NRS 493 Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention

NRS 493 Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention

NRS 493 Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention

One change theory, very widely used in nursing, is Lewin’s Change Theory. Lewin developed the change model to illustrate how people react when facing changes in their lives. The three stages of this process include unfreezing (the person has an existing state), moving or changing towards new ways of being, and then refreezing into a new state. The theory has barriers and facilitators, referred to as driving and resistant forces. Driving forces facilitate change because they push the person in the desired direction. For this theory to be successful the facilitating factors must overcome barriers and resistance (Current Nursing, 2020).

Kotter’s Eight-Step Change Model, created in 1995, includes the following change management steps: create a sense of urgency for change, form a guiding change team, create a vision and plan for change, communicate the change vision and plan with stakeholders, remove change barriers, provide short-term wins, build on the change, and make the change stick in the culture. According to Kotter change happens when at least 75% of employees are convinced that change is necessary. This sense of urgency is developed among employees by “change leaders” with a focus on what are new realities, what are threats and new opportunities. In this theory, the vision for change needs to be agreed upon Barrow, Annamaraju &Toney-Butler, 2021).

 

Lewin and Kotter’s theories both must overcome resistance for change to occur. Lewin’s theory, more generalized, is described in three steps as opposed to Knotter’s whose theory put emphasis on organizations, highlighting teamwork and coalition formation.

 

References

 

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Change Management. StatPearls StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459380

 

Current Nursing. (2020). Change Theory – Kurt Lewin.  https://www.currentnursing.com/nursing_theory/change_theory.html

Kurt Lewin not only has a nursing theory, he is considered the father of social psychology and the designer of the nursing model known as Change Theory and it his original theory which others have used as a foundation. (Petiprin, 2020). Lewin’s Change Theory is known as the “unfreeze-change-refreeze model” with 3-concepts or steps which are the “driving forces, restraining forces and equilibrium” per Petiprin (2020). The key points of Lewin’s change model is compelling forces, “restraining forces and equilibrium” (Petiprin, 2020).

Step 1 = “Unfreeze”: to put aside old ways of doing things. Helping people to do away with old patters or habits, increasing the key need to readdress away from the something has always been done.

Step 2 – “Change” in ways of thinking, acting and/or feeling that is a more productive manner.

Step 3 = “Refreeze” establishing solid actions, ways of doing things or habits in such (firm/solid/established) way that the actions, thoughts or feeling replace the prior. If this is not fully established the olde ways shall become new again ~ not actually replaced per Petiprin, 2020. (side thought: if no fresh trays and water for the “icecubes of life”…trays of ice just left on the counter and melted, but not really dealt with ~ using the same olde water, not a fresh source for fresh cubes to be created)

           Lippitt has a Seven-Step Change Theory that has the foundation of Levin’s change theory [er .

Step 1: Acknowledge (Diagnosis) the problem: come to grips as to the issue or problem by looking at information, data or the big picture to assess what needs to be and that whoever shall be affected by the change is committed to the outcome needed.

Step 2: “Assess the change agent’s motivation and capability for change”: assess what shall be needed to in the process of achieving the change.

Step 3: “Assess the change agent’s motivation, resources, experiences, stamina and dedication”

Step 4: “Select progressive change objectives”: assess what needs to be done, what is needed to achieve accomplish it and how to go about it to get it done.

Step 5: “Explain the role of the change agent to all employees” to assure everyone fully comprehends what is needed and expected of them.

Step 6: “Maintain change”: encourage and welcome interaction from employees

Step 7: “Gradually terminate the helping relationship of the change agent”: due to a full understanding and utilization of change incorporated, the change agent shall not be needed, as the employees shall fully realize the importance of the changes made and shall “take ownership” going forward and sharing the information/new ways/procedures/interventions with others. (per Wisconsin Technical Manner, n.d.)

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           The comparison is that Lippitt’s change theory made use of the foundation of Levin’s change theory which was

NRS 493 Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention
NRS 493 Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention

concise and to the point and branched it out to expound upon it, creating a more detailed set of steps (WTCS, n.d.). Although it seems too many steps, Lippitt’s 7-Step Change Theory seems to make most sense, especially in the light of out-patient care regarding Covid-19 at the site of my preceptorship and capstone. The site I am at does not utilize either theory, yet verbalized Lippitt’s theory would work well in most medical settings.

Resources

Petiprin, A. (2020). Kurt Lewin – Nursing theorist. Nursing Theory. https://nursing-theory.org/nursing-theorists/Kurt-Lewin.php

Wisconsin Technical College System (WTCS) . (n.d.). https://wtcs.pressbooks.pub/nursingmpc/chapter/4-3-implementing-change/#footnote-993-1

Change management is vital when instituting change in an organization. This is because appropriate change management ensures that organizations are well prepared on how best to transition to the new mode of operation, in addition to ensuring that the previous culture is replaced by a culture that is in line with the change. Change management models contribute to change by guiding organizations on how best to make organizational change and navigate the process of transformation and eventually attain optimal outcomes such as the acceptance of change into practice.

The first change management mode is the 3-stage of Changes Model by Kurt Lewin. Popularly termed as Lewin’s 3-stage model of change, this model executes change in three phases which are Unfreeze-Change-Refreeze. Based on this model, when instituting change, the first step entails unfreezing current processes and the best way to do it is to create the urgency for change and ensure that everyone understands the need for change (Conne & Unni, 2020). When this happens, the next step entails making the change and guiding the employees through the change process and in this phase, the employees are empowered to appreciate the change and through the transition. The final step entails refreezing which basically involves turning the new status quo into organizational culture. The second model is Kotter’s Change Management model and this is a more complex model that builds on the Unfreeze-Change-Refreeze model. The model is divided into eight stages and these are creating a sense of urgency, building the change team, forming a strategic vision, communicating the vision, removing the barriers to change, maintaining momentum and finally instituting change.

The first similarity between these models is that both of them initiate change by first ensuring that the members of the organization understand the need for change. This is facilitated by creating the need for change and generating urgency for change. This involves ensuring that the members of the organization are well motivated to engage in change. Furthermore, both of these models facilitate the creation of change by first changing organizational culture.

These models similarly have a range of difficulties and they include those associated with the conclusion of the change. In Lewin’s model, the change process ends with the refreezing of change and this involves tuning the organization’s culture to reflect the change and aligning the change to organizational needs (Haas et al., 2019). On the other hand, Kotter’s change model stops at the institution of change and thus, this model assumes that once changes are in place, cultural changes will automatically follow.

I believe that a hybrid of both models would make sense of the EBP intervention. The suggested hybrid is using Kotter’s model during the change pros and then concluding with the ‘Refreeze’ step that is contained within the change process and this ensures that even after the model has been implemented, there are active steps to solidify the change into culture. This way, the change becomes a part of the core culture of the organization and the healthcare system and guarantees optimal outcomes in the long-run.

References

Cone, C., & Unni, E. (2020). Achieving consensus using a modified Delphi Technique embedded in Lewin’s change management model designed to improve faculty satisfaction in a pharmacy school. Research in social & administrative pharmacy : RSAP, 16(12), 1711–1717. https://doi.org/10.1016/j.sapharm.2020.02.007

Haas, M., Munzer, B. W., Santen, S. A., Hopson, L. R., Haas, N. L., Overbeek, D., Peterson, W. J., Cranford, J. A., & Huang, R. D. (2019). #DidacticsRevolution: Applying Kotter’s 8-Step Change Management Model to Residency Didactics. The western journal of emergency medicine, 21(1), 65–70. https://doi.org/10.5811/westjem.2019.11.44510