NUR 590 Review the different models and frameworks that can be used to facilitate change

The ADKAR Change Management Model focuses on the individual involved with the change. It is comprised of 5 sequential building blocks. A-awareness, D-desire, K-knowledge, A-Ability, R-Reinforcement. All steps must be met for change to successfully be implemented. “When change is not implemented, it is usually because one or more of the five blocks is missing (Proseci, 2022). When working towards change it is imperative to get support from leadership, however, it is more important to have support and buy-in from the stakeholders involved. Using the ADKAR model allows us to answer the “why” which is what everyone wants to know,(why change, why now, why this way, why doesn’t the old way work, the list goes on).

Kotter’s Change Model is an 8-step process toward change. Create a sense of urgency (inspire stakeholders to act), build a guiding collation (committed stakeholders), form a strategic vision (clarify how the past looks different from the future), enlist a volunteer army (active contribution/unification), enable action by removing barriers (remove silos/obstacles), generate short-term wins (recognize small wins to persist), sustain acceleration (don’t skip steps), institute change (connect new behaviors to success/wins).

Both models are important when implementing change that carries over multiple disciplines and areas within an organization. ADKAR is an important model that each stakeholder who will be impacted or wants to be involved with the change should use to guide them and scale their level of commitment. However, Kotter’s model can help influence the stakeholders through the change agent. For this reason, the Kotter Change Model would be a better choice for my evidence-based project as some stakeholders don’t realize or understand there is a need for change. Those of us who do can become the volunteer army (power in numbers) to educate and support others along the change.

kotter2022. (2023, June 16). The 8-step process for leading change: Dr. John Kotter. Kotter International Inc. https://www.kotterinc.com/methodology/8-steps/

Prosci. (2022, November 2). The prosci ADKAR model: Why it works. Prosci. https://www.prosci.com/resources/articles/why-the-adkar-model-works

Kotter’s change model is effective in certain organizations and situations that is why I personally think that ADKAR is such a widely accepted model because it is appropriate to many different possible cases and conditions as it advocates a bottom-up approach that begins with the individual employee and ends with organizational change (Melynk & Fineout-Overholt, 2018). I feel strongly about recognizing the change in our small and personal ways and working our way up to that big organizational changes.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based practice in nursing and healthcare (4th ed.). Wolters Kluwer Health.

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The ADKAR model is a change management framework widely used to guide individuals and organizations through the change process. ADKAR stands for Awareness, Desire, Knowledge, Ability, and Reinforcement, the five key stages individuals typically go through during transition. The ADKAR model is a sequential process, and individuals must progress through each stage to successfully navigate change. It provides a structured approach for change management practitioners to effectively guide individuals and organizations through the change process.

Prosci. (2022, November 2). The prosci ADKAR model: Why it works. Prosci. https://www.prosci.com/resources/articles/why-the-adkar-model-works

The Iowa Model for Evidence-Based Practice is an excellent example for facilitating change in an organization. Because it utilizes a team in order to conduct research and has several feedback loops, this is useful for my EBP proposal. My EBP is focused on a change within nursing practice, in order to identify and address substance use disorder (SUD) among nurses. Formulating a team and feedback loops helps each organization to tailor their SUD education and reporting in a way that most benefits their specific needs. This model remains fluid, and utilizes constant data and results to hone the process (Melnyk et al., 2019).

The ARCC Model is useful because it was formulated with cognitive behavior therapy, which is useful when working with individual behaviors, such as SUD. Additionally, I had intended on having subject matter experts (SMEs) involved in education and implementation of change for my EBP proposal. The ARCC Model utilizes “mentors (i.e., healthcare providers with in-depth knowledge and skills in EBP as well as individual and organizational change strategies along with mentorship skills)” (Melnyk et al., p.400), which would align with the desire to have resources for staff to obtain guidance throughout the implementation process. The ARCC model focuses on cognitive behavior therapy (CBT) in order to guide behavioral change. “Based on CBT, a tenet of the ARCC© Model contends that when clinicians’ beliefs about the value of EBP and their ability to implement it are strengthened through strategies such as education and skills building, there will be greater implementation of evidence-based care”(Melnyk et al., p.400). Because my EBP focuses on educating nurses about the risks and implications of SUD among their peers, the ARCC model would help by getting staff to formulate a vested interest in helping to mitigate this issue.

Though both of these models could be utilized for my EBP proposal, I feel the CBT piece of the ARCC model makes it more fitting for my specific approach.

Resource:

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539

I have chosen the Iowa model as well for the same reasons that you have described. My EBP project is based on end-of-life care. To give the best experience with the most favorable outcomes, this project will rely heavily on the input of a collaborative team. The team will consist of doctors, nurses, case management, clergy, nursing education, administration, and family members. Due to its sensitive nature the input of all of these stakeholders is important. The Iowa model is also flexible enough to allow for revisions or changes as needed without deviating from the goal.

I agree with you about choosing the Iowa Model for Evidence-Based Practice (EBP) as one of the change models for your proposed project. The model is a cyclical framework with eight steps that can be used to facilitate change in an organization to address substance use disorder (SUD) among nurses. According to Melnyk and Fineout-Overholt (2019), the model guides nurses and other clinicians in making decisions about clinical and administrative practices that affect healthcare outcomes. It can be used to facilitate change to address SUD among nurses by providing a systematic and evidence-based approach to problem-solving. It can also help organizations identify the most effective interventions for nurses with SUD and implement those interventions in a way that is likely to be successful. Furthermore, the model emphasizes the importance of collaboration and sustainability among nurses, healthcare providers, and other stakeholders. This collaboration is essential for identifying the problem, finding evidence, and implementing change.

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

NUR 590 Review the different models and frameworks that can be used to facilitate change