1. Prepared by Miss Samah Ishtieh
Change
Prepared by Miss Samah Ishtieh
5/13/2018
Miss samah Ishtieh

2. Why do we Change? First, change is natural:
Every healthy living thing changes, if we stop changing, then we weaken and eventually die.
Second, change is required:
The world is not static, and we must keep up with the speed of change of the rest of the world or we will fall behind.
Third, change leads to well-being: Change involves giving up the old & welcoming the new If change has been well-planned, the change will lead to a better place.
5/13/2018
Miss samah Ishtieh

3. Change Change is constant in today’s health care organization.
Definition:- Making something different from what it was.
An alteration, haphazard or planned to make something different.
Any alteration, regardless how slight or how major, or how large or small the object of change.
5/13/2018
Miss samah Ishtieh

4. One who works to bring about a change.
Change Agent:
One who works to bring about a change.
An outside helper used to planned implement the process of change.
Driving Force:
Behaviors that facilitate change by pushing
participants in the desired direction.
Restraining forces:
Behaviors that impede change by discouraging
participants from making specified changes.
5/13/2018
Miss samah Ishtieh

5. Change can be:
A. Planned: actively involves predetermined goals, participative management, mutual goal setting, equal power ratio, deliberativeness, a change agent and a target date.
B. Unplanned: a reactive process where change either occurs without personal involvement or is introduced from outside.
5/13/2018
Miss samah Ishtieh

6. Types of Change Coercive change. Emulative change. إجبارى.
Indoctrination.
Interactional change.
Natural change.
Socialization change.
Technocratic change.
Planned change.
إجبارى.
عن طريق الإنصهار فى السلطة
التغيير تحت سيطرة السلطة.
للتفاعل.
طبيعى (بالقضاء والقدر).
بالمشاركة.
المبنى على المعلومات
المخطط
5/13/2018
Miss samah Ishtieh

7. Types of Change…
Coercive change: Nonmutual goal setting, imbalanced power ratio, and one-side deliberative (حيثيات مقصوده ومتعمدة).
Emulative change: بإبراز القوة ينافس ويضاهي
change is fostered through identification with and emulation of power figures.
Indoctrination: التغيير تحت سيطرة السلطة
mutual goal setting, imbalanced power ratio, and is deliberative مقصوده ومتعمدة)).
Subordinates are instructed in the beliefs
of the power sources
5/13/2018
Miss samah Ishtieh

8. Interactional Change: Mutual goal setting, fairly equal power, but no deliberativeness. Parties may be unconsciously committed to changing one another.
Natural Change: These changes include accidents and acts of God. They involve no goal setting or deliberativeness.
Socialization Change: ((بالمشاركة Direct relationship with interactional change. One conforms to the needs of a social group. When there is greater deliberativeness on the power side, change becomes indoctrination.
5/13/2018
Miss samah Ishtieh

9. Technocratic change: Collecting and interpreting data bring about change. A technocrat merely reports the findings of the analysis to bring about change.
Planned change: Involves mutual goal setting, an equal power ratio, and deliberativeness.
5/13/2018
Miss samah Ishtieh

10. Change Could Be …
Exogenous: which means outside the organization. Example :
* Political
* Economical
* Social
* Client demand change
* Client expectation.
Endogenous: which means within the organization. Example :
* People / Employees * Tasks .
5/13/2018
Miss samah Ishtieh

11. Change Theories Lewin’s Force-Field Model: Unfreeze. Movement.
Refreeze.
Lippitt’s Phase Model.
Havelock’s Model.
Rogers's Diffusion of innovations.
5/13/2018
Miss samah Ishtieh

12. Lewin’s Force-Field Model (1951):
Provides a social-psychological view of the change process. He sees behavior as a dynamic balance of forces working in opposing, directions within a field.
To plan change, analyze forces and shift the balance in the direction of change through a three-step process: unfreezing, moving, and refreezing.
Basically, strategies for change are aimed at increasing driving forces, decreasing restraining forces, or both.
5/13/2018
Miss samah Ishtieh

13. Lewin’s Force-Field Model analysis
Present equilibrium
(Status Quo)
Restraining Forces
Driving Forces
Refreezing
Moving
Unfreezing
New equilibrium
5/13/2018
Miss samah Ishtieh

14. Lewin’s Force-Field analysis
Present
(Status Quo)
Force will be toward change
Some long-term employees resist changes
Almost complete turnover of staff (many new nurses)
Restraining Forces
Driving Forces
Interested
Vice-president
Administration Mandate a change
Need new solution
(old one doesn’t work)
Budget in red
(Financial incentive to change)
Entrenched director of nurses
Nurse Manager lacks change agent skills
Fear of job loss
5/13/2018
Miss samah Ishtieh

15. Lippitt’s Phases Model (1958):
Lippitt and colleagues extended Lewin's theory to a seven-step process and focused more on what the change agent must do.
They emphasized participation of key members of the target system throughout the change process, particularly during planning. Communication skills, rapport building, and problem-solving strategies underlie their phases.
5/13/2018
Miss samah Ishtieh

16. Lippitt’s Seven Steps Change…cont
Diagnose the problem: Involve key people in data collection and problem solving.
Assess the motivation and capacity for change: What are the financial and human resources and constraints? Are the structure and function of the organization conducive to change? What are the possible solutions, and which are preferred?
Assess the change agent's motivation and resources: This assessment is important. Consider the change agent's own commitment to change, energy level, future ambitions, and power bases.
5/13/2018
Miss samah Ishtieh

17. Select progressive change objects: Develop the action plan, evaluation criteria, and specify strategies.
Choose a change agent role: The change agent can act as cheerleader, expert, consultant, or group facilitator. Whichever role is selected, all participants should recognize it so that expectations are clear.
Maintain the change: Communication, feedback, revision, and coordination are essential for this phase.
Terminate the helping relationship: The change agent withdraws from the selected role gradually as the change becomes institutionalized.
5/13/2018
Miss samah Ishtieh

18. Havelock’s Model (1973):
Havelock described a six-step processes, which are a modification of Lewin's model.
Havelock describes an active change agent as one who uses a participative approach.
5/13/2018
Miss samah Ishtieh

19. Havelock’s Six Steps Change
He emphasizes the unfreezing or planning stage
as:
Building a relationship.
Diagnosing the problem.
Acquiring resources.
This stage is followed by the moving stage:
Choosing the solution.
Gaining acceptance.
Refreezing is referred to as:
Stabilization & Self-renewal.
5/13/2018
Miss samah Ishtieh

20. Rogers’s Diffusion of innovations (1983)
Rogers takes a broader approach than Lewin, Lippitt & Havelock through five-step details how an individual or decision-making unit passes from first knowledge of an innovation to confirmation of the decision to adopt or reject a new idea. He emphasizes on the reversible nature of change.
Rogers stresses in two important aspects of successful planned change: Key people and policymakers must be interested in the innovation and committed to making it happen.
5/13/2018
Miss samah Ishtieh

21. Roger’s five Steps Change…
Knowledge: The decision-making unit is introduced to the innovation and begins to understand it.
Persuasion: A favorable or unfavorable attitude toward the innovation forms.
Decision: Activities lead to a decision to adopt or reject the innovation.
Implementation: The innovation is put to use, and reinvention or alterations may occur.
Confirmation: The individual or decision-making unit seeks reinforcement that the decision was correct. If there are conflicting messages or experiences, the original decision may be reversed.
5/13/2018
Miss samah Ishtieh

22. Comparison of Change Models
Lewin
Lippitt
Havelock
Rogers
Unfreeze
1. Diagnose problem
1. Building a relationship
1. Knowledge
2. Moving
2.Assess motivation
2. Diagnosis the problem
2. Persuasion
3. Refreezing
3.Assess change agent’s motivation & resources
3.Acquiring resources
3. Decision
4. Select progressive change objects.
4. Choosing the solution
4. Implementation
5. Choose change agent role.
5.Gaining acceptance
5. Confirmation
6. Maintain change
6. Stabilization & self-renewal
7. Terminate helping relationships
5/13/2018
Miss samah Ishtieh

23. Source of Individual Resistance to change
Habit
Individual
Resistance
Security
Economic Factors
Fear of Unknown
Selective Information Processing
Habit
Individual
Resistance
Security
Economic Factors
Fear of Unknown
Selective Information Processing
5/13/2018
Miss samah Ishtieh

24. Source of Organizational Resistance to change
Limited focus of change
Organizational
Resistance
Structural inertia
Threat to expertise
Threat to established resources allocation
Threat to established power relationship
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Miss samah Ishtieh

25. Change Process Assessment Planning Evaluation Implementation 1 2 3 4
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Miss samah Ishtieh

26. Strategies for Change Power coercive approach.
Normative re-educative approach.
Rational-empirical approach.
5/13/2018
Miss samah Ishtieh

27. 1. Power-coercive approach
We use Legitimate Power to induce change
We use MUSCLES
5/13/2018
Miss samah Ishtieh

28. 2. Normative re-educative approach
Based on Assumption that people are committed to socio cultural norms.
If we want to make Change, we need intervention by using or aid learning and relearning process.
We use HEART or EMOTIONS.
5/13/2018
Miss samah Ishtieh

29. 3. Rational-empirical approach
Human being are rational, so they will support what is advantageous for us.
Human beings follow their interests, so in this strategy, we use BRAINS.
5/13/2018
Miss samah Ishtieh

30. Strategy Selection Depends On
Situation
Maturity Level
Methods of reducing resistance to change.
5/13/2018
Miss samah Ishtieh

31. Reasons Why People Resist Change???
Fear about their interest.
They do not know any information about the change.
They do not like to take the risk.
They consider it as a challenge.
Fear of failure.
Group norms are vitiatedمعايير المجموعةِ فاسدة
5/13/2018
Miss samah Ishtieh

32. Other Causes Peer Pressure Change for the wrong person
It will increase workload
They have lack of involvement
5/13/2018
Miss samah Ishtieh

33. Methods of Reducing Resistance to Change
Good Planning / Communication, Preparation.
Allow Participation.
Education.
Manipulation to threat or to reward.
Mediation: used third party, try to conceive people who resist.
5/13/2018
Miss samah Ishtieh

34. Thanks
5/13/2018
Miss samah Ishtieh