Complex adaptive systems require that, in order for organizations to maintain equilibrium and survive, the organizations must respond to an ever-changing environment. Healthcare organizations are complex adaptive systems where change is a complex process with varying degrees of complexity and agreement among disciplines. Lewin’s Change Management Theory is a common change theory used by nurses across specialty areas for various quality improvement projects to transform care at the bedside The answer may lie within the work of several change leaders and theorists. Although theories may seem abstract and impractical for direct healthcare practice, they can be quite helpful for solving common healthcare problems. Lewin was an early change scholar who proposed a three step process for ensuring successful change. Other theorists like Lippitt, Kotter, and Rogers have added to the collective change knowledge to expand upon Lewin’s original Planned Change Theory. Although each change theory is different with unique strengths and weaknesses, the theories’ commonalities can provide best practices for sustaining positive change. Lewin’s Theory of Planned Change includes the following change stages
  • Unfreezing (understanding change is needed)
  • Moving (the process of initiating change)
  • Refreezing (establishing a new status quo).
Once the change has become part of the department’s new culture, leaders still must periodically validate departmental processes and solicit staff feedback. Change agents can redefine their relationship with the staff to take on a less active role in the change maintenance process. However, once the change leader begins to release control over the change process, staff members may slowly revert to old, negative behaviors. Periodic spot-checking and continued data monitoring can solidify the change as the department’s new status quo. Change managers should celebrate wins with staff while continuing to share evidence of success in staff meetings or with departmental communication boards.

References

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. Journal of healthcare leadership13, 85–108. https://doi.org/10.2147/JHL.S289176 Nelson-Brantley, H. V., & Ford, D. J. (2017). Leading change: a concept analysis. Journal of advanced nursing73(4), 834–846. https://doi.org/10.1111/jan.13223