This document discusses change management and leading organizational change. It describes Lewin's change management model of unfreezing, moving to change, and refreezing. It also discusses William Bridges' transition model of endings, a neutral zone, and new beginnings. The document emphasizes that effective change requires managing both the external change and internal transitions people experience. It provides strategies for leadership to effectively facilitate change, including communicating vision and the change plan, overcoming resistance, and fostering innovation through transformational leadership and diffusion of new ideas.

1. Change Management
Dr. Vickie Hughes

2. ► In the face of an emotional outburst, a person may ask in
disbelief: "What did I do?"
► The better question is: "What did you expect?"
► Expectations hold people hostage; unmet expectations can
generate strong emotions
• Sensemaking can be powerful in working through unmet
expectations
Leaders Manage Expectations

3. ► Appreciate the difference between transitions and types of
change
► Describe Lewin’s Change Management Model
► Identify issues in change management and managing
transitions according to the William Bridges Model
► Discuss leadership strategies to effectively facilitate change
in the workplace
► Identify importance of evidence-based practice & innovation
in health care
Objectives

4. What is the difference between change and transition?
► Change is an external event or situation
► Transition is the inner psychological process
► Change will only be successful if leaders address the
transition experience of people during change
► Bridges Transition Model stages of transition
Bridges, 1986
Endings
Neutral or
Transition
Zone
New
Beginnings

5. William Bridges Managing Transition Model
Adapted from Managing Transitions, William Bridges, 1986
Ending
Neutral or Transition
New
Beginning
Uncertainty Commitment
Skepticism Exploration
Anxiety
Resistance
Innovation
Creativity
High Energy Learning
Confusion
Ambivalence
Frustration
Denial
Reservation
Confusion
Relief Trust
Excited
Letting Go
Uncomfortable: Need to
spend some time here
Acceptance

6. Types of Change
► First order change
• Evolutionary; Continuous improvement
• Restoration of balance
► Second order change
• Revolutionary; Disruptive
• Episodic; Creates new way/new learning
► Planned change
• Deliberate; Organized; Improvement
focus
► Unplanned change
• Unanticipated
• Adaptive
Change cannot be avoided…it is ever
present…but we can influence
circumstances and consequences…we can
give it direction
Porter-O’Grady & Malloch, 2018

7. Force Field Analysis in Lewin’s Change Model
Marquis & Huston, 2017
Driving
Forces
(Positive forces for change)
Restraining
Forces
(Obstacles to change)
Present
State
or
Desired
State
Driving forces
move a system
toward change
Restraining forces
move a system
away from change

8. Lewin’s Change Model
Unfreeze
• Gather data; determine what needs to be changed
• Force Field Analysis; ensure strong support from upper management; manage doubts/concerns
• Create the need for change; unless the driving forces are stronger than the restraining forces change will not
happen
Change
• Develop a plan with goals, objectives, target dates
• Communicate often with all affected by the change; identify areas of support & resistance; dispel rumors
• Empower action; involve people in the process; be available to support and encourage through the change
• Evaluate the change; modify the change if necessary
Refreeze
• Anchor the changes into the culture
• Develop ways to sustain the change
• Provide support and training
• Celebrate success
Marquis & Huston, 2017

9. Leadership Strategies for Managing Change
and Transitions
► Communicating the change (4Ps) (Bridges, 2009)
• Purpose: Why making change?
• Picture: What will it look like?
• Plan: What is the plan/path?
• Part: What part will they have in creating
the plan and end point?
► Resistance to change/transition
• Look for the commitment behind the resistance
o Staff going through grief/loss in transition
o Consider personality type and response to change
• Not all stakeholders equal
o Approve, Responsible, Consult, Inform
• Informal leaders
o Opinion leaders and change champions

10. Communication Tips
► Communicate vision, mission, values
• Say it 6 different times, 6 different ways
► Listen twice as much as you speak
• People complain before they create
► Listen to understand
• Understanding is more important than
agreement
► People trust behavior over words
• Provide two-way communication
• Utilize Reina trust building behaviors
► Tell the truth: good and bad news
• Admit when you do know the answer

11. Evidence-Based Practice
► Evidence-based practice
• “The conscientious and judicious use of
current best evidence in conjunction with
clinical expertise and patient values to guide
health care decisions” (p.126)
► Translation science
• “The investigation of methods, interventions,
and variables that influence the adoption by
individuals and organizations of EBPs to
improve clinical and operational decision
making in health care” (p. 129)
► What translation pathway is appropriate
based on the analysis of the evidence?
Titler, 2008

12. Diffusion of Innovation Creating Change
Innovation
Motivation
Change
► Develop culture of innovation using transformational
leadership (Titler, 2008)
• Capitalize on innovation
• Merge motivation to think and act
• Move toward change
► Motivational factors
• Achievement, recognition, growth, enjoying the work
itself, advancement, responsibility, belonging, meaning,
passion
► Roger’s (1983) Diffusion of Innovation
• Innovators, early adopters, early majority, late majority,
laggards
• Leadership from a dancing guy:
https://www.youtube.com/watch?v=hO8MwBZl-Vc

13. Summary
• Transition is the inner psychological process
• Change is an external event or situation
Transitions Versus Change
• Unfreeze Movement (Change) Refreeze
Lewin’s Change Model
• Leaders must effectively manage both change and transition
• Remember the 4Ps, strategies to overcome resistance, & communication tips
Leadership Strategies for Change & Transitions
• What is the current best practice? What translation pathway fits based on the strength of the evidence?
• Transformational leadership, Roger’s diffusion of innovation, and first follower relationships foster
movement of innovation to worksite change
Evidence-Base Practice & Innovation

14. References
► Bridges, W. (1986) Managing Organization Transitions. Organizational Dynamics,
15(1), 24-33.
► Bridges, W. (2009), Managing transitions: Making the most of change (3rd ed.).
► Marquis, B.L. & Huston, C.J. (2017). Leadership Roles Management Functions in
Nursing: Theory and Application. Philadelphia, PA: Wolters Kluwer.
► Porter-O’Grady, T. & Malloch, K. (2018). Quantum Leadership (5th ed). Burlington,
MA: Jones & Bartlett Learning.
► Rogers, E.M. (1983). Diffusion of Innovations. New York: The Fee Press.
► Titler, MG, (2008). Evidence on EBP implementation. AHRQ Publication No. 08-
0043,Chapter 7, 126-145.