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Change Theories

Author: Sophia

what's covered
This lesson will cover two theories related to change in the healthcare environment. Specifically, it will cover:
  1. Kotter’s Change Model
  2. Institute for Healthcare Improvement (IHI) Psychology of Change Framework
  3. Reflect

1. Kotter’s Change Model

Professional literature is full of change theories. For the purposes of this course, two will be discussed in detail. The first theory is Kotter’s Change Model. Although not frequently used as a framework for nursing or healthcare-related change initiatives, Kotter’s change model:

  • Has demonstrated effectiveness as it is clear and easy to apply to practice
  • Uses graphics that staff nurses can understand
  • Is clear and easy to apply
  • Presents a structure to address system change designed to address patient safety-related issues (Small, Gist, Souza, Dalton, Magny-Normilus, & David, 2016; Beverly, 2016; Aziz, 2017)
Kotter’s Model (2012) consists of eight steps. These steps are:

step by step
  1. Create urgency
  2. Form a positive coalition
  3. Create a vision for change
  4. Communicating the vision
  5. Empower action
  6. Create quick wins
  7. Build on the change and don’t let up
  8. Make the change stick

8 Step Kotter Model of Change

8 Step Kotter Model of Change


2. IHI Psychology of Change Framework

The other change theory is IHI Psychology of Change Framework, which consists of five interrelated domains of practice that can be used by organizations to promote and sustain change (Hilton & Anderson, 2018). These domains are:

  • Unleash Intrinsic Motivation
  • Co-Design People-Driven Change
  • Co-Produce in Authentic Relationship
  • Distribute Power
  • Adapt in Action
According to the authors, the domains can be used in any order. The key to success in using this model (Figure 1) is to tap into the power of people (Hilton & Anderson, 2018).

IHI Psychology of Change Framework

IHI Psychology of Change Framework

Figure 1. IHI Psychology of Change Framework. By Hilton K, & Anderson A, 2018. Copyright 2018 by Institute for Healthcare Improvement.

big idea
Both Kotter and IHI’s models recognize the need to overcome resistance to change, drive action by creating a sense of urgency for the change, engage people in the change-related activities, measure and monitor progress and sustain the change by focusing on its impact. Data is important to all aspects of these change frameworks.

Video Transcript


3. Reflect

As a nurse manager, you have been tasked with implementing a new shift-to-shift hand-off communication process.

reflect
Using either Kotter’s Change Model or the IHI Psychology of Change Framework as a foundation for your project, describe your plan to initiate, implement, and evaluate the hand-off communication process.

hint
Please consider using data to create a sense of urgency. Remember you have a variety of sources to gather data. Talk about how you will engage your staff in the plan, and how you will evaluate the success of the implementation.

Authored by Anne E. Lara, Ed. D., MS, RN, CPHQ, CPHRM


Support

If you are struggling with a concept or terminology in the course, you may contact NurseLeaderSupport@capella.edu for assistance.

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