Forces of Change

Force

The force for change can be classified into two groups: i.e. internal and external forces.

External forces:

These include environmental shifts and time base change over which management has little control. Fast advancements in technology, politics, culture and the market are just a few of the elements that contribute to this dynamic. Some examples are explained below:

1. Educational and cultural forces:
   It includes the advancement of education, the different pattern of culture, custom patterns, traditions, etc.
2. Political, economic, and social factors:
   Included in this is a rethinking of how health services are delivered and a corresponding shift in government policy and regulation. The public's perspective on health, their needs and wants in terms of health care, and the government's goals in these areas are also included.
3. Technology:
   It represents the primary driving factor for transformation from the outside world. As a result of scientific discoveries and technological innovations, the health care industry is undergoing transformations. This is essential for continued existence, for meeting obstacles, and for keeping up with the public's rising need for high-quality care, such as CT scanning, MRI, Lap chole, Lap cystectomy, and many advance laboratory tests.

Internal forces:

What we mean by "internal forces" are those factors that exist within an organization and work to effect change there by way of the personnel structure and the organizational processes. Management can influence the organization's internal factors. Because of the subsequent circumstance, change occurs:

1. People related:
   Change is inevitable when there is low work satisfaction, low morale, high absenteeism and turnover, high accident rates, frequent organizational conflict, etc., or when there is a change in top-level management, because the new boss may not share the same traits.
2. Structure related:
   There is a breakdown in communication, a lack of uniformity in policies and plans, a lack of coordination across departments, a lack of cooperation between management and employees, and the creation of pointless committees. Due to the effects of these variables, it is necessary to reevaluate current plans and methods.

Need for change:

In many organizations, the need for change is not recognized until there is a serious problem. The important factor to recognize change the need for change is feedback.

There are the following aspects for changes:

• Science and technology:
  • Growth to science, research and developments, intellectual technology, social-political, and economic changes, and improvement of technology system institutions.
• Adjustment to environmental changes:
  • Because of how rapidly environmental conditions are shifting, organizations must adapt their processes, organizational frameworks, and personnel investments to enjoy the rewards of the new surroundings.
• Performance Gaps:
  • The organization's goals and objectives are not being met or other organizational needs are not being satisfied. Changes are required to close these gaps.
• The internal balance of an organization among its different sub-systems.
• To eliminate the frustration of employee as the new schemes keeps the high morale of the employee.

Change process:

Steps in the change process, employee resistance to change, and strategies for overcoming this resistance are all important considerations for anybody interested in understanding the process of change.

For effective change management, a structured procedure that can be broken down into smaller steps is necessary. This is the crux of the most often-used approach for effecting change management. It puts the spotlight on the outsider who plays a pivotal role in driving the process of change by acting as a catalyst and a leader in the transition.

Kurt Lewin developed a change model involving three steps: Unfreezing, changing and refreezing. The model is a straightforward and useful tool for learning about the transformation procedure. According to Lewin, the process of changing people's behavior involves first convincing them that change is required, then gradually bringing them to the desired level of conduct, and lastly establishing the new pattern as the standard. Indeed, many of today's change models may trace their roots back to this paradigm. To implement change in a company, a change agent must follow a certain method.

The change process contains the following three phases:

• PHASE-I: Unfreezing (create felt need for change)
• PHASE-II: Changing (Implement the change)
• PHASE-III: Refreezing (stabilize the change)

Phase-I:

The first step in making a change is for individuals to acknowledge that a shift is necessary. People are not likely to be motivated or ready to change, and they may even work against it, if they do not perceive a need for it. This initial stage is meant to set up conditions that are amenable to change, which in turn generates a desire for said change. At this point, the agent of change has unfreezed the forces that uphold the status que and raised awareness of the opportunity, need, or problem that necessitates action.

The agent of change does an analysis of the current state of affairs to get an understanding of the difficulties or problems that need change, and to discover the potential obstacles to and opportunities for the implementation of the desired transformation. Individuals are led to believe that adjustments must be made to their worldviews, values, and actions, as well as structural and procedural aspects of their organizations, for the latter to flourish.

Actionable inspiration to alter behavior emerges here. The inv Change Agent creates an atmosphere where employees feel comfortable asking questions about the change and receiving answers. The role of the change agent is to engage individuals in a series of discussions about the current state of affairs, the necessity of change, the scope and pace of the proposed change, and the consequences of such change. In this phase, people's minds have essentially made up their minds to accept and tackle the issue or problem head-on.

Phase-II:

The second stage, called Cha implementation, aims to successfully introduce the planned change. Due of its complexity, change requires careful preparation and Cha precision or precise timing. After a population has shown signs of openness to change, a change agent might devise ways to subdue opposition and make the most of support. Simply said, the change agent's job is to weaken the opposition and bolster the proponents of the proposed change. In order to implement the new methods for change, the change agent uses a participatory decision-making strategy to win over the group's trust and support. All those who will be impacted by and responsible for enacting the change get thorough briefings from the change agent. Identifying new and more effective ways of solving the problems (changes), selecting the best (appropriate) solutions in terms of tasks, people, structure, or technology, and acting on them in order to bring about the desired change are the steps necessary for successful implementation of the change.

Phase-III: During the last phase of change

process, the change agent helps to stabilize the transformation so that it may become a permanent part of the established order. We may refer to this time period as one of stabilization, assimilation, and institutionalization. It takes time to alter people's ways of thinking and the underlying beliefs and ideals that shape their actions. Therefore, provide individuals engaged in the change sufficient time to adjust. For refreezing to take place, the agent of change must be encouraging and bolster the adaptive efforts of everyone who will be impacted by the transformation. It's important to note that the previously altered behavior is crucial if the refreezing process is insufficient. Developing fresh protocols and regulations aids in refreezing the system at a new equilibrium point. When things are refrozen, the new normal is established.

Change management:

Individuals, groups, and entire organizations can benefit from a change management strategy since it facilitates their transition from the present condition to the intended future one. The term "change management" refers to a set of methods, strategies, and procedures for handling the human element in implementing and adapting to organizational transformations.

Change management process:

The change management process is the sequence of steps or activities that a change management team or project leader would follow to apply change management to a project or change.

Change management processes contain the following three phases:

• Phase-1: Preparing for change
• Phase-2: Managing change
• Phase-3: Reinforcing change

1. Preparing for change (assessment)
   • Identifying the problem: Opportunity that necessitates change (symptoms).
   • Data collection: Gathering structural, technological, and people information and the effects of these elements on the process.
   • Data analysis: Summarizing the data (advantages, disadvantages, risks, and consequences)
   • Strategic determination: Identifying. possible solutions, barriers, and strategies.
   • Decide if the change is necessary.
   • Make others aware of the need for the change
      
2. Managing change (planning and implementation)
   • State goals and specific measurable objectives and also the time allotted.
   • Establishing the who, how, what, and when of change.
   • Allocating resources, budget, and evaluation methods.
   • Plan for resistance management.
   • Identify areas of support and resistance.
   • Include everyone in the planning that will be affected.
   • Establish target dates for implementation.
   • Develop appropriate strategies for alteration.
   • Be available to support others through the process.
   • Evaluate the change then modify it if necessary.
      
3. Reinforcing (evaluation)
   • Determining the effectiveness of change.
   • Achieved objectives and benefits qualitative as well as financial and documented evidence of being achieved.
   • Stabilize the change: taking measures to reinforce and maintain the change.

Nurse as a change agent

As a branch of healthcare, nursing is an important part of the healthcare industry. Whether in a hospital, community, educational institution, or health-related international or national organization, the nursing profession has become more complicated and has tied itself to social, behavioral, and management sciences.

A nurse's ability to influence change is essential in her several leadership roles as a nurse, including charge nurse, supervisor, nursing educator, principal, and manager. Helping people—health care providers, patients, consumers, and organizations, among others—see why and how change is beneficial is central to the role of a change agent. Being a change agent is a major function of care nurses. Nurses as change agents have to carry out different activities in different three stages of the change process according to Lewin Model:

Unfreezing(create felt need for changes):

Nurses as change agents have to do the following activities in unfreezing stage.

1. Determine what needs to change.
   • Survey the organization to understand its current state.
   • Understand why change has to take place.
      
2. Ensure there is strong support from superior management.
   • Use stakeholder analysis and stake holder management to identify and win the support of key people within the organization.
   • Frame the issue as one of organization-wide importance.
      
3. Create the need for change.
   • Create a compelling message about why change has to occur.
   • Use the vision and strategy in terms of the change required.
   • Communicate the vision in terms of the change required.
   • Emphasize the why.
      
4. Manage and understand doubts and concerns.
   • Remain open to employees' concerns and address them in terms of the need to change.

Changing (implement the change ):

Nurses as change agents have to do the following activities in changing stage:

1. Communicate often
   • Communicate throughout the planning and implementation of the changes.
   • Describe the benefits.
   • Explain exactly how the changes will affect everyone.
   • Prepare everyone for what is coming.
      
2. Dispel rumors
   • Answer honestly, questions and openly
   • Deal with problems immediately.
   • Relate the need for change back to operational necessities.
      
3. Empower action
   • Provide a lot of opportunity employee for involvement.
   •  Have line managers provide day-to-day direction.
      
4. Involve people in the process
   • Generate short-term wins to reinforce the change.
   • Negotiate with external stakeholders as necessary.

Refreezing (stabilize the change):

Nurses as change agents have to do the following activities in the refreezing stage.

1. Anchor the change into culture.
   • Identify what supports the change.
   •  Identify barriers to sustaining change.
      
2. Develop ways to sustain the change.
   • Ensure leadership support.
   •  Create a reward system.
   • Establish a feedback system.
   •  Adapt the organizational structure as necessary.
      
3. Provide support and training
   • Keep everyone informed and supported.