Chapter 8 - Assignment Instructions: 1. Review Learning Exercise 8.3 - Using Change Strategies to Increase Sam's Compliance (located in Chapter 8 of the textbook) 2. Answer the following questions: a. What change strategy or combination thereof (rational-empirical, normative-reeducative or power-coercive) do you believe has the greatest likelihood of increasing Sam's compliance? b. How could you use this strategy? c. Who would be involved in this change effort? d. What efforts might you undertake to increase the unfreezing so that Sam is more willing to actively participate in such a planned change effort? 3. Your paper should be: o Typed according to APA style for margins, formatting and spacing standards. o Typed into a Microsoft Word document, save the file, and then upload the file Chapter 8 Planned Change • Please show Parts 1 and 2 of Leadership Video Case: Change Management, available as part of Lippincott CoursePoint for Marquis and Huston: Leadership Roles and Management Functions in Nursing, 9th edition. • For more info, visit thePoint.lww.com/CPMarquis9e. Copyright © 2018 Wolters Kluwer · All Rights Reserved Direction of Change in 21st Century Health-Care Organizations • Organizational restructuring • Quality improvement • Employee retention Copyright © 2018 Wolters Kluwer · All Rights Reserved Qualities of Change Agents • Visionary • Risk taker • Flexible • Excellent communicator • Creative • Sensitive • Current Copyright © 2018 Wolters Kluwer · All Rights Reserved Kurt Lewin’s Change Theory • Unfreezing: The change agent convinces members of the group to change or guilt, anxiety, or concern are elicited. • Movement: The change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces. • Refreezing: The change agent assists in stabilizing the system change so that it becomes integrated into the status quo. Copyright © 2018 Wolters Kluwer · All Rights Reserved Lewin’s Driving and Restraining Forces • Driving (facilitators): forces that push the system toward change • Restraining (barriers): forces that pull the system away from change Copyright © 2018 Wolters Kluwer · All Rights Reserved Driving and Restraining Forces (Goal: Return to School) Forces driving to reach the goal • Opportunity for • Low energy level advancement • Status, social gratification • Enhanced self-esteem • Family supportive of efforts • Pay increase Forces restraining from reaching the goal • Limited financial resources • Unreliable transportation • Time with family already limited Copyright © 2018 Wolters Kluwer · All Rights Reserved Lewin (1951) Identified Several Rules That Should Be Followed in Implementing Change • Change should only be implemented for good reason. • Change should always be gradual. • All change should be planned and not sporadic or sudden. • All individuals who may be affected by the change should be involved in planning for the change. Copyright © 2018 Wolters Kluwer · All Rights Reserved Stages of Change Model (Burrowes and Needs, 2009) • Stage 1: Precontemplation • Stage 2: Contemplation • Stage 3: Preparation • Stage 4: Action • Stage 5: Maintenance • No current intention to change • Individual considers making a change. • There is intent to make a change in the near future. • Individual modifies his or her behavior. • Change is maintained and relapse is avoided. Copyright © 2018 Wolters Kluwer · All Rights Reserved Classic Change Strategies • Rational–empirical strategies: used when there is little anticipated resistance to the change or when the change is perceived as reasonable • Normative–reeducative strategies: use group norms and peer pressure to socialize and influence people so that change will occur • Power–coercive strategies: feature the application of power by legitimate authority, economic sanctions, or political clout of the change agent Copyright © 2018 Wolters Kluwer · All Rights Reserved Question A nurse-manager is attempting to restructure the unit to prevent understaffing of the nurses. The nurses agree this is a needed change. What type of change strategy would be most effective? A. Rational–empirical strategies B. Normative–reeducative strategies C. Power–coercive strategies D. None of the above Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer A. Rational–empirical strategies Rationale: When using rational–empirical strategies, the change agent assumes that resistance to change comes from a lack of knowledge and that humans are rational beings who will change when given factual information documenting the need for change. This type of strategy is used when there is little anticipated resistance to the change or when the change is perceived as reasonable. Copyright © 2018 Wolters Kluwer · All Rights Reserved Reminder • Because change disrupts the homeostasis or balance of the group, resistance should always be expected. Copyright © 2018 Wolters Kluwer · All Rights Reserved Complex Adaptive Systems Change Theory • Suggests that the relationship between elements and agents within any system is nonlinear and that these elements are the key players in changing settings or outcomes • Olson and Eoyang (2001) suggest that the selforganizing nature of human interactions in a complex organization leads to surprising effects. Copyright © 2018 Wolters Kluwer · All Rights Reserved Chaos Theory • Really about finding the underlying order in apparently random data • Determining this underlying order, however, is challenging, and the order itself is constantly changing. • Changes in outcomes are not proportional to the degree of change in the initial condition. Copyright © 2018 Wolters Kluwer · All Rights Reserved Organizational Aging • Organizations progress through developmental stages. • As organizations age, structure increases to provide greater control and coordination. • The young organization is characterized by high energy, movement, and virtually constant change and adaptation. • Aged organizations have established “turf boundaries,” function in an orderly and predictable fashion, and are focused on rules and regulations. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is true or false: The young organization is characterized by low energy and resistance to change. A. True B. False Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer B. False Rationale: The young organization is characterized by high energy, movement, and virtually constant change and adaptation. Copyright © 2018 Wolters Kluwer · All Rights Reserved Planned Change Versus Accidental Change • Regardless of the type of change, all major change brings feelings of achievement, pride, loss, and stress. • Planned change, in contrast to accidental change or change by drift, is change that results from a wellthought-out and deliberate effort to make something happen. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question Which emotions are commonly associated with change? A. B. C. D. E. Pride Stress Loss Achievement All of the above Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer E. All of the above Rationale: Change is associated with a wide range of feelings, some positive and others negative. Copyright © 2018 Wolters Kluwer · All Rights Reserved Three Good Reasons for Change • Change to solve some problem. • Change to make work procedures more efficient. • Change to reduce unnecessary workload. Copyright © 2018 Wolters Kluwer · All Rights Reserved Resistance—The Natural and Expected Response to Change Individuals’ resistance typically depends on four things: • Their flexibility to change • Their evaluation of the immediate situation • The anticipated consequences of the change • Their perceptions of what they have to lose and gain Copyright © 2018 Wolters Kluwer · All Rights Reserved Question Tell whether the following statement is true or false: For change to be effective, it should be immediate and sweeping. A. True B. False Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer B. False Rationale: Change should be gradual and carefully planned rather than sudden. Copyright © 2018 Wolters Kluwer · All Rights Reserved Question Presenting employees with the pros and cons of a new system to be implemented is an example of which type of strategy? A. Rational B. Normative C. Power Copyright © 2018 Wolters Kluwer · All Rights Reserved Answer A. Rational Rationale: A rational change agent uses empirical reasoning as a tool for initiating change. Copyright © 2018 Wolters Kluwer · All Rights Reserved Resistance to Change Perhaps the greatest factor contributing to the resistance encountered with change is a lack of trust between the employee and the manager or the employee and the organization. Copyright © 2018 Wolters Kluwer · All Rights Reserved Involvement in Change • Whenever possible, all those who may be affected by a change should be involved in planning for that change. • When information and decision making are shared, subordinates feel that they have played a valuable role in the change. Copyright © 2018 Wolters Kluwer · All Rights Reserved Integrating Leadership and Management Functions in Planned Change • Manager: mechanic who implements the planned change • Leader: inventor or creator of the planned change Both leadership and management skills are necessary in planned change. Copyright © 2018 Wolters Kluwer · All Rights Reserved • Please show Part 3 of Leadership Video Case: Change Management, available as part of Lippincott CoursePoint for Marquis and Huston: Leadership Roles and Management Functions in Nursing, 9th edition. • For more info, visit thePoint.lww.com/CPMarquis9e. Copyright © 2018 Wolters Kluwer · All Rights Reserved LEARNING EXERCISE 8.3 Using Change Strategies to Increase Sam's Compliance You are a staff nurse in a home health agency. One of your patients, Sam Little, is a 38-year- old man with type 2 diabetes. He has developed some loss of vision and had to have two toes amputated as consequences of his disease process. Sam's compliance with four-times-daily blood glucose monitoring and sliding-scale insulin administration has never been particularly good, but he has been worse than usual lately. Sam refuses to use an insulin pump; however, he has been willing to follow a prescribed diabetic diet and has kept his weight to a desired level. Sam's wife called you at the agency yesterday and asked you to work with her in developing a plan to increase Sam's compliance with his blood glucose monitoring and insulin administra- tion. She said that Sam, while believing it "probably won't help," has agreed to meet with you to discuss such a plan. He does not want, however, "to feel pressured into doing something he doesn't want to do." ASSIGNMENT: What change strategy or combination thereof (rational-empirical, normative-reeducative, and power-coercive) do you believe has the greatest likelihood of increasing Sam's compliance? How could you use this strategy? Who would be involved in this change effort? What efforts might you undertake to increase the unfreezing so that Sam is more willing to actively participate in such a planned change effort?
Purchase answer to see full attachment