This document discusses change management and creating a culture of safety in healthcare organizations. It outlines John Kotter's 8 steps of change as setting urgency, building a guiding team, developing a vision and strategy, communicating for buy-in, empowering others to act, producing short-term wins, not letting up, and creating a new culture. It also identifies errors to avoid like complacency and not celebrating wins. Finally, it discusses various change management models that can be used like the TeamSTEPPS model and the importance of leadership in cultural change.
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Change
Management
Change
Management
Objectives
īŽ List the Eight Steps of Change
īŽ Identify errors common to organizational
change
īŽ Discuss what is involved in creating a
new culture
īŽ Begin planning your nursing homeâs
change strategy
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Change
Management
Set the Stage and
Create a Sense of Urgency
īŽ Get peopleâs attention!
īŽ Sell the need for change âĻ describe the
consequences of not changing
īŽ Immerse people in information about the change
īŽ Discuss ways to solve the problems people
identify with the change
īŽ Empower people to solve the âproblemâ
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Change
Management
Pull Together the Guiding Team
īŽ Choose key players, especially staff-level managers
īŽ Identify a Guiding Team that is multidisciplinary
īŽ Consider the credibility and integrity of change
leaders
īŽ Choose proven leaders who can drive the change
process
īŽ Strong position power, broad expertise, and high credibility
īŽ Ensure the Guiding Team has both management
and leadership skills
īŽ Management skills control the process
īŽ Leadership skills drive the change
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Change
Management
Develop the Change Vision
and Strategy
Senior Leadership is responsible for:
īŽ Establishing the definition of a âculture of safetyâ
aligned with expectations, core values, and shared
beliefs
īŽ Informing the nursing home of these values and
evaluating the culture
īŽ Leading the process of:
īŽ Translating values into expected behaviors
īŽ Establishing trust and accountability
īŽ Communicating a commitment to shaping the culture
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Change
Management
Communicate for Understanding and Buy-In
īŽ Provide supportive actions for fear, anger, and resistance
īŽ Encourage discussion, dissent, disagreement, debateâ
keep people talking
īŽ Tell people what you knowâand what you donât know
īŽ Acknowledge concerns, perceived losses, and anger
īŽ Model the expected behaviors
īŽ Value resisters
īŽ They clarify the problem and identify other problems
that need to be solved first
īŽ Their tough questions can strengthen and improve the
change
īŽ They may be rightâit is a dumb idea!
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Change
Management
Empower Others to Act
īŽ Provide direction
īŽ Allow others to find their own team-driven solutions
īŽ Encourage others to speak up and take risks
īŽ Share the information you know
īŽ Encourage teamwork and collaboration
īŽ Encourage personal reflection and learning
īŽ Train employees so they have the desired skills
and attitudes
īŽ Track activities and progress
īŽ Set short-term goals
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Change
Management
Produce Short-Term Wins
īŽ Show visible success; further impetus for change
īŽ Provide positive feedback; recognize and reward
contributions to wins
īŽ Further builds morale and motivation
īŽ Leverage lessons learned to help plan next goal
īŽ Create greater difficulty for resisters to block further
change
īŽ Provide leadership with evidence of success
īŽ Build momentum
īŽ Helps draw in neutral or reluctant supporters
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Change
Management
Donât Let Up
īŽ Acknowledge hard work
īŽ Celebrate successes and accomplishments
īŽ Reaffirm the vision
īŽ Bring people together toward the vision
īŽ Acknowledge what people have left behind
īŽ Develop long-term goals and plans
īŽ Provide tools and training to reinforce new behaviors
īŽ Reinforce and reward the new behaviors
īŽ Create systems and structures that reinforce new
behaviors
īŽ Prepare people for the next change
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Change
Management
Create a New Culture
īŽ Develop action steps for stabilizing, reinforcing, and
sustaining the change:
īŽ Give people time to mourn their actual losses
īŽ Provide skill and knowledge training
īŽ Develop new reward systems
īŽ Recognize and celebrate accomplishments
īŽ Develop performance measures to continually monitor the
results from the change and to identify opportunities for
further improvements
īŽ Make adjustments to the change vision and strategy to reflect
new learning and insights
īŽ Encourage people to be open to new challenges, forces, and
pressures for the next change
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Change
Management
Errors Common to
Organizational Change
īŽ Allowing for complacency
īŽ Failing to create a sufficiently powerful
Guiding Coalition and Change Team
īŽ Not truly integrating the vision
īŽ Allowing obstacles to block change
īŽ Not celebrating short-term wins
īŽ Declaring victory too soon
īŽ Neglecting to anchor changes firmly
in the culture
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Change
Management
Culture Change Comes Last,
Not First!
īŽ Most alterations in norms and shared values
come at the end of the transformation process
īŽ New approaches sink in after success is shown
īŽ Feedback and reinforcement are crucial to buy-in
īŽ Sometimes the only way to change culture is to
change key people
īŽ Individuals in leadership positions need to be on
board, or the old culture will reassert itself
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Change
Management
Change Management Models
īŽ PDSA: Plan, Do (TeamSTEPPS), Study, Act
īŽ DMAIC: Define, Measure, Analyze, Improve (TeamSTEPPS),
Control
īŽ IHI Model for Improvement: Forming the Team, Setting Aims,
Establishing Measures, Selecting Changes, Testing Changes,
Implementing Changes (TeamSTEPPS), Spreading Changes
īŽ CUSP: Assemble the Team, Engage the Senior Executive,
Understand the Science of Safety, Identify Defects through
Sensemaking, Implement Teamwork and Communication
(TeamSTEPPS)
īŽ https://www.ahrq.gov/professionals/education/curriculum-
tools/cusptoolkit/index.html
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Change
Management
On-Time Quality
Improvement Model
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Change
Management
Catalytic Event Drives
Need For Change
Build Team,
Strategy, Buy-In,
Establish Goals
Implement Action Plan,
Train, Empower Others
TeamSTEPPS
Change
Coaching
Iâm staying right
here. Yeah,
theyâll be back.
What
are they
doing?
Why do
we need
change?
FUTURE
Celebrate Wins!
Staying the Course
Sustaining
Develop Action
Plan
Test
Intervention
(Outcomes)
Monitor, Integrate, Continuous
Process Improvement
Prepare
the Climate
Roadmap to a
Culture of Safety