ch. 17

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unplanned change (NONLINEAR / COMPLEX CHANGE)

= a change that does not have a cause and unknown effect. * this change is difficult to predict and happens suddenly

planned change (LINEAR CHANGE)

= a change that is expected and we can determine it's barriers & facilitators ("force field analysis") ex: quality improve programs (bc we expect to have change in order to improve quality of care)

force field analysis

A technique for determining which forces drive a proposed change (facilitators) and which forces restrain (barriers) it.

ways to support change as an individual

Listen Establish connection with staff Build trust Dialogue Empower Facilitate Cooperate Coerce (Persuade) Manage information Manage relationships

what to do to make change happen as an individual/ organization?

Recognize when change is needed. Be proactive. Know how you react to change. Expect people to respond to change differently. Be prepared for change.

responsibilities of leaders and managers during a change

ensure that safety and effective care are maintained leaders/ managers serve as a change agent supportive during time of difficulty (while moving toward a change) recognize how self is reacting to the change remember to assess how change affect everyone at the system, unit, team, and individual level.

who are good with handling change?

people who are: - enthusiasm - lifelong learners - good communicators - referent power (= know well known people)

types of changes

planned change (first-order change) unplanned change (second-order change)

change theory

Kurt Lewin's change theory is widely used in nursing and involves three stages: the unfreezing stage, moving stage and refreezing stage. Lewin's theory depends on the presence of driving and resistant forces. The driving forces are the change agents who push employees in the direction of change. The resistant forces are employees or nurses who do not want the proposed change. For this theory to be successful, the driving force must dominate the resistant force.

change

the process of altering things (that involves individuals, groups, organizations, society) change is "unavoidable" "changes" are differs based on the speed and complexity.

what characteristics allows a leader/ manager be an agent of change?

Committed to the best way of doing things Courageous Take initiative & Think outside the box Motivated Caring Humble Sense of humor ----- leaders/ managers need to do these to lead change: Lead RELATIONSHIPS Serve as a coach and a guide Develop awareness of interdependencies Foster trust Promote openness Lead PROCESSES Serve as a facilitator Solve process problems Lead with the team Lead CULTURE Endorse the behaviour you want Promote accountability Reward best practices Empower staff Keep the patient at the center

5 ways to support change as an organization

Systems thinking - framework development Personal mastery - openness to change using self-awareness and reflection Mental models - helping others become aware of how they think, what they value, their impact on the organizations performance Shared vision - creating common view about where organization is going. Team learning - promotion of teams to think together, collaborate, share ideas, knowledge and perspective

some expected reactions to changes from the employees

innovator = thrives on change early adopter = ready to accept change and serves as a guidance for others towards change early majority = prefers to do the old way, but eventually accept new ideas late majority = openly agains change, but agrees to accept it after the majority of others have accepted it laggard = forever prefers the old way and openly resist change, but develop an evil plan to stop change. rejecters = develop strategies to stop "change" from success.

what is the function of a manager in a change?

planning (this also includes assessment first!) organizing (the plan for change) implementing (the plan for change) evaluating (the change) seeking feedback from team about the change.

stages of change (the "change theory" by kurt lewin)

unfreezing = ensure that employees are READY FOR A CHANGEr moving = execute the intended change. (LET'S DO IT!) refreezing = ensure that the change becomes permanent (MAKE SURE THE CHANGE STAYS!) ----- Kurt Lewin's change theory is widely used in nursing and involves three stages: the unfreezing stage, moving stage and refreezing stage. Lewin's theory depends on the presence of driving and resistant forces. The driving forces are the change agents who push employees in the direction of change. The resistant forces are employees or nurses who do not want the proposed change. For this theory to be successful, the driving force must dominate the resistant force.


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