Organizational change models

Description

Models of successful change are useful for nursing leadership. This article discusses various models of change. A useful way to view change is to consider organization behaviour, structure and processes. As such, managing change is multifaceted and can involve power, reason or re-education, or taking structural, behavioural or technological approaches. Managing change usually involves simultaneous changes in structure and process.Three examples of successful change models from clinical nursing arenas present alternative strategies for nursing leaders to consider: Model 1: Instituting Patient-Focused CareModel 2: Improving Rehabilitative Handling for Stroke PatientsModel 3: Building Capacity for Magnetism

Steps for Using Method/Tool

Model 1: Instituting Patient-Focused CareThe structural approach includes: determining a vision to merge selected experiences in medical and nursing education so that each group enters practice with a respectful, accurate knowledge of each other’s contribution; establishing ethics committees; and considering nurse managers and medical directors as peers with equal accountability for clinical outcomes and team performance. The behavioural approach includes interdisciplinary patient rounds, dealing with competence issues directly and respectfully and encouraging personal integrity in the behaviour of all team members. The re-education approach includes seeking and engaging in interdisciplinary educational programs that improve communication and collaboration.

Model 2: Improving Rehabilitative Handling for Stroke PatientsThe primary aim for this model in the short term was to facilitate changes in moving and handling practice that were consistent with manual handling regulations. In the long term, the goal was to move the unit toward rehabilitative handling in caring for patients who had experienced a stroke. Change agents in this setting used an insider participatory action research approach. The key to the success of this change in nursing practice was that those directly involved in moving and handling were facilitated to take ownership in their practice.

Model 3: Building Capacity for Magnetism Parsons’ Health Promoting Organizations Model is an open-system, participative approach to whole-systems change. Key concepts are unit-shared leadership, participatory management and empowerment. Global exemplary efforts further illustrating participatory action research as a powerful model for change include: efforts to implement change in public health nursing in the United States; strategies to develop role clarity in advanced practice nursing in Canada; and ways to improve medication safety in residential aged care settings in Australia.