planned change – custom papers



planned changeOrder DescriptionIdentify a problem, inefficiency, or issue within a specific department/unit.Describe a specific, realistic change that could be made to address the issue.Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the chaLewin’s Theory of Planned Change as aStrategic ResourceShirey, Maria R. PhD, MBA, RN, NEA-BC, FACHE, FAANAuthor InformationAuthor Affiliation: Associate Professor, Doctor of Nursing Practice Program, College of Nursing and Health Professions, University of Southern Indiana, Evansville.The author declares no conflict of interest.Correspondence: Dr Shirey, College of Nursing and Health Professions, University of Southern Indiana, 8600 University Blvd, HP-2044, Evansville, IN 47712 ([email protected]).AbstractThis department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practicalapproaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. Inthis article, the author explores the use of the Lewin’s Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with adiscussion of its strengths, limitations, and targeted application.The American Organization of Nurse Executives identifies 5 nurse executive competencies to include communication, knowledge, leadership, professionalism, and business skills.1 Within the categoryof leadership is the requirement that nurse executives demonstrate proficiency with change management. Most often, successful change initiatives use change theory or a planned approach to implementorganizational shifts. Change management relates to the “process, tools, and techniques to manage the people side of change to achieve a required business outcome.”2(p2) Although there are amultitude of change theories to frame the change process, nurse leaders must understand the nuances related to appropriate theory selection to apply, lead, and manage sustainable change. Shanley 3argues that nurse leaders should not dismiss change management theory as unnecessary. Those responsible for organizational success must appreciate the different approaches to managing change andmatch these approaches to their particular circumstances optimizing the best strategy for success.3Graphic Figure. No caption a…This article explores the use of Lewin’s Theory of Planned Change (TPC)4,5 as a strategic resource to mobilize the human capital aspect of change. An overview of the theory is provided along with adiscussion of strengths, limitations, and targeted application.Back to TopOverview of Lewin’s TPCBack to TopBackgroundKurt Lewin, a social psychologist of the early 20th century, is known as a pioneer in the study of group dynamics and organizational development. Among his many accomplishments is the earlydevelopment of force field analysis (FFA) as a framework for identifying and examining the factors or forces influencing a situation.4,5 Force field analysis “maps out the totality and complexityof the field in which the behavior takes place”6(p311) and then uses this information to guide actions. An FFA specifies forces as either driving (helping forces) or restraining (hindering forces)movement toward a goal. Lewin’s approach postulates that behavior is a function of the group environment or field.6 Lewin’s view is “that if one could identify, plot and establish the potency of(driving and restraining) forces, then it would be possible not to only understand why individuals, groups and organizations act as they do, but also what forces would need to be diminished orstrengthened to bring about change.”6(pp981-982) This important FFA framework forms the foundation of Lewin’s 3-stage TPC commonly referred to in the phases of unfreezing, moving (ortransitioning), and refreezing.5Back to TopElementsUnfreezing, the 1st stage, involves getting ready for change. This stage entails a change agent such as a nurse leader recognizing a problem, identifying the need for change, and mobilizing othersto see the need for change. Unfreezing may begin with nurse leaders conducting a gap analysis illustrating discrepancies between the desired and current state. Creating a sense of urgency forchange is part of unfreezing. A solution is then selected, and preparation for moving away from a current reality or equilibrium ensues. This stage is the basis of what Lewin calls the FFA,5 whichrequires identifying the factors for and against change. Successful change necessitates strengthening the driving forces and/or weakening the restraining forces.Moving or transitioning, the 2nd stage of Lewin’s theory, entails looking at change as a process rather than an event. Transitioning is the inner movement that individuals make in reaction tochange and requires unfreezing or moving to a new way of being. This stage necessitates creating a detailed plan of action and engaging people to try out the proposed change. Often, this stage isdifficult because it has uncertainty and fear associated with change. The transition stage involves coaching to overcome fears and clear communication to avoid losing sight of the desired target,which is a new and improved reality.Refreezing, the 3rd stage of the theory, demands stabilizing the change so that it becomes embedded into existing systems such as culture, policies, and practices. In refreezing the change, nurseleaders consider the FFA to accentuate the driving forces facilitating change and counteract the restraining forces getting in the way of change. With refreezing the new change, this dynamicproduces a new equilibrium, which is then recognized as the new norm or higher level of performance expectation. This 3rd stage is important because locking in or institutionalizing change will becrucial to its sustainability over time.Back to TopEvidenceLewin’s TPC has traditional application in the social sciences and organizational development. A brief review of the literature demonstrates that the theory is also used extensively in clinicalnursing practice,7,8 nursing education,9,10 educational administration,11 nursing research,12 and healthcare operations.13 The structure and processes of Lewin’s theory assist in avoiding thecommon pitfalls that thwart change initiative success 9 and offer a framework to guide change. The use of FFA concepts provides for a better understanding of how to design detailed action plans anddecision matrices for change.Much of the literature that addresses Lewin’s 3-stage theory focuses on unfreezing and moving. To a lesser extent, however, the change management literature speaks to Lewin’s refreezing stage,which deals with sustainability. In a synthesis paper on sustainability, the authors 14 conclude that sustainability is dependent on multiple factors, at different levels of analysis, and includeindividual, managerial, financial, leadership, organizational, cultural, political, procedural, and contextual. These factors are significant because before initiating change, they cannot always bedetermined. Tools to assess staff perceptions of change sustainability are available in the literature,15 as are measures to determine readiness for change.16Back to TopStrengthsThe strengths of Lewin’s TPC are that it is versatile, practical, simple to use, and easy to understand. Because the theory represents one of the oldest change management models in existence, thereis much experience with this framework. Lewin’s work, particularly the field theory element, continues to be relevant today.17The theory is considered most effective when used in a top-down approach to change. In this scenario, senior members of an organization and other formal leaders drive and support change. Theliterature suggests that change to be successful requires champions to drive it.3Back to TopLimitationsAlthough Lewin’s theory is a commonly used change management theory, it may not always be appropriate. The theory is criticized for being too simplistic, quaintly linear, and framed from a staticperspective.6 Positions vary from “for” to “mixed” to “against” regarding the perceived linear aspects of Lewin’s theory.6 Some postulate that today’s healthcare systems are nonlinear and dynamic;thus, change happens more quickly than Lewin’s theory accommodates. Others argue that complexity theories are more dynamic and emergent than the TPC.6 However, some indicate careful interpretationof Lewin’s original theoretical work is a back-to-the-future experience that illustrates Lewin’s propositions as consistent with those of more contemporary complexity theorists.6Lewin’s TPC is considered a rational-linear change management model. Because change is often complex and unpredictable, it is not always possible to frame it from an unfreezing, moving, refreezingperspective. Desirable change may not be driven from a top-down perspective and may need to be more organic and bottom-up to be accepted and internalized.Back to TopTargeted Application of Lewin’s TPCBack to TopExemplarTo apply Lewin’s TPC, Figure 1 shows targeted use of the theory. In this hypothetical example involving the creation of a leadership development program for a successful 200-bed community hospital,the change project is top-down driven. The change initiative resulted from identification of a future need to grow internal nurse leaders and address succession planning in the nurse manager role.Figure 1 represents the use of an FFA to identify pertinent driving and restraining forces needed to pursue the goal of a ready future leader pipeline. Concurrent with the FFA, senior leaders andcurrent middle managers developed a detailed plan of action to engage potential charge nurse participants. They held town hall meetings with staff nurses to describe the anticipated nurse managerneeds for the hospital’s next decade of operations and beyond.Graphic Figure 1Using Figure 1, the driving forces for the desired change include anticipated retirement of nurse managers over the next 5 to 10 years, competition from larger hospitals for nurse manager talent,and higher costs associated with recruiting external talent as compared with using a growing your own approach. The identified restraining forces are lack of staff nurse motivation to assume formalnursing leadership roles, resistance of nonnursing departments for allocating leadership development resources to nursing, and noncompetitive nurse manager compensation when compared with largercompetitors in the marketplace. Using Lewin’s framework and understanding these forces in this application, nurse leaders should strengthen the driving forces and weaken the restraining forces.To strengthen the driving forces, nurse leaders enlist a team of collaborators to develop a detailed plan of action emphasizing communication. The plan focuses on creating a sense of urgency forwhy the leadership development program is needed. Senior leaders may present a grid and graphs documenting an aging workforce and the anticipated demands for filling the nurse manager role givenprojected organizational growth in services. Documentation could also be shared to demonstrate that internally developed candidates stay with the organization longer, have lower turnover costs, andcan be productive more quickly than individuals not familiar with the institution and the culture.To weaken the restraining forces, nurse leaders provide support structures in the nurse manager role to make it more desirable for staff nurses to aspire to these positions. In addition,clarification is given to other departments that the leadership development program is being pilot tested in the nursing division, with full anticipation that it can also be implemented in otherdepartments after the trial period with nurses. Lastly, the nurse leader engages the human resources department to examine management wages relative to competitors in the marketplace and based onidentified inequities moves to adjust the nurse manager salary structure as needed.Lewin’s TPC is selected for this example because it is best used in highly stable environments (eg, hospital is currently successful) when there is time to implement deliberate, small-scale changes(eg, not addressing urgent situation and having time for planning). In highly unstable environments and under emergency situations, grounding change using Lewin’s theory may be counterproductive.In this hypothetical hospital’s top-down approach to succession planning, the senior leaders are the champions driving the change. The senior leaders, in response to staff feedback for moreleadership development opportunities, conceive an initiative that coincides with their workforce development efforts (eg, win-win situation for nurses, leaders, and hospitals).Back to TopOther ConsiderationsUsing change management models facilitates the people side of change. Approaching change management without also incorporating project management activities needed to monitor change can be comparedwith navigating without oversight and controls. Regardless of the change management theory or framework, any change to processes, systems, organizational structures, and/or job roles requires botha technical side and a people side.2 Positioning for successful change also requires effective leadership and sponsorship.2Back to TopConclusionThis article explores the use of Lewin’s TPC as a strategic resource to mobilize the people side of change. Robust evidence exists regarding the efficacy of Lewin’s 3-stage theory.17 Although thistheory dates back to the early 20th century, the premises still apply today and form the foundation for other more modern change management frameworks. Understanding the theory along with strengthsand limitations is important for its targeted application. Lewin’s framework is best used with change that is planned, where the initiative starts as a top-down effort, and when there is stabilityand time to produce change. Moving an organization to a future desired state also requires incorporating both change management and project management principles.nge effort.
 
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