Change is one of the inevitable aspects of healthcare. Unfortunately, it is affected by poor planning, unmotivated staff, excessive frequency changes, and poor communication. As a nurse leader, you’re expected to drive organizational change. In this case, change management theories in healthcare may be an effective tool to provide successful and subsequent practice improvement.
Change management theories in healthcare
We have compiled a comprehensive guideline for Kurt Lewin and Ronald Lippitt’s change theories. Read through to identify the main terms of the theories which can help you provide an effective change in your organization.
Aspect | Lewin’s Change Theory | Lippitt’s Change Theory |
---|---|---|
Stages | 1. Unfreezing 2. Change 3. Refreezing | 1. Diagnose the problem 2. Assess motivation and capacity for change 3. Assess change agent’s motivation and resources 4. Choose progressive change objects 5. Select and clarify change agent role 6. Maintain change 7. Terminate the helping relationship |
Focus | Emphasizes the process of change itself | Emphasizes the role of the change agent |
Complexity | Simpler, more straightforward | More detailed, breaks down the process further |
Timeframe | Doesn’t specify a particular timeframe | Implies a longer-term process |
Flexibility | More rigid, follows a set sequence | More flexible, allows for adaptation |
Origin | Developed in the 1940s | Developed in the 1950s, building on Lewin’s work |
Application | Widely applicable across various fields | Often applied in organizational and community settings |
Key Concept | Force field analysis (driving and restraining forces) | Change agent as a catalyst for change |
Strengths | Easy to understand and apply | Provides more detailed guidance for change agents |
Limitations | May oversimplify complex change processes | Can be time-consuming to implement fully |
Kurt Lewin’s Theory
This theory is based on a three-stage model; unfreezing-change-refreezing model. Nurses can unfreeze the status quo by increasing motivation and decreasing straining forces to blend these two approaches.
In this case, nurses need to build trust and recognition, which can help other followers to feel the need for the change process. Ideally, they can achieve this by recognising the issues in the healthcare organisation and providing the appropriate solutions.
On the other hand, the second stage involves achieving change through employee persuasion to work together in providing a new approach. In this stage, teamwork is one of the most practical aspects that can bring together different individual views, which can aid in providing the most effective change approach.
Moreover, the third stage occurs after the change has been implemented to allow the integration of new behaviours and desired outcomes in the organisation. This stage provides equilibrium with new desired behaviours.
Additionally, this theory stipulates that different forces may influence the change process, including the driving, restraining, and equilibrium forces. In this case, the driving forces provide the requirements for the change process. Nonetheless, the restraining forces limit the change process, while equilibrium forces balance the two.
Application
Lewin’s theory of change is an instrument that is mainly used in a medical setting to facilitate change. For instance, with the increasing ethical issues in healthcare delivery, medical safety is one of the important aspects that nurses should focus on to improve healthcare outcomes.
However, technological advancement presents a challenge for nurses, mainly due to insufficient knowledge of their operations. In this case, implementing change in healthcare environments may result in anxiety among nurses following the change resistance.
Nonetheless, Lewin’s change management theory provides a framework that can help understand human behaviour and change resistance patterns. As a result, it can help nurses adopt bar codes in medication to reduce medical errors, enhancing patient safety.
First, healthcare organisations freeze the status quo by educating nurses on using barcodes and their importance in enhancing patient safety. Second, organisations implement the use of new technology to drive change. Lastly, the refreezing process would include making this technology a part of the healthcare organisation’s culture, where nurses must use barcodes while providing medication to patients.
Ronald Lippitt’s Change Theory
Lippitt’s change theory emphasises the responsibility of nurses and their role in change, insisting on the need for communication for the success of the process. This theory is based on a seven-step process that includes the following.
- Diagnosing the problem- The first step in this change theory is identifying the problem by examining all possible consequences and the people affected by the change. Additionally, collecting data and ensuring successful implementation of change. Investigators must create confidence in their team members to drive change. They should address any underlying beliefs that can limit the implementation of this change.
- Assessment of motivational factors- In the second step, nurses can evaluate motivation and change capability. Specifically, they can identify the human and financial resources and organizational structure required to achieve this change. Luppitt suggests that nurses must reassure their team members of the need for change, build trust and provide realistic expectations on the change implementation.
- Identification of the change capacity- This stage involves assessing the change agents’ resources, including motivation, experience, dedication, and stamina.
- Commitment to the change process- In this state, nurses can select change objectives through change process definition, developing an action plan and strategies to drive these changes.
- The role of change agents- In the fifth stage, nurses explain the change agent’s role to all the facility employees. In this case, they identify the different stakeholders’ roles, such as the expert, facilitator and consultant. They also provide clear expectations on what the change process requires.
- Maintaining change- In this stage, nurses maintain change by providing the necessary feedback, enhancing effective communication and coordinating the effects of the change.
- Change agents termination- This stage marks the end of the change process, where nurse leaders terminate the role of the change agents following the achievement of the change objectives.
Similarities Between the Change Theories
- They are both goal-oriented.
- While Lewin’s theory is a three-stage process, Luppitt’s change theory expands the three stages into seven steps.
- Both theories depend on the change agents to enhance change in healthcare.
- The two theories are based on the capacity and motivation of the organisation in change accommodation.
Differences Between the Change Theories
- Lewin’s theory is based on three forces that determine the change direction. Ideally, this theory is centred on an external agent of change, while Lippitt’s change theory targets the spread of change across all healthcare system units.
- Lewin’s theory relies on the habit of refreezing to ensure that the necessary changes have been made. In this case, it involves applying reinforcing measures to prevent the change implemented from backsliding. However, Lippitt’s theory involves terminating all change agents’ roles to mark the change implementation.
- Lastly, Lewin’s theory depends on the internal mechanism to plan and execute change, while Luppitt’s theory relies on introducing external agents to drive change.
FAQs
What are the five components of the theory of change framework?
- Inputs
- Activities
- Outputs
- Outcomes
- Impact
What is the main concept of Lewin’s theory?
Lewin’s theory identifies learning as a relativistic process in which the learner develops new insights or changes their old beliefs. It is through this process that individuals get to implement change.
What are the three elements of change?
Successful change takes place where there is a vision, method and intention.
What are the main theories of change management?
- Lewin’s change model
- The McKinsey 7s model
- Nudge Theory
- Luppit’s change theory
- Bridges Transition Theory
- Kotter’s change management theory