Effective Leadership and Management in Nursing, 8th Edition

- 3 - 3 Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Effective Leadership and Management in Nursing, Eighth Edition Eleanor J. Sullivan Effective Leadership and Management in Nursing CHAPTER EIGHTH EDITION Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Effective Leadership and Management in Nursing, Eighth Edition Eleanor J. Sullivan Click to edit Master text styles Second level Third level Fourth level Fifth level Click to edit Master title style Click to edit Master text styles Second level Third level Fourth level Fifth level Initiating and Managing Change Learning Outcomes Explain why nurses have the opportunity to be change agents. Describe how different theorists explain change. Discuss how the change process is similar to the nursing process. Differentiate among change strategies. Learning Outcomes Discuss how to handle resistance to change. Describe the nurse s role in change. Change Change Is essential for adaptation and growth Is the process of making something different from what it was Is a continually unfolding process rather than an either/or event Change Change Can be threatening May cause a grief reaction even when planned Produces new opportunities Institute of Medicine Report (2010) Future of nursing Proposed radical changes, including Nurses should be full partners with physicians and other health care professionals in redesigning health care in the United States. Change Agents Change agents Work to bring about change Are role models for others Stimulate the need for change and help shape its success Nurse as Change Agent Nurses facilitate change Must be proactive in shaping the future Opportunities exist now for nurses, especially in management positions Lewin Driving forces versus restraining forces Three-step process Freezing Moving Refreezing Lippitt Expanded Lewin s theory to a seven-step process Focuses on what change agent must do Emphasizes importance of participation of key members for success Havelock Modified Lewin s theory to six-step process Describes active change agent Emphasizes participative approach Rogers The Change Process Same path as nursing process Assessment Planning Implementation Evaluation Table 5-2 Steps in the Change Process Assessment Identify the problem or the opportunity Ask the right questions Where are we now What is unique about us What can we do that is different What is the driving stimulus in our organization What prevents us from moving What kind of change is required Assessment Collect data Identify all driving and restraining forces Assess political climate Assess costs and benefits Analyze data Planning Determine who, how, and when Include organization/system members Plan resources required to make the change and establish feedback mechanisms Implementation Plans are put into action. Akin to Lewin s moving stage Methods to change individuals Methods to change groups Evaluation Evaluate effectiveness Stabilize the change Energizer role is still needed to reinforce Power-Coercive Strategies Based on the application of power by legitimate authority, economic sanctions, or political clout Useful when a consensus is unlikely despite efforts to stimulate participation Patient Protection and Affordable Care Act (PPACA) Revolves around knowledge Assumption is that people are rational and will follow their rational self-interest Assumption that people act in accordance with social norms and values Power Skill in interpersonal relationships Effective in reducing resistance, stimulating creativity Resistance to Change If no resistance, change may not be significant enough Forces changes agent to Clarify Keep interest high Establish reason for change Reasons for Resistance to Change Lack of trust Vested interest in status quo Fear of failure Loss of stature or income Misunderstanding Belief that change is unnecessary or that it will not improve the situation Six Responses to Change Innovators love change Early adopters still receptive to change Early majority prefer the status quo Late majority resistant, then accept Laggards openly antagonistic Rejecters actively oppose, may sabotage Managing Resistance to Change Talk to those who oppose the change. Clarify information. Be open to revisions. Present negative consequences of resistance. Emphasize positive consequences. Managing Resistance to Change Keep resisters involved Maintain climate of trust, support, confidence Divert attention Change not always initiated from top management level Staff nurses can initiate change Mandotory skill for nurses Cultivate and master characters of successful change agents Engage strategies for accessing power Nurses Role in Change Assist in other ways Planning Information sharing Managing the transition Change has become the norm