PLANNING FOR CHANGE IS

PLANNING TO SUCCEED

-BRET T BLUMENTHAL
 SEMINAR ON-
PLANING FOR CHANGE

MODERATOR- PRESENTED BY-

MISS. PRIYANKA MALHOTRA AARTI
NURSING TUTOR M.Sc. NURSING
COLLEGE OF NURSING 2nd YEAR
AIIMS,RISHIKESH ROLL NO. -1
INTRODUCTION

 Austin and Currie (2003) and McLean (2011)

described two aspects of altering practice:

Change Transition
CHANGE TRANSITION

 Change is a continual  Transition describes what

unfolding process rather people feel, experience
than an either/ or event. and see as important
The process begins with
the present state, moves
through the transition
period, and ultimately
comes to a desired state.
PHASES OF CHANGE PROCESS :
 There are four phases of change process-
Deciding
Identifying a
Suggesting
problem by grasping
priorities
solution
Deciding
Identifying
the and
ina an
whole situation
Suggesting
acceptable
solutions:
problem
in way:
by grasping
the ward:
priorities
solution and
in an
the whole situation
acceptable
the ward: way:
solutions:
in

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MEANING

 Planned change involves a deliberate and

conscious set of carefully orchestrated actions
that will result in a better product, work
environment, service, and other factors affecting
an organization.
DEFINITION OF PLANNED CHANGE

 "The deliberate design and implementation of a

structural innovation, a new policy or goal, or an
overt change in operating philosophy, climate,
and style is called a planned change".

-Thomas and Bennis, 1972

 FUNCTIONS OF PLANNED CHANGE

Solve organizational
problems
Improve performance
Learning from experiences
(benchmarking)
Influence future
Reframe shared changes
perceptions

Adapt to external
environmental changes
 Planned change attempts at all aspects of the
organization which are closely interrelated;

TECHNO
TASK
LOGY

STRUCT
PEOPLE
URE
 TECHNOLOGY TASK

 Changing problem  High internal work

solving & decision motivation
making procedures  High quality work
 Introduction of
performance
automated data
processing devices
 STRUCTURE PEOPLE

 Changing the no. of  These changes may

hierarchical levels
be of two types; i.e.,
 Changing one form of
skills & behavior.
organization to another
form
 Changing span of
management
 Changing line staff &
functional authority
CHANGE AGENT

 A change agent is a person who seeks to cause

or create change. This person may originate the
ideas for change or may be an individual who
recognizes the value of new ideas originated by
others
Change Agent Strategies (Bennis et al,
1969):

Normative–
Rational– Power–
reeducative
empirical coercive
 Lewin (1951) identified several rules that should be
followed in implementing planned change:
1.Implemented only for good reason.
2.Always be gradual.
3.Should be planned, and not sporadic or sudden.
4.All individuals who may be affected by the change
should be involved in planning for the change.
THEORIES OF PLANNED CHANGE:

Lewins’
Change
Model

Action
research Positive
Model Model
I. Lewins’ Change Model
 Kurt Lewin provided the earliest model of
change.
 Change as a modification of forces keeping the

systems behavior stable.

 There are three phases:

UNFREEZING

MOVEMENT

REFREEZING
UNFREE Occurs when the change agent convinces
●
●

members of the group to change or when

ZING guilt, anxiety, or concern can be elicited.

MOVEM The change agent identifies, plans, and

●
●

implements appropriate strategies, ensuring

ENT that driving forces exceed restraining forces.

REFREE ●
● The change agent assists in stabilizing the
system change and she is being supportive,

ZING helping people to adapt to change.

Kurt Lewin’s process model for organizational
change: The role of leadership and employee
involvement: A critical review

 Findings:
 Leadership style and employee involvement in

change is encouraging step for change process of

organization.
 This study illustrates the effect of leadership style

in terms of employee involvement in change,

motivating employee for change, share the
knowledge at individual and organizational level to
make the loop of the change process
 At each phase of the process model, the leaders
and employees are considered to be one unit, and
each phase will be shifted to the next step of the
Kurt model.

Hussain, S. T., et al.JIK. 2016;26:6

II.ACTION RESEARCH MODEL

 Planned changed as a cyclical process.

 It is aimed at:
–Helping specific organizations implement
planned change
–Developing general knowledge that can be
applied to other settings.
Problem identification Joint diagnosis

Consultation wth behavioural scientist Joint action planning

Data gathering and preliminary diagnosis Action

Feedback to the client Data gathering after action

An Action Research Model for the Management
of Change in Continuing Professional Distance
Education
 Purpose : The model proposed emerged from the need
to manage a complex change process from traditional
paper-based distance education to e-learning . It
describes and discusses such a change process in a
CPDE Masters programme.
 The Educational Management Action Research (EMAR)
model conjugates pedagogical thinking, curriculum
design and organizational context.
 Spiral of Action Research Cycles (Coghlan and Brannick,
2001:19)
 Its usefulness was of such crucial importance, that the
team is now using EMAR as a management tool, in
order to address the continuing needs for persistent
change in e-Learning and IT.

Baptista M, Pherson M.ITALICS.2015;2(1):1-6

III. POSITIVE MODEL

 Focuses on positive dynamics in organizations

that give rise to extraordinary outcomes
• AI- appreciative inquiry reformist and rebellious
form of social constructionism
 Promoted broad member involvement creating a
shared vision about the organizations’ positive
potential
Discover
Initiate
preferred
best the
future
practices
inquiry
themes
Inquire
Envision ainto
preferred
best practices
inquiry future
themes

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n
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d
d
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iv
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w
a
ys
to
cr
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tu
re
FORCES LEADING TO PLANNED
CHANGE

●
E.g: insurance agencies,
External forces government, consumer, new
technology etc

E.g: strategies for success formulated

●

Internal forces by top management, decision to

purchase new technology
TYPES OF PLANNED CHANGE

 Policy planning: Focuses on changing the

value system or laws and regulations.
 Strategic planning: Applies when an
organization considers longer range issues and
goals.
 Project planning : Focuses on operational

matters in the organization.

STEPS OF PLANNED CHANGE
1. Determining the change agent

2.Develop
2.Develop a
a trusting
trusting relationship
relationship with
with those
those who
who are
are involved
involved in
in the
the change
change
through open communication:
through open communication:

3.Participation and involvement

4.Provision of resources

5.Other approaches
OTHER APPROACHES

NEGOTIAT
ION

COOPE COERCI
RATION ON
FACTORS RESPONSIBLE FOR SLOW
PACE OF INNOVATION ADOPTION

FACTORS
●
● Characteristic
Characteristic of
of the
the
innovation
innovation
● Characteristics of the
●
Characteristics of the
innovation
innovation adopters
adopters
● Contextual factors
Contextual factors
●
Actions to avoid during planned
change:
 Simply announce a change without laying the
foundation
 Ignore or offend powerful people
 Violate the authority and communication lines in an
organization
 Rely only on formal authority
 Overestimate your formal authority
 Organizational change in hospitals: a
qualitative case-study of staff perspectives
 Results
 Some staff expressed apprehension and held negative
expectations regarding the organizational change.
 Concerns included inadequate staffing and potential for
collaboration breakdown due to new layout of workspaces.
 These fears were compounded by current experiences of
feeling uninformed about the change, as well as feelings of
being fatigued and under-staffed in the constantly changing
hospital environment.
 Nevertheless, balancing this, many staff reported positive
expectations regarding the benefits to patients of the change
and the potential for staff to adapt in the face of this change.
 Conclusions
 Throughout the processes of organizational change, such
as a hospital redevelopment, staff needs to be engaged,
adequately informed, trained, and to feel supported by
management.
 The use of champions of varying professions and lead
departments may be useful to address concerns,
adequately inform, and promote a sense of engagement
among staff.

Pomare.C, Churruca. K, Long .C , Braithwaite. BMC Health Serv

Res.2019;19.
ROLE OF NURSES

 Build interpersonal relationship with staff nurses

 Compared the actual ward situation with the
ideal one
 Makes right judgment on basis of information
 Prioritize problems to be solved and change
 Stay proactive about future crises
 Considers staff nurses’ characteristics such as
age or years of experience, and the balance of
power among staff nurses.
 Brought the influencer
 Considers timing of communicating the change
 Assess change outcomes based on information
 Positive feedback to staff nurses
Nurse Managers’ attributes to promote change
in their wards: a qualitative study
 Results : Four attributes of nurse managers,
“having both micro and macro perspectives,”
“respecting own beliefs and external standards,”
“being proactive,” and “having empathy for staff
nurses,” were identified as indispensable factors
promoting change in their wards.
 Nursing administrators should support the
cultivation of nurse managers’ attributes for
successful change.

Fukahori H, Kodama Y.Nursing Open. Oct 2017;4(4):209-217.

1.For example, a female nurse manager questioned a
clinical situation involving many sudden changes in a
patient’s condition and interviewed some nurses about
this situation. She deeply assessed the content of
interviews and inferred that staff nurses’ physical
assessment skills were quite low: “After I was assigned
this ward, a patient’s condition suddenly deteriorated.
Similar deteriorations occurred three times… I
understood the situation that staff nurses did not have
knowledge about emergency nursing, reported patients’
conditions to doctors too late and could not appropriately
assess their vital signs, by interviewing staff nurses…
eventually, I recognized that they did not have enough
education (about acute care nursing)” (ID 7).
2. For example, a male nurse manager had a strong
belief about building a healthy work environment
and his belief was consistent with his hospital’s
mission:
“My policy as manager is no working overtime..
I kept my ward mission and hospital mission in
mind. And then, I talked about a problem
(overtime) for staff nurses”
3. A female nurse manager recognized that nursing
shortages affected patient safety, that staff nurses
suffered from the stress of this situation, and that
in the future, this situation would lead to more
turnover:
“I performed interviews with staff nurses until
May. I understood the shortage of staff nurses
in the ward (ICU)… If this situation continued, I
thought that all staff nurses might leave the
hospital”
4.A female nurse manager said that when she desired
to stop unnecessary routine weight measurement,
she carefully communicated so that she would not
hurt staff nurses’ pride or deny their efforts in routine
work:
“(I was assigned new ward) staff nurses who
provided unnecessary care(weight patients),
every Saturday as routine work. This care was not
provided as routine work in our hospital. If a
nurse manager said to me that your care is a
traditional way, I would be angry… I considered
the manner of making this suggestion”
 CONCLUSION

 Planning for change is one of the fields that

require intensive approaches by the nurse
managers.
 This is the reality of the hour and we nurses
should have adequate skills so as to be able to
bring it into practice and make the long needed
change in the field of nursing.
RESEARCH ARTICLE
Nurses' views of organizational readiness for
change

 Results : The lowest means, indicating unreadiness for

change, were reported for the following items: having
developed plans for expanding ambulatory care or
enhancing continuity of care, including nurses on all
committees, and involving them in policy development
and strategic planning efforts.

 The governmental hospital was more ready than the

private hospital in “collaboration and multidisciplinary
work":
 Implications for practice and nurse leaders: 
 To prepare for change, nurse leaders should initiate
interventions to enhance organizational readiness and
facilitate the integration of change, such as continuing
education courses for staff and focus on teamwork, open
communication, total quality management, strategic
planning, advanced nursing practice and participatory
management, especially shared decision-making and
policy development.
 Successful leaders support employees' creative ideas,
focus on the timing of the change, and provide training
on change management.

Mrayyan T. Nurs forum. April,2020; 55(2):83-91

Management of change for nurses: lessons
from the discipline of organizational studies

 Key issues: Important aspects of change management

explored are the roles of power and political behavior,
how much change can be planned and controlled, how
to combine top‐down and bottom‐up approaches to
change, the role of emotions in the change management
process, a comparison of prescriptive and analytical
approaches to understanding change, and the
connection between theory and practice in managing
change.

Shanley C. J Nursing Management .15 June 2007;15(5): 538-546

Implementing Change in an Organization: A
General Overview

 This was a review which selectively examines some of

the theoretical and empirical organizational change
literature, and the implementation of change in
organization.
 Two of the cornerstone models or theories i.e. Kurt
Lewin and Lippitt, Watson, and Westley used in this
review for understanding and implementing
organizational change.
 CONCLUSION:
 Change is something that is a necessity, not a mere
phenomenon. Change may occur, whether we like it or
not. However, it is in our power to direct change. In other
words, change can work for or against you.
 We are given the privilege each day to make a difference
because of this word: change. As professionals, it is our
duty to make to make a positive difference where we
work, how we work, and be channels of change.

Higgins D, Bourne PA. Sch J Psychol & Behav Sci. 2018; 1(1):2641-1768
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 Pomare C, Churruca K, Long C , Braithwaite J.

Organizational change in hospitals: a qualitative
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[Accessed 22nd September,2020]
THANK YOU