Abstract
Kotter’s change model is an 8-step approach to implementing change. The 8 steps include: create a sense of urgency, create a guiding coalition, develop vision and strategy, communicate the vision, empower others to act on the vision, generate short term wins, build on the change, and anchor the change in the organizational culture. Kotter identifies the role of emotions in the change process and recommends that change leaders adopt a ‘see-feel-change’ approach where they use compelling situations to evoke positive emotions and motivate staff to adopt change. Using change models in the planning and implementation process of quality improvement initiatives can save time, minimize risks, and increase the chances of success.
Kotter’s Change Model
Kotter’s change model is one of the organizational models for change. The model provides a roadmap for successful change process and is widely used in business to implement and operationalize initiatives. The model builds on Lewin’s change theory and places emphasis on the implementation stage, rather than the entire change process (Finkelman, 2018). A major idea in the model is that for a change process to be successful, people must be presented with compeling reasons why a change is needed (Webster, 2017). Kotter recommends that managers adopt a ‘see-feel-change’ approach during the change process, where change leaders use compelling situations to drive motivation for change among the staff (Campbell, 2008). Healthcare organizations can utilize the Kotter’s change model to successfully implement quality improvement initiatives.
Applying Kotter’s Change Model
Kotter’s change model identifies 8 steps in the change process (Webster, 2017).
Step1: Create a sense of urgency. The first step to implementing a quality improvement initiative is convincing the group that a problem does exist, and change is needed. Without a sense of urgency, change is unlikely to be successful. This step encourages a group to accept change by highlighting the problem and how addressing the problem can improve processes (Campbell, 2008). For instance, nurse leadership can create a sense of urgency for improving in order to improve patient safety and effectiveness of care by highlighting the consequences of current practices and policies.
Step 2: Create a guiding coalition. As an executive, I would be part of the guiding coalition. A guiding coalition comprises change leaders who continue to build urgency for change by persuading the whole group to adopt new practices. The coalition also builds momentum around the change process and guides the whole process.
Step 3: Develop a vision and strategy. At this stage, the climate for change is solidified. A clear vision motivates staff to implement actions outlined in a quality change plan. The guiding team also creates a strategy for realizing the vision. The strategy includes what tasks are to be performed, knowledge and information needed, financial aspects, equipment, and time among other elements.
Step 4: Communicate the vision. The vision and strategy are communicated to the staff who are to execute the plan. This is done using avenues such as staff meetings or education sessions. The entire staff is involved, their concerns addressed, and any necessary modifications to the change plan are made.
Step 5. Empower others to act on the vision. Up to this point of the change process, the vision and strategies for realizing it have been communicated and the staff is already executing the plan. However, the vision can be impeded by several barriers such as a current policy or some people within the organization (Campbell, 2008). Hence the need for the change leadership to identify and address such obstacles in order to empower the staff to execute the plan and help the change move forward.
Step 6. Generate short term wins. It is usually easy to envision and initiate change, but difficult to sustain. Success drives motivation. The staff and other stakeholders are likely to be demoralized if no clear improvements in the quality of health care are observed following the implementation of a quality change project. Kotter recommends that the change leadership should plan for and create achievable short term wins in order to motivate the entire staff and sustain change (Campbell, 2008). An example of a short term win is a reduction in medication errors one week after implementing a safety improvement initiative.
Step 7: Build on the change. To further sustain change, the organization should produce more change by building on what they did right to produce short term wins and identifying what should be improved to drive more success. This may include identifying the need for training and education or additional personnel.
Step 8: Institutionalize change in the organizational culture. For a change to solidify and stick, it must be anchored firmly in the organization’s culture (Finkelman, 2018). By integrating the new practices into the organization’s culture, the values promoted become part of the day-to-day activities. This is further enhanced by integrating the new vision in the orientation of new staff and leaders. This ensures that the support from the staff and leadership is sustained and failure to do so is likely to cause a descent.
Benefits of Using the Model in Quality Improvement Changes
- The model enhances the chances of success. Like other organizational change models, Kotter’s 8-steps model provides a systematic plan for change. Kotter developed his 8-step change model based on research, hence serves as a roadmap for success. In addition, Kotter’s model emphasizes a people-driven approach to change which is likely to foster success as people are motivated to drive change when they see the reason for it and are empowered.
- Change models help save time and reduce risks. The model provides an effective framework for planning and implementing quality improvement changes, thus saving time. Having a change management plan also reduces risks that may be associated with the planning and implementation process.
Reference
Campbell, R. J. (2008). Change management in health care. The Health Care Manager, 27(1), 23-39. doi: 10.1097/01.HCM.0000285028.79762.a1
Finkelman, A. W. (2018). Quality improvement: A guide for integration in nursing. Burlington, MA : Jones & Bartlett Learning
Webster, V. (2017). Successful change management – Kotter’s 8-step change model. Leadership Thoughts. Retrieved from https://www.leadershipthoughts.com/kotters-8-step-change-model/