation can be tricky.

K: Knowledge- The third stage is to make sure all parts of the organization are informed about the change and how it will be implemented. Everyone needs to be aware of what the change is, why the change is needed, how the change is going to work, and when the change will start. Here, everyone will know what part they will play in the change, what to expect, and how to assess the progress of the change.

A: Ability- The fourth stage is that the organization has the ability to initiate the change. This means that the organization has the funds, enough employees, and the resources for the change. Furthermore, the organization has to make sure everyone has the ability to act on these changes; keeping in mind scopes of practice, paygrades, level of experience, and skill levels.

R: Reinforcement- The fifth and last stage of this model is that those who are leaders in the change are assessing the progress of the change and how effective it is. If the change yields positive results, reinforcement to employees or participants needs to be made to maintain the positive results; this is typically done with some type of reward or incentive.

Change will have each stakeholder involved in the change play a different and specific role. For example, mandating all employees on the floor to wear masks involved administration to make sure the new mandate was ethical, affordable, and plausible. Leadership on the floors needed to ensure that were enough supplies and that employees were being compliant. The employees needed to be compliant and hold each other accountable.

References:

Giva Inc. (2021). The 3 best change management models in healthcare practices. Giva. Retrieved from https://www.givainc.com/blog/index.cfm/2021/5/10/the-3-most-effective-change-management-models-for-healthcare-practices

A wide variety of organizational change models can be utilized to structure a business and, in turn, influence its operations and results. Models can be used to direct health promotion and disease prevention initiatives. These frameworks can describe and predict how people’s health-related habits change over time.

Lewin’s Change Theory is a three-step model based on the premise that behavior is a dynamic balance of forces working in opposition. To facilitate change by pushing employees in the desired direction and inhibiting forces hamper change because they make employees in the opposite direction. Lewin’s three-stage change framework can be used as one of the change models. This model is a three-step procedure for analyzing the organizational environment’s change process and devising strategies for challenging the status quo in order to create meaningful transformation. The paradigm suggests that group actions will dictate how an individual responds to the proposed change. Leaders, it follows, need to see members’ actions as a barometer of how their teams feel about the proposed transformation if they want to see any real results (Hussain et al., 2018). The model’s three steps of transformation are unfreezing, change process, and refreezing. When unfreezing a company, it is important to communicate with employees about the upcoming changes and gain their buy-in and support. The second step is to put the plan into action through communication and strong leadership. The third phase, “refreezing,” is when the modified elements of the organization’s culture are fully embedded through persistent application and, if necessary, course corrections.

Stakeholder management is a powerful tool used by successful people to get the support of others. Stakeholder management is an essential skill that can help save your projects from failure. Your projects have staunch advocates in the form of stakeholders, who may also act as roadblocks. Therefore, it is essential to identify your stakeholders and quickly gain their support.

References

Hussain, S., Lei, S., Akram, T., Haider, M., Hussain, S., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123–127. https://doi.org/10.1016/j.jik.2016.07.002

MindTools. (2022). [Article]. Lewin’s Change Management Model. Retrieved December 2, 2022, from https://www.mindtools.com/ajm9l1e/lewins-change-management-model

Change occurs often in our lives whether we accept it or not, but change can be good. During the first couple of years that I was a nurse, we were using paper charting. As we switched to EPIC computer charting system, many older nurses were not computer savvy, so this change caused a lot of them to retire. As humans, we are often set in our ways and many of us do not like change. Denisco, (2021) listed the eight steps of change as making sense or unfreezing, which is the proposal of small changes that may affect one or many people, step 2 involves leading or serving on an interprofessional change team where members of the change team should be professional and trustworthy, step 3 is developing a team vision and change. Step 4 is identifying and analyzing forces of change, step 5 is developing a work plan for change implementation, step 6 is implementing that change, step 7 is evaluating outcomes as refining as needed, and step 8 is incorporating changes into the culture. In Lewin’s theory, he developed unfreezing, which is the process which involves finding a method of making it possible for people to let go of an old pattern that was somehow counterproductive. I find this to be the most valuable method. It’s hard getting people out of their comfort zone. The next stage is the change stage, which is moving to a new level or adapting change. Lastly, the refreezing stage is establishing the change as the new habit, so that it now becomes the “standard” (Hussain et a.,2018). Without this final stage, it can be easy for the person to go back to their old habits.

DeNisco, S. M. (2021). Advanced Practice Nursing: Essential Knowledge for the Profession: (4th ed.). Jones & Bartlett Learning.

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127.

Change is unavoidable and often necessary, especially in healthcare. Although it may be necessary, many people are comfortable, and change makes them uncomfortable. Having a process to create change is important in any business. As varying organizational theories and change models have been presented over the years, all the differing models “basically have four distinct phases: assessing the problem/need for change, setting change objectives, implementing change, and evaluating the outcomes of the change (DeNisco & Barker, 2019).” Interestingly enough, the first change theory which was introduced by Kurt Lewin in 1974, was simple but could easily be applied and useful to this day. His three basic ground rules unfreezing, freezing and re-freezing. The idea was to unfreeze by challenging the staff in order to gain support that change is necessary, freeze to make the change, and then refreeze in order to make sure the culture shift and change was continuously being made (DeNisco & Barker, 2019). My unit went through some large flow and staffing changes recently, where a professional group was contracted in order to help drive the process and change. Long story short, the group basically used this model to help drive the transformation. I think that the biggest part of the success was having the key stakeholders, which were the managers and leaders, be on the floor to help drive the change and not let staff easily fall back into their old ways.

DeNisco, S. M., & Barker, A. M. (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570

NUR 514 Describe an organizational change model that can be used in a dynamic health care environment