4131 Week 2

  1. Lewin's Rules for Change (Lewin, 1951)
    • 1. should be implemented only for good reason
    • 2. should always be planned and implemented gradually
    • 3. should never be unexpected or abrupt
    • 4. all people affected should be involved in planning for change
  2. Principles for Change (Grossman & Valiga, 2009): 11
    • 1. change in one part of a system affects other parts and other systems
    • 2. people affected by change should participate in making the change
    • 3. people should be informed
    • 4. concrete and specific feedback about the change process will enhance acceptance
  3. Principles for change part 2
    • 5. people need support in dealing with the effects of change
    • 6. contributions and suggestions should be encouraged from people
    • 7. change must be reinforced
    • 8. conflict can occur at any stage
  4. Principles for change part 3
    • 9. trust in change agent increases likelihood of support
    • 10. the more compatible new ideas are with one's values and needs, the more easily a change will be adopted
    • 11. one's past experience with change can profoundly affect one's willingness to support a new idea
  5. What do we need for successful change?
    • -means to identify that change is needed
    • -knowledge and method for planning and implementing change
    • -mechanisms to enhance participation
    • -ways to communicate change
    • -methods to evaluate change process, and also outcomes
    • -quality improvement strategies
  6. Strategic Planning (Cherry and Jacob, 2005)
    • -provide direction
    • -identify strategies to respond to changes (client need, health care direction, etc.)
    • -dedicate resources to priority services
    • -decrease duplication and waste
  7. Steps in Strategic Planning Process (similar to ADPIE or nusing process)
    • 1. Perform an environmental assessment
    • 2. Conduct a stakeholder analysis
    • 3. Review the literature for evidence and best practices
    • 4. Determine congruence w the organizational mission
    • 5. Identify planning goals and objective
  8. Steps in Strategic Planning Process part 2
    • 6. Estimate resources required for the plan
    • 7. Prioritize according to available resources
    • 8. Identify time lines and responsibilities
    • 9. Develop a communication plan
    • 10. Write and communicate the business or strategic plan
    • 11. Evaluate
  9. Strategic Planning (image 1)
    • Image Upload 1
    • Image Upload 2
  10. Mission Statement?
    • -Identifies why an organization exists (often identifies who the organization is and what it does)
    • -formal expression of purpose/reason
  11. Vision Statement?
    Articulates aim or function of the organizaiton; focuses on future outcomes
  12. Organizational Philosophy?
    Relates the values and beliefs that guide all actions of the organization
  13. Goals and Objectives
    The ends towards which an organization is working
  14. Goal
    Desired result towards which effort is directed; usually have multiple objective
  15. Objectives
    Identify how and when a goal is to be achieved (are explicit, measurable, observable and obtainable); focus on process or result
  16. SMART GOALS (Diem & Moyer, 2005): 5
    • 1. Specific: well defined and clear goals
    • 2. Measurable: can determine if change has occurred
    • 3. Appropriate: relevant for the situation
    • 4. Reasonable/Realistic: likely to occur (consider resources)
    • 5. Timed/Time-framed: established deadlines
  17. To identify time lines and responsibilities - use the GANTT Chart (timeline)
  18. PDSA
    • -First publised in '92 by Langley, Nolan et al.
    • -Provides a framework for developing, testing and implementing changes changes geared toward improvement
    • -Helps you make rapid change
    • -Model consists of 2 parts:
    • 1. "thinking part" - 3 fundamental questions essential for guiding improvement work
    • -what are we trying to accomplish?
    • -how will we know if a change is an improvement
    • -what changes can we make that will result in improvement?
    • 2. "doing part," made up of plan, do, study, act
  19. PDSA pic 1
    Image Upload 3
  20. PDSA pic 2
    Image Upload 4
  21. Steps in PDSA cycle: PLAN
    • -plan the test/observation, including plan for collecting
    • -state the objective of the test
    • -predict what may happen and why
  22. Steps in PDSA cycle: DO
    • Try out the test on a small scale
    • -carry out the test
    • -document problems and unexpected findings
    • -begin analysis of the data
  23. Steps in PDSA cycle: STUDY
    • Set aside time to analyze the data and study the results
    • -complete analysis of the data
    • -compare data to your predictions
    • -summarize and reflect on what was learned
  24. Steps in PDSA cycle: ACT
    • Refine the change based on what was learned from the test
    • -modify plan as required
    • -plan for the next change test
  25. The following slides according to Androwich O'Mally & Androwich, 2008
  26. Mission Statement
    • -formal expression of purpose/reason for existence of organiztation
    • -declaration of its primary driving force
  27. Philosophy of an organization
    • -embedded in mission statement
    • -known as a value statement of the principles and beliefs that direct the organization's behavior
  28. Vision
    • -provides clear picture of what future will look like for organization
    • -usually defines key results achieved and the goals that are sitll to be accomplished
    • -also describes key behaviors
  29. Values
    -boundaries organizations will have while pursuing its vision
  30. Strategic Planning
  31. Strategic Planning
    -sum total or outcome of the processes by which an organization engages in environmental analysis, goal formulation, and strategy development with the purpose of organizational growth and renewal
  32. Reengineering
    -fundamental rethinking and redesign of the process under review to bring about radical and dramatic improvements and increases in value
  33. Steps in strategic planning processes (similar to nursing process)
    1. Environmental assessment: requires a broad view of the organization's current environment

    • Swot Analysis: tool that's frequently used to conduc environmental assessments. Stands for:
    • Strengths
    • Weaknesses
    • Opportunities
    • Threats

    This identifies strengths and weaknesses in the internal environment and opportunities and threats in the external environment

    • 2. Community and stakeholder assessment
    • -Stakeholder: any person, group or organization with a vested intereset in the program or project under review
    • -Stakeholder assessment: systematic consideration of all potential stakeholders to ensure that the needs of each of these stakeholders are incorporated in the planning phase. When stakeholders aren't involved in the project planning, they don't gain a sense of ownership and may accept a program or strategic goals with only limited enthusiasm, or not at all

    • 3. Other methods of assessment
    • -surveys and questionnaires: large number
    • -focus groups and interviews: time consuming
    • -advisory panel: for large projects
    • -review of literature
  34. Organizational Structure (2)
    • -highly bureaucratic/authoritarian structure: well suited for military
    • -multidisciplanry group of professionals: can only participate in participative, democratic manner

    • Types:
    • 1. Matrix
    • 2. Flat vs tall structure
    • -flat: eg. nursing school that has no dept's and many faculty members report to one dean of nursing
    • 3. decentralized vs. centralized: refer to degree which an organization has spread its lines of authority, power, and communication
Card Set
4131 Week 2
Change Toolbox