5. Change Management

Change, at all levels, is an inevitable, constant, pervasive, and natural process. This is particularly true in health care where the context is constantly changing with the advent of new technologies, advances in health care, aging populations, a changing workforce and, most recently, COVID-19.

Healthcare systems and organisations operate as open systems and therefore are subject to many influences which may lead to change.  An open system is one that is affected by, but also affects, the environment in which it operates.  Change takes multiple forms; it can be emergent (developmental, spontaneous) or planned.  Emergent change occurs when organisations and systems grow and change.  Emergent change can also be spontaneous, occurring as a reaction to a spontaneous event; the COVID 19 pandemic is an example of this.  Planned change has been the dominant approach to change and it is the process of preparing for new goals or directions and can occur at the organisational level or within a unit of the organisation.

Change agents lead the change efforts of an organisation.  According to the American Organisation of Nurse Leaders (AONL), nurse managers should have competency in facilitating change as part of strategic management. Nurse managers should be able to assess readiness for change, engage staff in change processes, communicate change, and evaluate outcomes (AONL, 2015).

In this module, you will learn about the key drivers of an organisation’s culture, change management in organisations and the role of the nurse leader as a change agent, change management theories, how to assess an organisation’s readiness for change and how to develop and enact change management strategies.