state if you are going to roll the change out gradually or have a ‘day zero’ where the change happens all at once.

Change management

 

Firstly don’t use any of the links in here as references – they’re not academic.

Secondly this is only a suggestion – the final decision is yours (in conjunction with your facilitator).

 

 

This example uses Lewin’s three stage model as the overall structure:

 

Part 1 Unfreeze

This is the biggest section and is where you ready the area for the change.

 

First do a stakeholder analysis:

I would suggest doing this as a diagram and then adding a brief explanation afterwards thus saving a lot of words but giving lots of information. For instance the Director of Nursing will be high power and high interest (as patient safety is part of their corporate role) and thus you should see them as a key player. Staff nurses have less power but high interest and should still be a key player. The Chief Exec has a lot of power but little interest and thus go in the yellow section.

 

Next look at the drivers and resistors to change – again use the following diagram. It is Lewin’s force field model. Label each arrow with a driver or resistor and then alter the size of the arrow to show how big the force is.

 

Lewin states that it is better to reduce resistance than increase drivers.

 

You may wish to have a change champion on board but it Is not absolutely necessary. NOTE: you are the change agent.

 

Change champions, a definition: http://involve.co.uk/what-does-a-change-champion-look-like/

This is a bit simplistic as I reckon there are three types of change champion:

  1. Authority based change champions. It’s always good to have power on your side even if they are not actively involved. This could be the Director of Nursing, matron or senior medical staff. Anyone with a bit of power you can say are supporting the change.
  2. Expertise based change champions: those who have respect in the field of your change due to their expertise (for instance a wound management nurse, critical care outreach team). This gives the project credibility.
  • Peer change champions: as change agent you cannot be there all the time and you need people ‘on the shop floor’ who can promote the change and problem solve when you aren’t there and there is (for instance) a problem with your innovation or people are backsliding.

Needless to say the peer based change champions are going to need a lot of support and training.

 

Finally plan how you are going to overcome the barriers and promote the drivers for change:

  1. Adults don’t do things because they are told to, they need education to persuade them to do it. Why is the change good? Why is no change bad? I don’t need a teaching session planned, just the fact you would do it. Don’t forget, for most of you, the change is on a ward and will need repeating several times. This needs to be face to face and allow for questions. Education increases drivers and reduces resistance.
  2. Reminders such as emails, posters etc.
  • Possibly a ‘league table’ pitting ward against ward for compliance – but this can be divisive.

 

 

Part 2 Change

A very small section. Basically, state if you are going to roll the change out gradually or have a ‘day zero’ where the change happens all at once.

Keep up the education/reminders to keep the message in people’s minds. Use the peer change champions.

 

Part 3 Refreeze

Hopefully the change is bedded-in and you can stop the active change management.