Res App Team

Change Management

Nature of change

Lewin, Kotter, Bridges

• See also organizational cultural analysis and change articles for this week
• 2/8/20
• CHS 5300

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(Lewin, 1951) Change Model

• Unfreezing (Vision, Support, Positive Outlook & Modelling)

This can be done by providing information or examples of new ways of doing things or getting the job done or by raising everyone's awareness that the goal or goals of the organisation are not being met in some way and that a change is necessary to get back on track.

It is necessary to make those involved in the process feel secure and at ease with the proposed change or changes to reduce threats to the safety and security of those involved and reduce resistance to the proposed change.

During unfreezing, the process of developing an awareness to a need or problem is started and change is seen as the only solution.

Securing Individual & Group Level Change

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(Lewin, 1951) Change Model

• Unfreezing (Vision, Support, Positive Outlook & Modelling)
• The change agent needs to increase pressures toward the change and reduce threats associated with changing. According to Lewin, this is done through three mechanisms.

Disconfirmation: occurs when the change agent introduces evidence that a need is not being met. This can be done through meeting with the staff in small groups to discuss inadequacies or problems.

Inducing guilt or anxiety: can be accomplished by introducing a period of uncomfortableness about the way things are and how they are not meeting an important goal or value.

Creation of psychological safety: the third mechanism is important to provide sufficient security to minimise risk involved with the change. The change agent can provide time for discussion, involvement, education, supervision and approval to small advances toward the intended change.

Securing Individual & Group Level Change

Towards Safe Uncertainty!!

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(Lewin, 1951) Change Model

• Moving or Changing (Planning, Overcoming Resistance, Implementation, Open Communication & Support)
• This is the actual change or implementation phase of the change process. During the moving stage, the driving forces have overcome the restraining forces and the change moves ahead
• A new way of behaving or working is established as information and feedback is used to encourage group involvement and allow the participants to discuss and assimilate the change into their practice.
• The change is planned in detail and then implementation begins. Time must be allowed for support, group discussion, evaluation, and feedback to deal with resistance as it occurs. Open communication is important.

Securing Individual & Group Level Change

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(Lewin, 1951) Change Model

• Refreezing (Embedding the change into the artefacts values, beliefs and behaviours of the client system as the basis of cultural regeneration/reinvention)
• During Refreezing, the change has been implemented and needs to be stabilised.
• The organisation (client system) must return to its normal level of functioning and the change consolidated into the regular operations of the organisation.
• The change becomes integrated into the whole organisation as part of its routine functioning.
• The change agent must provide guidance and support to ensure that the change will be maintained.
• The change agent needs to reduce participation in the functioning of the change and delegate responsibility for the continuance of the change.
• The integration of the change allows the change process to end and the participants (client system) to take on the responsibility for the continuance of operations.
• Refreezing takes place as the group has moved to a new equilibrium of the driving and restraining forces with the change functioning in place.

Securing Individual & Group Level Change

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Kotter J P, 1980, 1995 n-stage model

• Establish a sense of urgency
• Examine the organisation's operating environment for change factors and competitive realities
• Identify and discuss crises, or major opportunities
• Form a powerful enough guiding coalition
• Assemble a group with enough power to lead the change effort
• Encourage the group to work better as a team
• Create a vision
• Use every vehicle possible to communicate the new vision and strategies
• Teach new behaviours by the example of the guiding coalition
• Empower others to act on vision
• Get rid of obstacles to change
• Change system structures that seriously undermine the vision
• Encourage risk taking and non-traditional ideas, activities and actions

Securing Individual & Group Level Change

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Kotter J P, 1980, 1995 n-stage model

• Plan for and create short-term wins
• Plan for visible performance improvements
• Create those improvements
• Recognise and reward employees involved in the improvements
• Consolidate improvements and produce still more changes
• Use increased credibility to change systems, structures, and policies that don't fit the vision
• Hire, promote and develop employees, who can implement the vision
• Reinvigorate the process with new projects, themes, and change agents
• Institutionalise new approaches ie stabilise the change
• Articulate the connections between the new behaviours and corporate success
• Develop the means to ensure leadership development and succession

Securing Individual & Group Level Change

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Kotter & Schlesinger (1985) Methods for dealing with resistance to change?

Securing Individual & Group Level Change

…/CTD

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Bridges

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TRANSITION ZONE

• Inner psychological process that people go through as they internalize and come to terms with the new situation that the change brings about.
• Starting point for dealing with transition is not the outcome but the endings that people have in leaving the old situation behind.
• Getting people through transition is essential if the change is actually to work as planned

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ENDINGS

• Transition starts with an ending. paradoxical but true.
• first phase of transition begins when people identify what they are losing and learn how to manage these losses.
• They determine what is over and being left behind, and what they will keep. May include relationships, processes, team members or locations.

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NEUTRAL ZONE

• The second step comes after letting go: People go through an in-between time -the old is gone but the new isn’t fully operational.
• critical psychological realignments and repatternings take place
• Very core of the transition process. Time between the old reality and sense of identity and the new one. Create new processes and learning what the new roles will be, but it’s in flux and doesn’t feel comfortable yet. It is the seedbed of the new beginnings that are sought.

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NEW BEGINNINGS ZONE

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References

• Argyris, C. 1992. On organizational Learning. Oxford: Blackwell
• Argyris, C. and Schön, D. 1978. organizational Learning: a Theory of Action Perspective. Reading, Mass: Addison-Wesley
• Argyris, C. and Schön, D. 1996. organizational Learning II: Theory, Method and Practice. Reading, Mass: Addison-Wesley
• Beckhard, R. and Harris, R. 1987. organizational Transitions: Managing Complex Change. Wokingham: Addison-Wesley
• Bennis W, Beene K & Chin R, 1985, The Planning of Change (4Ed) cited in White K M, 1998, Chapter 13 – Planned Change in Rocchicciolo J T & Tilbury M S, 1998, Clinical Leadership in Nursing, W B Saunders, London
• Broome A, Managing Change (2nd ed.), 1998, Macmillan, London
• Bushy A & Kamphuis J, 1993, Response to innovation: Behavioural Patterns, Nursing Management, 24(3), 62-64
• Duck J D, 1993, Managing Change: The Art of Balancing, Harvard Business review, Nov/Dec, pp.109-118

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References

• Iles V & Sutherland K, 2001, Managing Change in the NHS: organizational Change – a review for health care managers, professionals and researchers, London: National Coordinating Centre fro NHS Service Delivery and organizational R & D (NCC/SDO)
• Kotter J P & Schlesinger L A, 1979, Choosing Strategies for change, Harvard Business Review, March-April, pp. 106-113
• Kotter J P, 1995, Why Transformation Efforts Fail, Harvard Business Review, March-April, pp. 59-68
• Lamb M C & Cox M A, 1999, Implementing Change in the National Health Service, Journal of Management in Medicine, 13 (5,) pp. 288-297
• Lewin K, 1951, Field Theory in Social Sciences, Harper Row, New York in Marquis B L & Huston C J, 2000, Leadership Roles and Management Functions in Nursing, Lippincott, New York
• Lippitt T, Watson J, Westley B, 1958, The Dynamics of Planned Change, New York, Harcourte-Brace in Rocchicciolo J T & Tilbury M S, 1998, Clinical Leadership in Nursing, W B Saunders, London
• Mabey C & Mayon-White B (Eds), 1993, Managing Change, Open University Press
• Perlman D & Takacs G J, 1990, The ten stages of change, Nursing Management, 21(4), pp.33-38

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References

• Proehl R A, 2001, organizational Change in the Human Services, London: Sage Publications
• Rea C, 1993, Managing Clinical Directorates, Churchill- Livingstone, London
• Rocchicciolo J T & Tilbury M S, 1998, Clinical Leadership in Nursing, W B Saunders, London
• Rogers E, 1983, Diffusions of Innovations (3rd Edition), New York, Free Press in Rocchicciolo J T & Tilbury M S, 1998, Clinical Leadership in Nursing, W B Saunders, London
• Senior B, organizational Change, 1997, Pearson Educational, Harlow, England
• Upton T & Brooks B, 1999, Managing Change in the NHS, Open University Press
• Weisbord, M. 1976. organizational diagnosis: six places to look with or without a theory. Group and organizational Studies 1: 430-47
• White K M, 1998, Chapter 13 – Planned Change in Rocchicciolo J T & Tilbury M S, 1998, Clinical Leadership in Nursing, W B Saunders, London
• Yoder-Wise P, 1999, Leading and Managing in Nursing, Mosby, St Louis, Missouri
• Yukl G, 1998, Leadership in Organisations (4Ed), Prentice Hall, New Jersey
• Ywe L & McClenahan T, 2000, Getting better with evidence, experience of putting evidence into practice, London: Kings Fund