Change management is an essential element in quality processes and their subsequent improvement. Planned change is at the heart of leadership, and the people implementing change need to disrupt initially the status quo in a bid to improve the internal processes within organizations (MPhil, 2012). After that disruption, change managers need to move everyone towards a new way of conducting activities in a manner that does not deteriorate back to their former state. Leaders initiating transformations need to ensure that they manage opposition effectively. Kurt Lewin’s change theory provides key steps that can be adhered to when managing change in the nursing department of any medical institution.
Problem in the nursing department and solution
Nursing is an essential part of healthcare delivery that employs over three million men and women all over the United States. However, most healthcare systems find it difficult to maintain and properly manage nursing staff that is strong and stable. Turnover rates in the nursing departments are quite high as compared to other departments. This is because the job satisfaction rate is low, and refilling vacant positions in the nursing profession can be quite expensive for healthcare institutions. In future, there will be a demand for more nurses since the US population is rising on a consistent basis. The low job satisfaction rates of nurses need to be improved on by implementing a nursing excellence program.
Importance of the nursing excellence program
A nursing excellence program is a coordinated effort that aims at improving the working environment of nurses and give them better professional advancement opportunities (Gretchen Berlin, 2013). The creation of sustainable change through a nursing excellence program is only possible if the program aligns itself with the healthcare’s mission, vision, values, and professional standards. For instance, the mission can be to assist individuals live the fittest lives possible. Their vision can be to be the provision of unusual care and grander service at the most reasonable prices. Values can be integrity, trust, excellence, accountability, and mutual respect when administering healthcare to patients within the facility. A nursing excellence program that is structured along such a mission, vision, values, and professional standards can prove to be quite effective in introducing credible change. A nursing excellence program essentially lowers the healthcare system delivery costs by lowering turnover rates thus saving on recruitment and training costs. Nurses who work within such a system are more enthusiastic and serve patients extraordinarily thereby ensuring the healthcare facility meets its objectives. It is imperative for healthcare facilities to implement the nursing excellence program as it saves on costs of operations while refining the quality of service that is offered to patients.
Choice of model and its rationale
The Kurt Lewin’s theory is chosen as the model of change management that will be quite effective in ensuring that the nursing excellence program is successful. It is a reliable model that has been utilized by many health care organizations to understand human behavior when it comes to the change of patterns of resistance that are related to that change. The model essentially comprises of distinct phases that are known referred to as unfreezing, moving, and refreezing. The model essentially attempts to identify factors that can impede change from taking place. Forces that are opposed to change are referred to as static forces while those that encourage and promote change are known as driving forces. Healthcare systems within the Kurt Lewin’s change theory attempt to understand fully the behaviors that drive or oppose change. After classifying them, these institutions work hard to strengthen the positive driving forces while discouraging static forces hence change can be sustained over a long time (Marquis, 2012).
In the Lewin’s model, the first stage is the unfreezing phase, which is the comprehension of the complications that are connected to the problem that has been acknowledged. Static and driving forces are recognized, and approaches are advanced that strengthen the driving forces while weakening those of static forces. Furthermore, in unfreezing, key players are identified, and ideas communicated to them in a bid to get their reactions. The second stage is the moving stage where actual change takes place, and the implementation of the project starts producing the desired change within the healthcare institution. Lines of communication are still kept open with the nursing staff to address any issues that might arise within the change process. The final step that takes place once the desired change has been achieved is the refreezing stage, which is used to evaluate the stability of the change and its overall effectiveness within the healthcare facility.
Steps that facilitate the change
This is the first step of Lewin’s analysis that involves the identification of the change of focus in this case being the implementation of the nursing excellence program. The key component in this step is communication where all stakeholders need to be communicated to on the changes that need to take place. At this point, there should be a definition of what the healthcare institution needs to achieve in terms of goals and objectives. Discussions should be held on the factors within the institution that discourage nurses from offering their best. Driving and static forces should be identified and proper structures laid in place to effect the change.
This is the phase where actual alterations take place in the institution. During this time elements that have the sturdiest negative bearing on the nurses’ job satisfaction should be discouraged. For example, a primary concern for nurses is burnout especially due to overtime and underpayment. Other factors include low rates of cooperation, minimal decision-making power, and power over operating environments. The moving stage should include nurse engagement, capability building, nurse-sensitive performance improvement, and evidence-based practice.
This is the final stage where the changed practices are maintained, and ongoing support of the operations are carried out. Every nurse who engages in the new program should be comfortable and report improved morale for their jobs. An evaluation and summary of the problems that have been encountered should be highlighted for future reference.
Management of change
It is important for the management of healthcare facilities to employ the services of a change management consultant who can utilize the theories, tools, and strategies of managing change effectively. This professional should be aware of the challenges nurses go through and should be able to conduct effective research that establishes their sensitivity to factors leading to low morale at work. With such attributes, they can be more efficient in meeting the objectives of health facilities.
Gretchen Berlin. (2013). Creating and sustaining change in nursing care delivery. Wahington D.C: McKinsey’s Healthcare Systems and Services Practice.
Marquis, B. L. (2012). Leadership roles and management functions in nursing: Theory and application . Philadelphia, PA: Lippincott, Williams & Wilkins. : Laureate Education, Inc., custom ed.).
MPhil, S. J. (2012, November). Change Management: A Classic Review. Review Website: