Summary

Change is both inevitable and natural. As open systems, health care organisations are subject to many influences that lead to change including new technologies, advances in health care, ageing populations, a changing workforce and, most recently, COVID 19.   An essential skill for nursing leaders is the ability to lead change.  A leader’s ability to understand organizational culture and lead cultural transformation creates confidence in the individuals they are asking to try something new, adopt new behaviours, change the way they solve problems, or modify the way they communicate.

There are two broad approaches to change – planned and linear and non-linear. The linear approach to change is best suited to less complex, incremental change although there are many examples of complex change for which linear models have been used.  Change agents involved in planned or linear change tend to be focused on the specific goals and incremental steps that are required to meet those goals.  In this module, we focused on 5 linear change models: Lewin’s three step model, Lippitt, Watson and Wesley, Roger’s innovation decision process, Havelock, and Kotter’s 8-step process for leading change.  Nonlinear approaches are best suited for guiding change in complex and uncertain change environments. These include chaos and learning organisation theories.

Successful implementation of change is one of the biggest challenges that organisations face.  The 3 C’s of change leadership (communicate, collaborate, commit) can be used to create organisational readiness for change. Nurse leaders play an essential role in change management and often act as change agents.

It is estimated that 70% of change processes do not meet the intended goals.  Barriers to change occur at many levels of healthcare organisations and systems and include the change management approach and the organisational culture.