Differentiate among change strategies.
INITIATING AND MANAGING CHANGE 57
they must be proactive in shaping the future. Opportunities exist now for nurses, especially those in management positions, to change the system about which they so often complain.
Change Theories Because change occurs within the context of human behavior, understanding how change does (or doesn’t) occur is helpful in learning how to initiate or manage change. Five theories explain the change process from a social–psychological viewpoint. See Table 5-1 for a comparison.
Lewin (1951) proposes a force-field model, shown in Figure 5-1. He sees behavior as a dynamic balance of forces working in opposing directions within a field (such as an organiza- tion). Driving forces facilitate change because they push participants in the desired direction. Restraining forces impede change because they push participants in the opposite direction.
To plan change, one must analyze these forces and shift the balance in the direction of change through a three-step process: unfreezing, moving, and refreezing. Change occurs by add- ing a new force, changing the direction of a force, or changing the magnitude of any one force. Basically, strategies for change are aimed at increasing driving forces, decreasing restraining forces, or both. The image of people’s attitudes thawing and then refreezing is conceptually use- ful. This symbolism helps to keep theory and reality in mind simultaneously.
Lippitt and colleagues (1958) extended Lewin’s theory to a seven-step process and focused more on what the change agent must do than on the evolution of change itself. (See Table 5-1.) They emphasized participation of key members of the target system throughout the change pro- cess, particularly during planning. Communication skills, rapport building, and problem-solving strategies underlie their phases.
Havelock (1973) described a six-step process, also a modification of Lewin’s model. Have- lock describes an active change agent as one who uses a participative approach.
Rogers (2003) takes a broader approach than Lewin, Lippitt, or Havelock (see Table 5-1). His five-step innovation–decision process details how an individual or decision-making unit
Figure 5-1 • Lewin’s force-field model of change. Adapted from Resolving Social Conflicts and Field Theory in Social Science by K. Lewin. Copyright © 1997, by the American Psychological Association. Adapted with permission.
Restraining forces
Driving forces
Example:
Fear of job loss
Nurse manager lacks change agent skills
Entrenched director of
nurses
Present (status quo)
Force will be toward change
Budget in red (financial incentive
to change)
Administration mandates the
change
Interested vice-president
Need new solution (old one doesn’t work)
Some long-term employees
resist change
Almost complete turnover of staff
(many new nurses)
Restraining forces
Driving forces
(unfreezing) (Refreezing)
New equilibrium
MovingPresent equilibrium (status quo)
Restraining forces