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Research change theories from scholarly literature resources. Choose a change theory and correlate the steps of the theory to a change that has occurred in your clinical area.

• Did the change follow the steps well?
• Was the change made successfully?
• If it did not go smoothly, how would you have improved the process? 
• REQ: provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples; and demonstrates a clear connection to the readings. 3 paragraphs (3-4 sentences each paragraphs) APA format, 3 references.

Change Theory

The nature of organizations is such that success in one area inevitably produces problems in another. Organizations, whatever their specific purpose, facilitate the production of dilemmas. Therefore, there is always a need for change and change management to affect growth and profits. The goal is to enhance change-facilitating forces while effectively diminishing the restraining forces.

However, organizations change as little as they must, rather than as much as they should.

Is planned change in complex organizations possible? Or do enormous internal and external forces overcome any attempt to control them?

There are limits to the potential for change.

• Not everyone has the power to effect change.
• Change cannot be ordered to happen.
• Conflicts of interests may resist change.

The need for change may make it harder to change.

• Adversity produces a sense of necessity for change that promotes innovation.
• However, scarcity of resources creates a climate less likely to utilize innovation than abundance.
• The ability of an organization to change significantly appears greatest when inclination to change is least.
• In times of plenty, these are increased resources for change but less necessity.

MEANING OF INTENTIONAL/PLANNED CHANGE

According to Kurt Lewin’s change theory in the 1940s, change was movement between discrete, fixed states. The classic model was of the system unfreezing, changing, and refreezing. This is no longer considered to be accurate, as systems and organizations never freeze. They are dynamic, always in a state of flux, and the stages of change constantly overlap.

What is the reality?

Organizations are always in motion. Change is always occurring, whether guided by the leaders or not. Change is not always planned nor desired. Those involved in controlling events or guiding change must always be aware of the nature of the networks within and around organizations. Forces that prompt change include the relationship of the organization with its environment, growth during its life cycle, and its internal and external struggle for power.

Change is ubiquitous in healthcare as an industry and within our organizations. Do you know what the big three model of change is all about?

The big three theory of change is the result of groundbreaking efforts by Rosabeth Moss Kanter—professor at the Harvard Business School. This theory focuses on various components that institute change in organizations.

THE BIG THREE THEORY OF CHANGE COMPRISES:

• Three kinds of movement
• Three forms of change
• Three action roles in the change process

TYPES OF MOVEMENT

Movement can be:

• Macroevolutionary—historical, related to whole industries, the movement of an organization as it relates to motion in its environment. The environment is always shifting due to geographical, political, economic, demographic, and social realties.
• Microevolutionary—developmental, related to the movement of parts of the organization as it grows, ages, and progresses through its life cycle. Momentum is created in an organization as it increases in size, and its members, values, and practices change.
• Revolutionary—the manipulation and struggle for power and control to make decisions or attain benefits from the organization. Over time, different stakeholders advance their own interests and make claims on the organization’s resources.

FORMS OF CHANGE

Change relates to:

• Identity—changes in the relationships between the organization and its environment; its assets and market; its relationships to customers and other organizations.
• Coordination—changes which involve the internal parts or configuration of an organization; the problems of shape and structure as it grows and ages.
• Control—changes that stress the political dimension; which coalition is dominant in the organization, which set of interests predominate, who governs and sets strategy; ownership.

ACTION ROLES

Action roles can be as:

• Change strategists—concerned with the organization’s direction and the connection between the organization and its environment; usually found in top leaders at the beginning of a change sequence.
• Change implementers—responsible for the change effort itself, concerned with internal organizational structure and coordination; usually the mid-level managers in the middle of the change sequence.
• Change recipients—those most strongly affected by the change and its implementation but without the opportunity to influence those effects; organizational staff at the end of the change sequence.

Nursing professionals don’t work in a vacuum. They create a framework for change within their work environment. For example, the culture change movement pioneered by Stephen Shields—president and CEO of the Meadowlark Hills retirement community in Manhattan, Kansas—has brought a radical transformation in the way patients are treated in long-term care facilities. This movement believes in moving away from the assembly-line approach to treating patients; to that of warm household community, where the patient and staff build a life together. The big three theory of change can be an important tool to affect change and influence certain health policy decisions.