Module 2-Management Strategies--Implementing Change

As health care leaders implementing changes in policies and protocols is a constant task.  Michelle Bennett, a senior staff nurse in a pediatric unit in the United Kingdom writes an article in Nursing Magazine-UK about the process of implementing new clinical guidelines in her unit concerning pediatric sedation.

 Bennett uses a democratic leadership style and organizes teams of nurses to help her in the process.  She clearly communicates information regarding the changes and why she needs their participation.  By doing this she motivates the team's participation to accomplish the goals.  Bennett feels that the best approach to implement the changes is to follow the Lewin Change Model which was developed by Kurt Lewin.  Lewin (1951) describes the change process in three stages:  1) Unfreezing (prepare and plan for the change), 2) Experiencing the change and 3) Re-freezing (solidify the change). 

Bennett's plan of action includes a ten step process:  1) Identify the need for change (the unfreezing stage in Lewin Change Model).  Changes needed to occur with the unstructured sedation practices causing extended length of stay due to drug withdrawal symptoms.  Bennett discussed her concerns with her colleagues and found that they all had the same concerns and agreed that change needed to occur.  2)  Establish the views of her colleagues and team members which is vital for effective change. 3) Perform a comprehensive literature review to provide evidence based research data backing up their decision for change.  4) Share results and obtain colleague input into compiling draft guidelines.  5)  Provide training and information resources in a flexible manner that best suits the department.  6)  Compiling draft guidelines that are clear, easy to understand and follow.  7)  Implementing draft guidelines.  This phase represents the experiencing the change in the Lewin Change Model and the guidelines are put into action.  8)  Review and amend guidelines.  Bennett identifies this phase as the re-freezing stage in the Lewin Change Model where the newly implemented guidelines are now monitored, evaluated for effectiveness and reinforced.  9)  Implementing amended guidelines.  Bennett communicates with team members and together fine tune any changes.  10)  Carrying out an audit.  This will help staff provide improved patient care and services.

As Bennett describes her process of implementing the changes in her department, it is clear that managers need to have a clear plan of action to successfully meet the goals of the department.



References

Bennett, M. (2003). Applied management. Implementing new clinical guidelines: the manager as agent of change. Nursing Management - UK, 10(7), 20-23.

 Lewin (1951) Field Theory in Social Science. New York, Harper and Row.