The aim of this report is to describe the application of Kotter's Change Theory to increase evidence-based practice (EBP) utilization around the American College of Cardiology's (ACC) and American Heart Association (AHA) recommendation that all patients aged 40-75 with diabetes and normal LDL levels should be prescribed a moderate-intensity statin (Stone, 2014). The implementation plan below intends to increase EBP utilization in patients with diabetes in a rural primary care clinic. Implementation Plan Kotter’s Change Theory John Kotter’s Change Theory is an eight-step process that can guide any leader on how to effectively facilitate change within their organization (Kotter, 2018). The theory was created after Kotter observed over …show more content…
His ideas of forming a diverse team (steps 2 and 4) and overcoming barriers until the vision is achieved (steps 5 and 7) are incredibly important in today’s increasingly complex health care system. Kotter (2018) focuses on the idea that the people within the organization “hold the energy” (p. 20) to make change happen. In order for change to happen and for EBP utilization to increase, Kotter makes it clear that people at all levels of the organization must be involved in the initiative. APNs must make sure they are pulling in all levels of the hierarchy into their initiatives, just as both providers and nurses were targeted in the implementation plan …show more content…
It is clear after this report how a clinician may go about increasing statin guideline adherence in their own clinic by adjusting the implementation plan above to work for their setting. More broadly, APNs should understand that although the eight steps are a step-wise approach, their change initiative might not always be completely linear. Through understanding Kotter’s theory, APNs should understand that initiative success depends on involving stakeholders at various levels of the hierarchy, per steps 2 and 4. APNs will understand that they can’t stop their efforts after a few small wins, but rather must surge their efforts so that their vision can become reality. Lastly, components of Kotter’s theory can be used to improve APN leadership and deepen understanding of the ethical principles that nurses adhere
John P. Kotter, a worldwide famous expert on leadership at Harvard Business School, was a graduate of MIT and Harvard. He joined the Harvard Business School faculty in 1972 and who was voted tenure and a full professorship at the age of thirty-three in 1980. Kotter's honors include an Exxon Award for Innovation in Graduate Business School Curriculum Design and a Johnson, Smith and Knisely Award for New Perspectives in Business Leadership. He again gained the title as the #1 ¡§Leadership Guru¡¨ from a survey for 504 enterprises that was conducted by Business Week magazine. Outline of this book
It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue.
Emory University Hospital is a teaching facility that embodies an “organizational culture that encourages critical thinking and acknowledges the inevitability of change” (Rubenfeld & Scheffer, 2015). By embracing a culture of change, Emory strives to fulfill its mission of “serving humanity by improving health.” This mission is being fostered, on my unit in particular, by the implementation of the evidence-based practice of an Accountable Care Unit (ACU). This transformational care model empowers nurses as leaders by giving them a voice and platform to advocate on their patient’s behalf. On my unit, these nurse leaders implement an ACU by offering and collecting information through their interaction with an interdisciplinary team, the patient,
In closing, as the healthcare climate consistently changes across the United States, it is imperative that registered nurses understand the demand for superior knowledge and lifelong commitment to nursing. As nursing theory and practice expand, our role as leaders is to place a high priority on our commitment to educate and guide nurses, thus improving the lives of their patients through the support of transformational leadership. The Institute of Medicine’s recent report, The Future of Nursing – Leading Change, Advancing Health, specifically calls for nurses to advance and embrace leadership roles on all levels and fronts – from collaborative improvement to positive identification of areas facing challenges within the healthcare setting.
The future of healthcare is ever changing, and with that comes change management, which brings individuals on board with that change. According to Vora (2013), the change management model includes first, determine the need for change. Second, prepare and plan for the change. Third, implement the change. Finally, sustain the change (Carroll, 2015). As a leader, I feel that it is my obligation to not only continue with my education, but to aid others in furthering their education and
This addresses the environment in which nurses practices and strives for “an innovative environment where strong professional practice flourishes and where the mission, vision, and values come to life to achieve the outcomes believed to be important for the organization” (ANCC, 2008). This type of environment is accomplished by nurses working together towards a strategic plan outlined with facility policies and knowledge-based nursing and skills to achieve desired outcomes and accomplish organizational goals. I believe my facility does a great job with structural empowerment. Our nurse manager makes sure we know what our goals are as a unit. We review hospital satisfaction scores and infection rates to determine what practices need to be addressed for achieving organization and desired outcomes. We work to provide cost-effective care that exceeds national standards for excellence while working to strengthen bonds between staff members and making sure that at our facility “caring comes first”
Some aspects of the nurse’s job have been made easy and facilitated with the aid of other well trained professionals within their working environments. According to the American Nurses Association (ANA) (2012), registered nurse’s performance has greatly improved over the years as a result of their coordination and partnership with the health care system with other health care providers. As a result, registered nurses are today seen to occupy important leadership positions in the healthcare system and they participate when they are making decisions for patients as well as for other
To make a change initiative organic, employees must be engaged within the process. The Kotter change model emphasizes the use of teambuilding, which is a key element in making change organic. Step one of establishing a sense of urgency requires leadership to engage the employees in a way that creates
The four areas of concern that were addressed by the ANA Agenda for Health Care Reform were critical issues that were found to be in need of “bold action” (ANA, 2008, p. 3) not only from the nursing profession but also from other stakeholders, e.g., “policy-makers, industry leaders, providers, and consumers” (ANA, 2008, p. 3) as well.
The first four steps of Kotter 's change model represent lewin 's "Unfreezing" stage. Within this stage Lewins focuses on creating motivation to enable change among employees. To begin the "unfreezing" stage Lewins described managers need to remove employee present behaviours and attitudes, to create a vision and urgency for
The initiative recognized that nurses have the opportunity to change health care, as we know it, and transform it to meet the needs of the ACA. The barriers that were identified include “outdated policies, regulations and cultural barriers” (IOM, 2011, p. 85). While increasing the scope of practice for APRNs was a large part of this key message, cultural diversity, gender diversity, and the aging workforce were also highlighted.
Yvonne, Doll and Billy Miller, “Applying the Kotter Model: Making a Transformational Change in a Large Organization”. Reproduced by the Command and General Staff College. L100 Book of Readings (Fort Leavenworth, KS: USASGSC, August 2011), 97 to 103.
The change process within any organization can prove to be difficult and very stressful, not only for the employees but also for the management team. Hayes (2014), highlights seven core activities that must take place in order for change to be effective: recognizing the need for change, diagnosing the change and formulating a future state, planning the desired change, implementing the strategies, sustaining the implemented change, managing all those involved and learning from the change. Individually, these steps are comprised of key actions and decisions that must be properly addressed in order to move on to the next step. This paper is going to examine how change managers manage the implementation of change and strategies used
However, Lewin’s central model centres on unfreezing, effecting change and then refreezing, starting from the status quo, then moving things and then continuing with the new status quo (Green, 2007). Kotter’s change model focuses on establishing urgency, guiding coalition, developing strategy, communication, empowerment, short-term wins, consolidation of gains to produce and anchor new changes (Sabri et al, 2007). Kotter does not engage with the complexity of organisational systems and potential clashing, he sees change being systematic, architectural, political and doesn’t engage strongly with the less deterministic metaphors in the latter steps (Smith et al, 2015). However, Kotter does highlight the importance of communicating the vision and keeping the communication high throughout the process although this starts with a burst of energy and in later stages its followed by delegation and distance (Cameron and green, 2009). Lewin’s change model focuses on people with the collaboration, contribution creating a force field approach to change including the power holders socially, culturally and behaviourally to drive change (Smith et al, 2015). However, Lewin’s approach ignores the metaphor of groups of people only willing to change if there is a need to do so, the model is more of a planning tool rather than an organisational development process (Cameron and green,
Consequently, the Robert Wood Johnson Foundation (RWJF), an avid advocate for the evidence-based recommendations for change and advancement of health care and the Institute of Medicine (IOM) in recognizing these challenges in 2008, partnered to establish a two-year Initiative on the Future of Nursing. The committee was tasked with producing a comprehensive report with recommendations for action-based blueprint for the future of nursing, redesigning the role of nurses, expansion of nursing faculty besides attraction and retention of well-prepared and qualified nurses in various care settings capable of handling present and future the nation’s health care needs..(IoM.edu, 2015). After two years of vigorously working, the committee formulated four key messages that formed the basis of their recommendations which