After reading Our Iceberg is Melting, consider Kotter’s “Eight-Step Process of Successful Change” in relation to Evidenced Based Practice . Think about a relevant evidence-based practice change occurring on your unit currently or in the past. (Don’t have a good example? It’s ok to come up with a hypothetical one based on experiences on your unit for this assignment.) I currently work on a inpatient psychiatric unit Identify one of the eight steps that was done well in your scenario.
Introduction
Change is an inevitable aspect of any organization, and effective change management is crucial for maintaining a successful and sustainable environment. In healthcare settings, evidence-based practice (EBP) initiatives are often implemented to improve patient outcomes and enhance the quality of care provided. John Kotter’s “Eight-Step Process of Successful Change” provides a framework for guiding organizations through change, and this framework can be applied to EBP implementation as well. In this assignment, we will consider one of the eight steps that was well-executed in a hypothetical EBP change occurring on an inpatient psychiatric unit.
Step 1: Create a Sense of Urgency
The first step in Kotter’s change model is to create a sense of urgency among all stakeholders involved. This involves appealing to emotions, highlighting the need for change, and emphasizing the potential consequences of not changing. In the context of the hypothetical EBP change on the inpatient psychiatric unit, the sense of urgency could be established by presenting evidence that current practices are not yielding optimal patient outcomes.
For example, suppose the unit has been using traditional restraint techniques for managing aggressive behaviors in patients with psychiatric disorders. However, research has shown that these methods may result in negative outcomes, such as physical injuries and psychological distress. By presenting this evidence to the stakeholders, including nurses, physicians, administrators, and even patients and their families, a sense of urgency can be cultivated, as the current practices are not aligned with the best available evidence.
Step 2: Form a Powerful Coalition
The second step of Kotter’s model involves forming a powerful coalition to lead the change effort. This coalition should comprise influential individuals who have the necessary knowledge, skills, and authority to drive the change forward. In the context of the hypothetical EBP change on the inpatient psychiatric unit, the coalition could be composed of the nurse manager, unit physician, nursing educators, and a representative from the hospital’s administration.
Each member of the coalition brings a unique perspective and contributes specific expertise to facilitate the successful implementation of the EBP initiative. For example, the nurse manager can provide insights into the current workflow and resource allocation, while the physician can offer clinical expertise and influence the medical staff. Together, the coalition can ensure that the necessary resources, such as educational materials, training sessions, and policy revisions, are available to support the implementation of the EBP change.
Step 3: Create a Vision for Change
The third step in Kotter’s model is to create a clear and compelling vision for change. This vision should articulate the desired future state, align with the organization’s mission and values, and demonstrate the benefits of adopting the proposed change. In the context of the hypothetical EBP change on the inpatient psychiatric unit, the vision could be to enhance patient safety, improve staff satisfaction, and achieve better patient outcomes through the implementation of evidence-based interventions for managing aggressive behaviors.
The vision should be communicated to all stakeholders, ensuring that they understand the purpose and potential impact of the change. This can be achieved through various means, such as town hall meetings, staff meetings, and written communications. By creating a clear vision, the stakeholders can rally behind the change effort and actively participate in its implementation.
Step 4: Communicate the Vision
The fourth step emphasizes the importance of communicating the vision for change regularly and through various channels. Effective communication ensures that all stakeholders are well-informed and engaged throughout the change process. In the context of the hypothetical EBP change on the inpatient psychiatric unit, regular communication could take place through departmental newsletters, email updates, and dedicated communication channels, such as bulletin boards or online discussion forums.
Additionally, the coalition members can actively engage with the staff during daily rounds, team meetings, and educational sessions, providing opportunities for clarification and addressing concerns or questions. By maintaining open lines of communication, the staff can remain informed about the progress of the EBP change and feel supported throughout the implementation process.
Step 5: Empower Others to Act on the Vision
Empowering others to act on the vision is the fifth step in Kotter’s model. It entails removing barriers, providing sufficient resources, and enabling individuals to contribute to the change effort. In the context of the hypothetical EBP change on the inpatient psychiatric unit, empowerment could involve providing training sessions on evidence-based interventions for managing aggressive behaviors, offering opportunities for staff to participate in decision-making processes, and allocating resources for implementing the change.
For instance, the nursing educators can organize workshops and simulations to enhance staff competencies in using evidence-based techniques, while the hospital administration can allocate funds for purchasing necessary equipment and supplies. By empowering staff members with the knowledge, skills, and resources needed to adopt the change, they become active participants in the implementation process, thereby increasing the likelihood of success.
Conclusion
Applying Kotter’s “Eight-Step Process of Successful Change” to EBP implementation on an inpatient psychiatric unit highlights the importance of creating a sense of urgency, forming a powerful coalition, creating a vision for change, communicating the vision, and empowering others to act on the vision. These steps contribute to a systematic and structured approach to change management, ensuring that the change effort is well-planned, well-executed, and well-supported. By focusing on these steps, organizations can effectively navigate the challenges associated with change and increase the likelihood of sustainable success in implementing evidence-based practices.