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Manager’s Checklist The nurse manager is responsible for: ● Communicating openly and honestly with employees who oppose change. ● Understanding resistance to change. ● Maintaining support and confidence in staff even if they are resistive to change. ● Emphasizing the positive outcomes from initiating change. ● Finding solutions to problems that are obstacles to change. […]

To access optimum power, use the following strategies: 1. Analyze the organizational chart. Know the formal lines of authority. Identify informal lines as well. 2. Identify key persons who will be affected by the change. Pay attention to those immedi- ately above and below the point of change. CHAPTER 5 • INITIATING AND MANAGING CHANGE

The manager, as well, may resist leading change. Afraid of “rocking the boat,” fearful that no one will join our efforts, recalling that past efforts at change had failed, or even the reluctance to become involved may prevent the nurse from initiating change. Making change is not easy, but it is a mandatory skill for

Maintain a climate of trust, support, and confidence. To manage resistance, use the following guidelines: 1. Talk to those who oppose the change. Get to the root of their reasons for opposition. 2. Clarify information, and provide accurate feedback. 3. Be open to revisions but clear about what must remain. 4. Present the negative consequences

Clarify information, and provide accurate feedback. Managers need to plan the resources required to make the change and establish feedback mechanisms to evaluate its progress and success. Establish control points with people who will provide the feedback and work with these people to set specific goals with time frames. Develop operational indicators that signal success

What will be the target system for the change? Planning Planning the who, how, and when of the change is a key step. What will be the target system for the change? Members from this system should be active participants in the planning stage. The more involved they are at this point, the less resistance

 Identify the problem or opportunity. TABLE 5-2 Steps in the Change Process 1. Identify the problem or opportunity. 2. Collect necessary data and information. 3. Select and analyze data. 4. Develop a plan for change, including time frame and resources. 5. Identify supporters or opposers. 6. Build a coalition of supporters. 7. Help people prepare

Who will gain from this change? Collect Data Once the problem or opportunity has been clearly defined, the change agent collects data external and internal to the system. This step is crucial to the eventual success of the planned change. All driving and restraining forces are identified so the driving forces can be emphasized and

What can we do that is different from and better than what our competitors do? \Start by asking the right questions, such as: 1. Where are we now? What is unique about us? What should our business be? 2. What can we do that is different from and better than what our competitors do? 3.

Comparison of Change Models Lewin Lippitt Havelock Rogers Prochaska & DiClemente 1. Unfreezing 1. Diagnose problem 1. Building a relationship 1. Knowledge 1. Precontemplation 2. Moving 2. Assess motivation 2. Diagnosing the problem 2. Persuasion 2. Contemplation 3. Refreezing 3. Assess change agent’s motivations and resources 3. Acquiring resources 4. Choosing the solution 3. Decision