Changes: Implementation process rationale

Changes are an inevitable aspect of responding to continuity, service improvement and response to stakeholders (Patron & McCalman, 2008). Having compared and contrasted Kotter’s 8-step change model Kotter (1996), and the change model Lewin’s model Lewin (1951) both models have advantages and disadvantages regarding the proposed implementation of change. Although Kotter’s (1996) model of change is in-depth and complex it does provide the change agent with a structured framework, whilst identifying key stages and principles to implement the change effectively. The stages present as easy to follow and can be utilized for both small and large-scale changes. The following are the  Kotter’s 8-step change model :

 Step one-Creating a sense of urgency

Creating a sense of urgency can be by starting discussions with the direct workforce about how to introduce Immersive fitness to the ward setting. By communicating with, and getting people talking and thinking about the idea. It increases the chances of people becoming interested and involved in the change intervention During periods of change. There are reciprocal interactions between the process and those involved. The literature shows that low levels of involvement in change and changes that are not perceived to be beneficial can negatively impact the workforce (Greenhalgh, Robert, Macfarlane, Bate & Kyriakidou, 2004). Likewise, it could be beneficial to identify strengths, weaknesses, opportunities, and threats [SWOT] (Helms 2013). By being able to identify, acknowledge, and address the potential threats such as patients unwilling to participate increases the chances of being able to prepare and strengthen your argument in a dynamic and convincing manner.

 step 2-Form a powerful coalition

To be able to create change, a change agent is crucial. To propose, the change agent would be myself. I would be the link between stakeholders, providing motivation to convince colleagues to get in and lead towards a creative vision to collaboratively drive the change together. Kotter (1996) explains that to form a powerful coalition, a varied network of key players equipped with expertise, credibility, leadership, and status are necessary. The coalition team will have a skill mix ranging from the change agent, management, nurses, healthcare assistants, patients’, and next of kin. This then encompasses a strong leadership ethos along with a visible support network (By, 2005). The individual drive to promote change from the key players is then reinforcing the continuum in building a sense of urgency and increasing the momentum towards creating the vision for change.

Create a vision for change – step 3

A clear vision will enable the team to be able to fully understand  the concept of what the overall achievement is. Initially, by supporting the team to create the vision as an interactive and shared process would drive towards a successful change (Kotter, 1996). The vision statement should link in the identified values along with quantifying what the team is trying to achieve .The team is then able to move forward and create a strategy that can execute this vision. By being able to gather all the facts from the evidence-base, the team will then be able to identify strategic objectives (Jalagat, 2016). The evidence base has identified that combining a healthy diet with physical activity has the potential to improve the quality of life. By referring to the SWOT analysis the team is then able to identify strategic objectives by incorporating a SMART goal plan.

Communicating the vision – step 4

Working together as a team, the change needs to be put across  often. Hence physically demonstrate what is the organization expects by applying the vision into practice (Kotter, 1996). Additionally, the agent would be communicating the vision to hierarchy to gain support from all levels of the organization (Kotter, 1996). Jalagat (2016) identified that for an effective change to happen, management needs to clearly understand the change intervention. It would be expected that the management team is informed of the evidence-base. As a result of surrounding a clear and defined vision to minimize the risk of confusion. Kotter (1996) ,suggests that the vision being put across appeals to all stakeholders both short and long-term. Further increasing the positivity to change with a higher level of participation .This is due to consistent two-way communication methods.

Remove obstacles – step 5

Barriers and resistance to change have been identified in the SWOT analysis. Mostly focusing on staff resilience and being unclear about their role within the project. This links back into the step-4 model by being open, honest, and empowering by involving staff. Employees try new ideas and approaches. Often just simply by the successful communication of the vision across the organization (Kotter, 1995). Implementation of staff training on the benefits of immersive fitness. Also how to use equipment and log effective data would be of use monthly for new staff.   Implementing can be at very little cost if this was done as in-house training.

Create short term wins – step 6

The leader should set high-performance expectations and reward behaviors that are direct towards fulfilment of the vision. It is also important that the leader models the behaviors that are required to institutionalize the change and sets the standards for the rest of the organization to emulate (Appelbaum, Habashy, Malo & Shafiq, 2012). By previously identifying baseline anthropometric measures, timeframes that are transferable to the project consist of, a short-term measure. Henceforth continuing the measures at a monthly interim for a period of 9 months, with continual monitoring throughout.

Build on the change – step 7

Kotter states that it may be tempting for managers to declare victory. That is, after the first signs of performance improvement are visible. However, as new processes can regress. Therefore, it is crucial for leaders to use these short-term gains to tackle other issues. That is, issues such as systems and structures that are not in line with the recent changes (Kotter, 1995). By being able to analyze short term wins helps team to monitor and measure the continuous improvement of the change. A team can utilize variety of methods . For example, over the first month have a noticeable improvement in patients mental state under observation.

Anchor the changes into corporate culture – step 8.

Kotter (1996) states this to be the crucial step towards engraining the change into a social norm for the organization.  The organization can recognize the change when training new and existing staff. The values that can be build upon over the implementation of the change ought to continue. Additionally, they have to speak of the it often and depict them in the relevant patient’s care plans . This is to ensure that the change becomes an integral part of the organizational culture .to change and continuous improvements. Culture often determines what to do, so the values behind your vision must show in day-to-day work. Make continuous efforts to ensure that the change is clear in every aspect of your organization.

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