So what is change? Change is making something different from what it was.

In the case of organizational change, meaning to plan a change in your organization, and organization plans to improve efficiency and maintain a positive financial balance. One of the models that is most used is called Lewins model of Change Theory. It has 3 simples steps, First is UNFREEZING, which is the current or old way of doing what Is flawed and change is needed for a specific reason. Second is called MOVING to a new level meaning intervention or change is introduced and explained. The benefits and disadvantages are discussed here and implemented. Third, and last, is the REFREEZING and that is the new way of doing what is incorporated in the routing of the affected people. There are other Change theorists, Lippitt, Havelock and Rogers. All of their work is on expanding on Lewins theory. There comes a period of chaos after change. Researchers now know that there is a phenomena called CHAOS THEORY, which hypothesizes that chaos actually has an order. There is also the LEARNING ORGANIZATION THEORY by Senge, which focuses on ways organizations learn and adapt and demonstrate responsiveness and flexibility. So, there are 3 reasons to have change, can you guys think of any? Yes, 1) is to solve a problem, 2) to improve efficiency and 3) to reduce unnecessary workload. You guys are too smart! Couldnt stomp you. The change process can be related to the Nursing process. First is the ASSESSMENT, which you identify the problem or the opportunity for improvement through change by collecting and analyzing data. The data and analysis should be from several sources, such as Structural: meaning space and configuration of physical space. If you dont have a good flow of the set up of the hospital, you can spend unnecessary time organizing and reorganizing space, time wasted. Or, it can be technological, meaning lack of wall outlet or equipment, poorly situated computer stations, etc. Or, it can be people, such as personnels with inadequate training, commitment or understanding. Lewin noted that there are other forces that need to be assessed. They are DRIVING FORCES, which are forces that are supportative to change. And there are RESTRAINING FORCES, which build barriers for change. If restraining forces outweigh the driving forces then the change must be abandoned because it cannot succeed. Can you guys name some driving and restraining forces? Yes, they are political, cost, safety, people and reputation.

Second comes PLANNING. The who, how and when the change is determined. The expected outcomes must be identified in measureable terms and the plan must be evaluated. Then comes IMPLEMENTATION. This is where the plan actually goes alive. This is a good phase to have optimism to build collaboration. Next, we have evaluation, whether the effectiveness of the change is evaluated according to outcomes identified earlier. This is where learning curves and time intervals should be identified. Finally, there is STABILIZATION of the change. After the effectiveness of the change is determined the stabilization of the change is completed. This is when the CHANGE AGENT leaves and the employees own the change. SO, who is the change agent and what is the change agent? The change agent is one who leads and manages changes. He or she can be a leader or a manager and they can be from inside or outside the organization. As changes come, conflicts surely arise from time to time. Conflict can be health and encourage creativity and open discussion for debate, but it can also lead to negative or no resolution and negative responses. It is good to acknowledge conflict so it can have an open, honest and clear communication to successful conflict management. It is the nursing managers role to create an environment that is calm and nurturing for acknowledge conflict. Some techniques for the use for conflict are: Avoiding, Accommodating, Competing, Collaborating and Confronting. When implementing change to any organization it is important to think of incentive. The question of who is the change actually benefiting should always be asked with the patient being the number one concern! When implementing change, you have to make sure that change is indeed what is needed and wanted, as you can change things forever. What can be a good change to have in the hospitals and what can be done to get thing going?