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Discussion: Evaluating and Sustaining Change

NURS 8302 Discussion: Evaluating and Sustaining Change

Discussion: Evaluating and Sustaining Change

Change Management and Change Leadership

Although the terms change management and change leadership sound relatively similar, people erroneously think that these terms are interchangeable. Change management seems to be somewhat of a “universal” umbrella term which is widely utilized to reference a set of basic tools, mechanisms, or structures used to ascertain implemented change remains under control (like not going over budget) with the intention of minimizing the disruptions, impacts, and distractions that often accompany change (Kotter, 2012). It involves the selection of strategies to facilitate the transition of individuals, teams, or organizations from a current state to a new desired state (National Association of County and City Health Officials [NACCHO], n.d.). Change management is associated with changes made on a small scale. Change leadership, on the other hand, is the driving forces, visions, and processes that fuel large-scale change, and is utilized to make change processes move faster, smarter, and more efficiently (Kotter, 2012). The distinction between these two terms in their purest essence is that change management is managing change while leadership change is leading the change initiative. More specifically, a change manager is responsible for the change process, such as articulating the required steps and actions needed to the responsible parties in an effort to achieve the desired outcome(s) while minimizing negative outcomes (Society for Human Resource Management [SHRM], n.d.), while the change leader is more of a visionary and is responsible for inspiring and influencing faculty, staff, students, and other stakeholders to exert effort to change for the greater good (Smith, 2017). Change leadership is the process of working together to develop the shared understanding of change required to execute the strategy and how to best implement them to achieve the desired goals (Center for Creative Leadership [CCL], 2020). It is clear effective leadership is essential for successful change, and ‘change-capable’ leadership is non-negotiable.

Leadership Approaches and their Relation to Process and Sustainment of Change

In order to achieve and sustain organizational change, change must be led, not managed. It is almost as to say that the leadership approach which best supports enduring organizational change is one of leading by example. Change leadership promotes leaders to proactively design and implant an organizational culture of collaboration and change that is sustained for the long run. To me, this is reminiscent of last week’s discussion on transformational leadership. Transformational leaders work to change the system while maximizing their team’s abilities, they serve as role models for their followers/team members and challenge their followers to overachieve and outperform by empowering them to perform at their very best. The leadership approach which is adopted and implemented has much to do with the degree of success with organizational change. Contributory factors for the sustainment of change include organizational culture, climate, organizational structure, size, and readiness for change (Ehrhart et al., 2018). The transformational leadership approach utilizes planning structures, sets goals, and then works to create new systems by gaining buy-in from their followers to adopt common goal(s)/vision(s) to achieve improvements that benefit all pertinent stakeholders, via the use of team communication, cohesiveness, collaboration, and effective and efficient team-building (Ali et al., 2021).  When collaboration and change are integrated into the organization’s fundamental culture, the result is a system that can embrace and endure change.

Change leadership, much like transformational leadership requires the leader to give up a certain degree of control in order to empower others, and it requires trust and an organizational culture that is permissive of ‘failures’, because there are times when

Discussion Evaluating and Sustaining Change
Discussion Evaluating and Sustaining Change

proposed changes may not succeed on the first attempt, and so not succeeding on the first attempt should not discourage leaders and their teams to give up and come complacent with routine and outdated approaches/methods. Leading by example is important to the development of trust and buy-in within an organization. It demonstrates that the leader themselves are not afraid to take on the proposed change and work their hardest to make sure that the change is successful. Leading by example promotes the process and sustainment of change by demonstrating that the proposed change is feasible. Sustainable initiatives hinge upon the participation of health care leaders, which in turn positions the organization for long-term change viability (American Hospital Association [AHA], n.d.). Effective leadership can bring about positive organizational change. Another effective leadership approach to support the change process and sustain change is decreasing employee feelings of uncertainty and insecurity. This is why the transformational leadership style is effective in addressing individual concerns, personalizing interactions with team members/employees, and providing encouragement and motivation for participation, self-reliance, and empowerment. Once employees become part of the change initiative and ‘own’ the process, they feel as though they are now also personally invested in the initiative and outcome.

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Leadership Function in Evaluating, Maintaining, and Sustaining Change, the Leadership Influence on these Aims and whether You Should Stop Measuring Change within an Organization

Leadership plays a major role in evaluating, maintaining, and sustaining change. Leaders are the driving force behind the vision for the proposed change, and also undertake the change process by identifying the area necessitating change/improvement, identifying the goal(s), and then outlining the plan to achieve the set goal(s). During the change process, it is the job of the leader to take the reigns and convey their vision, justify the project improvement investment to the proper stakeholders, secure resources, get the proper team members engaged to become active participants in the quality improvement team, develop a specific management plan, lead and motivate the team, execute the plan, monitor for change and progress, meet all due dates, and carry the project to completion (Sipes, 2020). An effective leader will continually monitor and evaluate the team and project progress, monitor that what is being measured is exactly what should be measured for change, to make sure that the project remains on track and that deadlines are being met. Sustaining change has all to do with the leader and whether they can achieve end-user and stakeholder buy-in. It is much easier to get people who agree with a change and/or see it’s potential for benefits and improvement to adhere to and sustain the desired changes than when individuals respond with opposition and resistance. Identifying the need for change/improvement is the very first step to initiating a change process, strategizing an action plan, including priorities, timeliness, tasks, structure, behaviors, and resources throughout the process, and then carrying out its execution (CCL, 2020). Leadership is a critical facilitator of sustained change.

With health care rapidly and continually changing with ever-increasing complexities, stopping the measurement of change with an organization seems not only counterintuitive but also counterproductive. Ceasing to measure change threatens sustainability and can lead organizations to revert back to the old and/or ineffective way of doing things. The National Health Service Sustainability Model helps to identify issues that affect the long-term success of quality improvement projects (Silver et al., 2016). Tools to help sustain improvement include process control boards, performance boards, standard work, and improvement huddles. Process control and performance boards are utilized to communicate improvement results to staff and leadership alike, while standard work is a written or visual outline of current best practices for a particular task and provides a framework to ascertain that changes that have improved patient care are continually, consistently, and reliably applied to each and every patient encounter (Silver et al., 2016). Improvement huddles are comprised of short, regular meetings amongst staff in an effort to anticipate and identify problems, review performance, and support an organizational culture of improvement. The overall health care goal aligns precisely with that of the U.S. National Quality Strategy, which is to improve the quality of care, improve the health of the population, and reduce the associated costs of care, and this is contingent upon the collection of and reporting of quality measures, more than 400 of which are currently endorsed by the U.S. National Quality Forum (Young et al., 2017). Improved health care can be achieved by following guidelines that align with the traditional strategies for process and quality improvement, such as Six Sigma and Lean thinking, which have both been powerful and efficacious tools in disease-specific care processes (Young et al., 2017). Change measurement, although oftentimes tedious, is absolutely necessary for health care process and outcome improvement.

References

Ali, H., Chuanmin, S., Ahmed, M., Mahmood, A., Khayyam, M., & Tikhomirova, A. (2021). Transformational leadership and project success: Serial mediation of team-building and teamwork. Frontiers in Psychology, 12(689311). https://doi.org/10.3389/fpsyg.2021.689311

American Hospital Association. (n.d.). Getting leadership support. http://www.sustainabilityroadmap.org/strategies/leadership.shtml#.YYw26mDMKUk

Center for Creative Leadership. (2020). How to be a successful change leader. https://www.ccl.org/articles/leading-effectively-articles/successful-change-leader/

Ehrhart, M. G., Torres, E. M., Green, A. E., Trott, E. M., Wilging, C. E., Moullin, J. C., & Aarons, G. A. (2018). Leading for the long haul: a mixed-method evaluation of the Sustainment Leadership Scale (SLS). Implementation Science, 13(17). DOI: 10.1186/s13012-018-0710-4

Kotter, J. (2012, February 6). Change management vs change leadership—what’s the difference? [Video]. YouTube. https://www.youtube.com/watch?v=2ssUnbrhf_U&t=46s

National Association of County and City Health Officials. (n.d.). Change management. https://www.naccho.org/programs/public-health-infrastructure/performance-improvement/change-management

Silver, S. A., McQuillan, R., Harel, Z., Weizman, A. V., Thomas, *A., Nesrallah, G., Bell, C. M., Chan, C. T., & Chertow, G. M. (2016). How to Sustain Change and Support Continuous Quality Improvement. Clinical Journal of the American Society of Nephrology: CJASN11(5), 916–924. https://doi.org/10.2215/CJN.11501015

Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.). Springer Publishing Company.

Smith, S. (2017). Are you a change leader or a change manager? https://er.educause.edu/blogs/2017/1/are-you-a-change-leader-or-a-change-manager

Society for Human Resource Management. (n.d.). Managing organizational change. https://www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/managingorganizationalchange.aspx

Young, R. A., Roberts, R. G., & Holden, R. J. (2017). The Challenges of Measuring, Improving, and Reporting Quality in Primary Care. Annals of Family Medicine15(2), 175–182. https://doi.org/10.1370/afm.2014

Change is something that every organization requires at some point. Changes in technology, lives, perceptions, and beliefs contributed to this. The outcome of the change process might be either positive or negative (Kotter, 2021). All an organization needs to do to avoid negative consequences is understand and properly employ change management in partnership with change leadership, ensuring that all change requirements are completed before and during the change process. Change management refers to a set of tools and procedures that must be in place to keep change efforts in check (Holten et al., 2019). The major purpose is to mitigate the negative effects of change. It’s a method of implementing massive changes in an organization while remaining sensible and in control. A perfect example occurred in my company during a raw materials shortage. The problem arose due to the company’s rapid change of chairman, and the new management decided that for the company to continue, it needed to transform its structure and operations. On the other hand, change leadership examines the forces driving change, as well as the vision and procedures that support more significant transformative changes (Holten et al., 2019). It is most commonly connected with introducing an engine into the entire change process to make it more efficient, faster, and more so in large-scale conversions.

The health care setting is dynamic due to constant changes to improve efficiency, quality of care, and patient safety. Leadership is needed to push these goals, ensure that the set goal and target are met, and enhance sustained change in the organization (Chartier et al., 2018). Leadership is required to evaluate and sustain change by navigating the complex web depicted by the different disease areas, multidirectional plans, and staff within the health care setting. Furthermore, some employees may resist the new changes as a result of experiencing poor past management. Leadership is needed to communicate the need for change, engage employees in decision-making, and mobilize necessary support for the change (Chartier et al., 2018). The leaders are required to provide the correct direction and motivate employees to improve and innovate continuously. An organization should not stop measuring change. Measuring change is critical in determining and communicating the success and acceptance of the implemented process.it also helps determine whether the persons influenced by the change are progressing towards the required direction (Sipes, 2021).

REFERENCES

Chartier, L. B., Vaillancourt, S., Cheng, A. H. Y., & Stang, A. S. (2018). Quality improvement primer part 3: Evaluating and sustaining a quality improvement project in the emergency department. CJEM, 21(2), 261–268. https://doi.org/10.1017/cem.2018.380

Holten, A. L., Hancock, G. R., & Bøllingtoft, A. (2019). Studying the importance of change leadership and change management in layoffs, mergers, and closures. Management Decision, 58(3), 393–409. https://doi.org/10.1108/md-03-2017-0278

Kotter. (2021, May 7). The 8-Step Process for Leading Change. https://www.kotterinc.com/8-steps-process-for-leading-change/

Sipes, C. (2020). Project management for the advanced practice nurse. http://dl1.tarjomac.ir/nursing-ebooks/TPC202202.pdf

Change is something that every organization requires at some point. Changes in technology, lives, perceptions, and beliefs contributed to this. The outcome of the change process might be either positive or negative (Kotter, 2021). All an organization needs to do to avoid negative consequences is understand and properly employ change management in partnership with change leadership, ensuring that all change requirements are completed before and during the change process. Change management refers to a set of tools and procedures that must be in place to keep change efforts in check (Holten et al., 2019). The major purpose is to mitigate the negative effects of change. It’s a method of implementing massive changes in an organization while remaining sensible and in control. A perfect example occurred in my company during a raw materials shortage. The problem arose due to the company’s rapid change of chairman, and the new management decided that for the company to continue, it needed to transform its structure and operations. On the other hand, change leadership examines the forces driving change, as well as the vision and procedures that support more significant transformative changes (Holten et al., 2019). It is most commonly connected with introducing an engine into the entire change process to make it more efficient, faster, and more so in large-scale conversions.

The health care setting is dynamic due to constant changes to improve efficiency, quality of care, and patient safety. Leadership is needed to push these goals, ensure that the set goal and target are met, and enhance sustained change in the organization (Chartier et al., 2018). Leadership is required to evaluate and sustain change by navigating the complex web depicted by the different disease areas, multidirectional plans, and staff within the health care setting. Furthermore, some employees may resist the new changes as a result of experiencing poor past management. Leadership is needed to communicate the need for change, engage employees in decision-making, and mobilize necessary support for the change (Chartier et al., 2018). The leaders are required to provide the correct direction and motivate employees to improve and innovate continuously. An organization should not stop measuring change. Measuring change is critical in determining and communicating the success and acceptance of the implemented process.it also helps determine whether the persons influenced by the change are progressing towards the required direction (Sipes, 2021).

REFERENCES

Chartier, L. B., Vaillancourt, S., Cheng, A. H. Y., & Stang, A. S. (2018). Quality improvement primer part 3: Evaluating and sustaining a quality improvement project in the emergency department. CJEM, 21(2), 261–268. https://doi.org/10.1017/cem.2018.380

Holten, A. L., Hancock, G. R., & Bøllingtoft, A. (2019). Studying the importance of change leadership and change management in layoffs, mergers, and closures. Management Decision, 58(3), 393–409. https://doi.org/10.1108/md-03-2017-0278

Kotter. (2021, May 7). The 8-Step Process for Leading Change. https://www.kotterinc.com/8-steps-process-for-leading-change/

Sipes, C. (2020). Project management for the advanced practice nurse. http://dl1.tarjomac.ir/nursing-ebooks/TPC202202.pdf

The healthcare system is constantly changing, and the demands of quality care are on the rise; hospitals strive to improve performance and patient safety. With this comes immense change and quality improvement (Murphree et al., 2011). Organizational changes in health care are more likely to succeed when health care professionals can influence the difference, feel prepared for the change, and recognize the value of the change, including perceiving the benefit of the shift for patients (Nilsen et al., 2020). Continuous professional education has become increasingly important to ensure that health care professionals’ competencies keep pace with current standards and to maintain and enhance the knowledge and skills needed to stay abreast of the newest evidence (Nilsen et al., 2020). Continuous improvement is a systematic, sustainable approach to enhancing the quality of care and patient outcomes that embraces practice change which is an ongoing journey in healthcare that requires commitment and persistence under effective leadership. (KPMG,2019). 

One of the challenges during this change process is sustaining practice change which requires robust and effective leadership to maintain a practical improvement (Bigelow et al., 2010). It is important to note that continuous improvement is driven and owned by frontline staff, reinforced by specialized, ongoing training, and supported by the entire organization starting with the board and the chief executive and permeating everywhere from the finance and human resources and information technology departments. Moreover, change must be underpinned by the right leadership behaviors with transformational leadership skills because such leaders support, mentor, and ask questions about the change process. Transformational leaders are successful leaders who possess certain qualities such as being a good change manager that promotes teamwork, guides staff through any transition period, identify support systems and possible barriers, and enabling tools needed to strengthen and support nurses during quality and safety movement (Richardson & Storr, 2010).  

According to Bigelow et al. (2010), many strategies exist for leaders to promote and sustain quality improvement, such as providing visual control, control charts, daily, weekly, monthly, and quarterly accountability processes. These strategies support the quality movement, provide bedside nurses with oversight and support of their daily practice. Similarly, nurse leaders can also utilize the Lean Six Sigma model in quality improvement because the model relies on a collaborative team effort in improving performance by systematically eliminating waste to maximize workflow (Bigelow et al., 2010). Finally, Leaders can also apply models such as the National health service (NHS) sustainability model in sustaining quality improvement changes because it assists them in implementing change, increasing the quality of care, and promoting a positive patient experience while reducing health care costs (Silver et al., 2016).