Change theories healthcare resources

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Moving to digital medical records has required many healthcare organizations to rework their entire medical records systems, but it also equips them for the future, increasing productivity and efficiency.

Technology adoption and change management in healthcare are fraught with similar challenges to technology adoption in any other industry. But in many ways, healthcare staff face more complex challenges to successful digital adoption than other industries.

Healthcare staff needs to understand the drawbacks as well as the benefits of any technology adoption. Suppose the team is given training before and during technology adoption. In that case, staff can help reduce losses, and when staff feels more confident with technology, they will be more open to embracing future technology adoption.

Staff is often motivated by opportunities or threats. One way to reduce resistance is to promote the opportunities of technology rather than its potential threats. In healthcare settings, there are several ways to communicate these benefits. EMRs are more easily shared, and patient history is more straightforward for clerical and medical staff to move from one healthcare setting to the next.

Additionally, convenience and efficiency are improved, leading to improved quality of care. Although managing change is more complex and challenging in health care than in other industries, the process is made more accessible and effective by choosing the most suitable change management methods.

In healthcare, leading change successfully is frequently achieved via change management methods, including According to research in conducted by Harrison et al. The other two models have been included for balance against more soft, person-centered approaches, as this is a large part of healthcare practice. Part of their value to healthcare is that some of these included models, such as the ADKAR model, focus less on tasks and do not make staff implement changes before they can understand them.

The ADKAR model focuses more on human psychology, helping staff to understand the need for change to support healthcare change management, making it more suitable and effective in healthcare organizations.

It helps manage change within short-term, intensive change initiatives due to the aggressive top-down approach to achieving change through three stages. The preparation stage. Look at how things operate to see the resources needed for the desired results.

Communication is essential in this phase, as healthcare staff must be aware of what changes need to happen to prepare them for the subsequent steps. The implementation stage. Project leaders set changes into motion, and communication is again of very high significance as change is a complex process to handle for team members. Support must be available via communication channels at this critical phase. Implement required skills of staff needed for change to take place.

The refreeze stage is part of an ongoing process to achieve success. This stage involves developing a strategy to ensure change sticks. Analyze the effect of the new changes and measure how close you are to achieving goals set at the unfreeze phase. Healthcare managers and change leadership should use this theory alongside a softer model for longer-term change management strategies. Leaders must bear in mind that without a softer model monitoring employee experience to some level alongside the Lewin Model, adverse effects on employee retention and performance may occur due to burnout.

This model supports change leaders with implementing change initiatives in healthcare organizations as it is task-oriented, and healthcare organizations are often driven by completing tasks to a schedule. The model includes eight steps:. Motivate the team by creating an environment filled with a sense of urgency. Build a guiding coalition, including all the right staff to plan, coordinate and carry out the change.

Establish a clear vision and each accompanying change initiative. Break goals into bite-size chunks and communicate successes little and often. Maintain momentum, and push harder after every successful implementation. The sense of urgency for short-term wins could lead to high rates of staff burnout.

Something healthcare staff are already at risk of before the change leader implements a change plan. Over a few months, short-period change management strategies in health care work well with this model.

One example could be a move to paperless patient onboarding in an ER unit, which is a high-pressure, task-oriented environment. Although burnout due to this change could potentially be high, staff may be more pragmatic and see improvements quickly, reducing staff stress and increasing patient care quality over the time taken to implement the change.

Paperless onboarding would primarily involve getting used to new technology and simple employee training , and the sense of urgency, the first step of the model, is innate in ER staff due to the nature of the work.

ADKAR Awareness, Desire, Knowledge, Ability, Reinforcement analysis is vastly different from the first two models as it focuses on understanding the emotions and thoughts of the people affected by the change. In healthcare, many stakeholders are affected by changes with different ways of gaining or losing. There are five steps to achieving an ADKAR analysis; the first is creating awareness for healthcare staff.

Show healthcare staff what changes are necessary and why. Detail is needed when explaining changes, and change leaders should define training schedules. Face-to-face announcements and training are preferred so staff can ask questions to enable them to participate early in the process. Create a desire to be supportive of the change to create an environment in which employee engagement increases so much that attitudes toward change become positive organically. Ensure adequate support is available for employees.

Training, coaching, and checklists provided by the business are some types of support. Ensure employees, relatives, and patients can give feedback about their change journey.

Leaders of change, such as project leaders or healthcare managers, record and action this to provide the best opportunity for learning and development. At this point, the change leader can make further adjustments to the plan based on the feedback. Use rewards and cash or holiday incentives to employees and other means such as championing staff who embody shared values.

Also, HR could implement an internal advertising campaign to remind everyone that the change leader adjusted the plan based on their feedback. These actions ensure the new status quo is maintained for ongoing performance improvement. Of all the change management tools in this list, the ADKAR model is the model most focused on human experience and supporting staff to engage with new ways of fulfilling their role naturally. For this reason, the ADKAR model can be effective for long-term change strategies within large or small teams.

It can be beneficial in healthcare environments due to the many stakeholders of different professions with competing goals. The ADKAR model is great for many healthcare contexts but particularly for departments caring for high vulnerability patients needing sensitive communication with patients and relatives, like an intensive care unit.

Staff in such care environments can hold more specialized skills than in other departments. The ADKAR change management model can support the change with constant feedback and communication to ensure that changes do not negatively impact care.

Developed by William Bridges over thirty years ago, the Bridges transition model focuses on the human experience of processing and acting on change. This model is softer, more philosophical, and more human-oriented than some of the other models and is formed of three basic principles Although it sounds somewhat philosophical, every ending is also a beginning.

This point forms the first phase of the Bridges transition model. This phase represents the human act of accepting and managing loss.

Within this stage, staff lose some things to a change management strategy and keep others. Managers strengthen professional relationships and increase communication by outwardly acknowledging this. Once the loss is accepted comes the next phase: the neutral zone. This zone is when the strategy has ensured the old culture is out, but the new culture is not in force. This stage is the most critical stage of the transition period when staff is changing their deeply embedded beliefs and routines for completing tasks and what values they hold.

Significant concepts such as identity and sense of reality are confronted in this stage and re-aligned. New ways of understanding things, new values, and new attitudes all contribute to forming a sense of the new status quo, cementing changes as part of a transformation strategy.

When change is well managed, staff members feel liberated and empowered as they begin to understand and act on their new role within a new system.

For some companies, change models such as the bridges transition model will help them to understand the employee experience of processing change. Understanding the employee experience of change is powerful in healthcare to reduce resistance to change because there are many different levels of staff with different specialisms who are empowered to complete tasks a certain way. Engaging with this hierarchy of specialisms is easier with the Bridges transition model as it encourages understanding staff mentalities.

However, using the Bridges transition model with a more task-oriented model can help establish leadership in health care environments and the need to reach specific change goals. A change leader is a senior staff member, often a healthcare manager, who becomes a change agent. A change agent is a staff member who begins the change process and often goes on to coordinate changes as a change leader. The essential attributes of a change leader are that they have a deep understanding of their current healthcare organization culture and communicate with staff effectively to implement change using the appropriate change model.

The leadership style of the change leader is an essential means of ensuring the best communication is possible and that the communication style fits with the change management model. The five leadership styles can be used for various reasons by a change leader in healthcare in many other applications.

The five leadership styles are below. I give a task; you do it. This premise is behind the authoritarian leadership style, with no dialogue between the change leader and the team. In this style, change leaders take on the role of a visible authority figure. This style is excellent when the change leader has superior knowledge on a topic compared to the rest of the team, and there are strict time constraints for change projects.

Debate in this journal has highlighted the risks associated with the changing political discourse away from health promotion de Leeuw, There is an imperative, therefore, to demonstrate the health, social and economic benefits that arise from organizational capacity building in health promotion.

If culture is formed through repeated experiences of success or failure, it would be disastrous if over time shared assumptions among policy entrepreneurs shifted, because they were unable to see how health promotion can bring about lasting change.

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It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Journal Article. Organizational change theory: implications for health promotion practice. E-mail: dimitri. Oxford Academic. Cameron Duff. Ben J. Select Format Select format.

Permissions Icon Permissions. Abstract Sophisticated understandings of organizational dynamics and processes of organizational change are crucial for the development and success of health promotion initiatives. Table 1: Summary of key perspectives on organizational change. Explanatory factors. Change strategy. As such causal relations can be analyzed. Change initiatives need to destabilize the status quo, implement the alternative and restabilize the environment.

The implementation process involves research and performs a learning function. Create the appropriate conditions for sustained change to occur through a group process of trial and error until an appropriate fit is found. Everett Rogers Messages about new ideas are communicated within an organization and this brings about uncertainty. An organization's propensity for innovation relates to structural factors within the organization, characteristics of individuals and external factors in the environment.

Innovations follow a sequential course within organizations, and attention to each stage is required for an innovation can fail before it has begun to diffuse. Organizational environments with a propensity towards defending existing norms have different capacity for learning and growth compared with organizational environments that are open and reflective.

Edgar Schein Culture can be observed and studied through the behaviour of groups and their beliefs, values and assumptions. The culture of the organization determines its actions. Culture is formed over time through shared experiences within groups. To embed a change it needs to become cultural. Repeated experiences of success or failure for a group undertaking an action will lead to them forming an assumption about the value of that action.

Values, beliefs and behaviours in support of that action indicate that it has become part of the culture of the group. Andrew Pettigrew, Ewan Ferlie and Lorna Mckee The degree to which a public sector institution is amenable to change depends on a combination of variables that are associated with the process and setting for change. These include quality and coherence of policy, availability of key people leading change, long-term environmental pressure, supportive organizational culture, effective managerial-clinical relations, cooperative inter-organizational networks, simplicity and clarity of goals and priorities, and fit between the district's change agenda and its locale.

Use the variables identified as part of a criteria for selecting settings that are likely to be receptive to change, and within those settings identify and manipulate the variables that are not static. Open in new tab. Size Size of the organization is related to propensity for innovation, generally the larger the organization the more innovative. Centralization Centralization in an organization involves the concentration of power to a few individuals; this has a negative effect on how innovative an organization is.

However, centralization can encourage the implementation of an innovation once a decision has been made to adopt. Complexity Complexity is the degree to which an organization's team members have a range of specialties and high level of knowledge and expertise. This is positive for the valuing of innovations, but consensus about implementation can become a challenge with complexity. Formalization Formalization through rules and procedures makes an organization bureaucratic; this acts as an inhibitor for organizations to consider innovations but encourages the implementation.

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