Week 6; QIP - Healthcare systems - planned change Flashcards
What 3 things do changes in healthcare most commonly relate to?
- organizational restructuring,
- quality improvement
- employee retention
What 4 things does an individual’s resistance depend on?
- Their flexibility to change.
- Their evaluation of the immediate situation.
- The anticipated consequences of the change.
- Their perceptions of what they have to lose and gain.
What are the 2 types of resistance?
- active
2. passive
What are strategies to decrease resistance to change?
- Implement gradually if possible
- Change agent needs to see it through
- Implement change for good reasons
What is a type of change agent strategy where the change agent knows that people have a lack of knowledge and once given that knowledge they will change when given the facts?
rational-empirical
What type of change agent strategy uses the grp process, assumes humans are social more easily influenced by others rather than facts, Change agent has good understanding of roles and relationships?
normative - re-educative
What type of change agent strategy uses power by legitimate source, economic sanction or political clout ie new law enactment?
power-coercive
When is rational-empirical change agent strategy used?
used when there is little anticipated resistance to the change or when the change is perceived as reasonable
What does normative - re-educative use?
use group norms and peer pressure to socialize and influence people so that change will occur
What does power-coercive feature?
feature the application of power by legitimate authority, economic sanctions, or political clout of the change agent
What are steps in the change process?
Assessment
Planning
Implementation
Evaluation
Who is the father of change theory?
kurt Lewin
What is the part of the change model is where the change agent convinces members of the group to change or guilt, anxiety, or concern are elicited?
unfreezing
What do you have to communicate in unfreezing?
you have to communicate why this change is necessary.
What 2 things do you have to make sure of with unfreezing?
- Make sure that everyone who will be affected by the change knows this.
- make sure that you deal with people’s doubts and concerns.
What part of the change model is where the change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces?
movement of change
What do people begin to get used to in the movement of change
get used to the idea that things will be different.
What do you want to continue to communicate in the movement of change?
how the change will benefit the people involved, so that they continue to support it.
What part of the change model is where the change agent assists in stabilizing the system change so that it becomes integrated into the status quo?
refreezing
What happens during refreezing?
the change is set in place, and becomes part of your organization’s culture.
What do you want to make sure of in refreezing?
make sure people have the training and support they need to stay on the right track
What do you want to regularly check in refreezing?
regularly check that the change has happened and that people are using the new processes that you’ve implemented.
What do you want to also do in refreezing that is important?
important that you celebrate everyone’s hard work in making the change a success.
Why is it important to celebrate in the refreezing stage?
helps people find closure, and it helps them believe that future changes will also be successful.
What are 4 restraining forces for returning to school in the future?
Low Energy
Limited Finances
Unreliable Transportation
Time w Family already impacted
What are 4 driving forces for returning to school in the future?
Opportunity for advancement
Status
Enhanced Self Esteem
Family is Supportive
What are the steps for leading the change?
- Identify the problem (Force Field Analysis)
- Identify the optimal outcome solution & the desired outcome objectives
- Identify constraints, capabilities, resources, & claimant groups
- Identify and explore potential solutions/ and then choose best solution (Decision Matrix)
- Plan the implementation process
- Implement the solution for a given time
- Evaluate the outcome
What are change agents? characteristics…
Visionary Risk taker Flexible Excellent communicator Creative Sensitive Current
Because change disrupts the homeostasis or balance of the group, what should always be expected?
resistance
Whenever possible, all those who may be affected by a change should be what?
involved in planning for that change
When information and decision making are shared, subordinates feel what?
that they have played a valuable role in the change
A nurse-manager is attempting to restructure the unit to prevent understaffing of the nurses. The nurses agree this is a needed change. What type of change strategy would be most effective? A. Rational–empirical strategies B. Normative–re-educative strategies C. Power–coercive strategies D.None of the above
A; When using rational–empirical strategies, the change agent assumes that resistance to change comes from a lack of knowledge and that humans are rational beings who will change when given factual information documenting the need for change. This type of strategy is used when there is little anticipated resistance to the change or when the change is perceived as reasonable
Presenting to a small group of vocal employees a new system to be implemented is an example of which type of strategy?
A. Rational
B. Normative
C. Power
B. Normative
Rationale: Uses the grp
Tell whether the following statement is true or false?
A typical young organization is characterized by low energy and resistance to change?
A. True
B. False
B. False; The young organization is characterized by high energy, movement, and virtually constant change and adaptation
Yes or no; squelch all dissent immediately - eliminate anyone who opposes the change
false
yes or no; Keep the pace of change high at all times.
not a good idea
yes or no; Make sure everyone understands what changes will be made and why.
yes
yes or no; Keep everyone informed as the change progresses.
yes
yes or no; Don’t allow any modifications once the change process is under way.
no; try to allow for flexibility
yes or no; Demonstrate clearly why the change is a beneficial one.
yes
yes or no; The work environment is not changing. Change is the work environment!
yes
According to Lewin, change should only be what?
implemented for good reason
According to Lewin, change should always be what?
gradual
According Lewin, all change should be what? and not what?
should be planned, and not sporadic or sudden
According to Lewin, all individuals who may be affected by the change should be what?
should be involved in planning for the change
As new grads, what will be expected to do?
- Revise old procedures
- Find new ways to improve
- Improve evaluation process, - - promotion process
- Participate in QI projects
- Prepare for accreditation visits
How one responds to change, the amount of stress it causes, and the amount of resistance it provokes, can be influenced by what?
your leadership
The process of making changes when are self-care is really required can be challenging, what is one way of approaching this?
think of VERY Small “one degree” change that is doable
