Sunday, November 24, 2013

Identifying a Problem and Managing Change in Nursing through the use of Lewin's Change Theory

Problem
A problem that has been identified as needing changed is low attendance at unit staff meetings.  Low staff attendance at unit meetings hinders communication of unit changes and recommendation.  Inadequate communication between staff and management negatively affects the ability to achieve the goals of the organization and promote optimum patient outcomes.
Advantages/Disadvantages of Change
There are many advantages to staff attendance of meetings.  Rapport is developed and improved between staff and management when communication is promoted.  Staff would have an increased awareness of changes taking place in the department by attending meetings.  Staff must be aware of changes taking place in order to remain compliant. 
The disadvantages of increased attendance at staff meetings are related to staff perception and attitudes towards attendance.  If the staff views meetings as an inconvenience or waste of time, they perceive they are being “forced” to attend.  If staff has a negative connotation regarding meeting attendance, they will not be receptive to the information offered.  In order to avoid the disadvantages of increased attendance, the staff must view the meetings as important and informative.  Staff must view the meetings as having a positive influence on their nursing practice.       
Change Theory
Lewin’s Change Process will be used to address and change to problem of low attendance at unit staff meetings.  Lewin suggested three elements for successful change and promoted increased understanding about how groups and organizations change (Huber, 2010, p.59).  This method was chosen due to the emphasis placed on the idea that no single intervention is suited to all situations (McGarry, Cashin, and Fowler, 2012).  The plans for change and methods to achieve change are individualized and based upon the group dynamics of the staff undergoing change.  Behaviors related to and barriers to overcome to achieve change are explored and understood in order to develop an individualized change plan. 
Outline a Plan for Change
The outlined plan is based on the three step model of change developed by Lewin: unfreezing, moving, and refreezing.  The change process begins with unfreezing.  Unfreezing would take place by motivating staff and assessing readiness for change.  The staff would explore the problem of meeting attendance and work to generate solutions.  Those involved in the change must understand and accept the necessity of change (Huber, 2010, p.60).  Management would provide current meeting attendance percentages and offer education to staff related to benefits of increased meeting attendance.
In order for the staff to feel motivating to make change, conditions must be created to promote new behaviors.  Management would promote change by supporting staff and allowing for input to identify barriers to the ability to attend meetings.  The behavior of low attendance at meetings can only be unlearnt if the staff is willing to challenge the existing problem.  Fears and opinions related to mandating an increased attendance rate would be explored.  Resistance to change is overcome by understanding and counteracting barriers and anxiety related to the change (McGarry et al., 2012, p.66). 
Moving is the next step of the change process.  Moving occurs when the staff moves to a new level of behavior.  The process of moving requires trial and error.  In order for the change to occur on the individual and group level, the expectation of meeting attendance must be specific and accepted by the staff (McGarry et al., 2012, p.66).  Management and staff would agree upon a required number of meetings that must be attended annually.  Management would also encourage staff input related to barriers of meeting attendance.  In the refreezing phase, management would make changes to overcome meeting attendance barriers.  Visible increases in meeting attendance would occur as a result of the change being planned and initiated (Huber, 2010, p.60).     
Refreezing is the final step of Lewin’s model of change.  The new changes are integrated and stabilized during refreezing.  Equilibrium of the environment and behaviors is re-established during this stage.  Adjustment to change must be achieved at the group level for the change to be sustained (McGarry et al., 2012, p.267).  The manager plays a vital role in the refreezing stage.  Reinforcement of behaviors is crucial.  Leaders must provide positive feedback, encouragement, and constructive criticism (Huber, 2010, p.60).  Monitoring attendance and discussing positive outcomes related to increased attendance with staff encourages open communication between management and staff related to change behaviors.      
Anticipate Reactions
Staff support and feedback from nursing leadership is necessary for the long term success of increased staff attendance at meetings.  Staff may react negatively to the change of mandating increased meeting attendance.  By including frontline staff in the change process, management would increase staff buy-in.  If staff remains unhappy and views meeting attendance as an inconvenience, management would encourage open communication and suggestions for overcoming barriers.  Allowing staff input on meeting day/times/length of meetings would encourage effective change implementation. 
Lewin’s model of change is a fluid process.  Change results from trial and error.  It requires staff support.  The manager’s role in change is to offer constant education, motivation, enthusiasm, and team building (Huber, 2010, p.60).  In order for change to be effective and sustained, the staff must view the change as congruent with their values. 

References

McGarry D Cashin A Fowler C 2012 Child and adolescent psychiatric nursing and the 'plastic man': Reflections on the implementation of change drawing insights from Lewin's theory of planned change.McGarry, D., Cashin, A., & Fowler, C. (2012). Child and adolescent psychiatric nursing and the 'plastic man': Reflections on the implementation of change drawing insights from Lewin's theory of planned change. Contemporary Nurse: A Journal for the Australian Nursing Profession, 41(2), 263-270.  2013111711450872676897

No comments:

Post a Comment