Jul 30, 2020 in Health

Assessing Readiness for Change

Introduction

Change is a significant process in a health care organization such as a hospital as it leads to the invention of new ways of doing things. Changing or improving the current means of performing certain health procedures help in enhancing the quality of care offered to the patients. Several models of change process exist. One of these change models is the Prochaska and DiClemente’s Stages of Change Model. This model helps individuals to make effective decision towards the desired change. A manager in any organization must choose a change model that will effectively facilitate the change process he or she expects to achieve in his or her organization. The paper will expound more on the introduction to change theory, the roles of a change agent, description of the next steps in the change process and evaluate whether the change process improve collaboration and impact of change.

The Process of Change

There are many models of change theory, but this paper will discuss the readiness of change as outlined by the trans-theoretical model of change. This model is related to change theory as it outlines and describes the steps required for an individual to achieve the desired healthy behavior change. This model of behavior change help in the assessment of the readiness of an individual to adopt a positive healthier behavior. The model has various stages including pre-contemplation, contemplation, preparation, action, maintenance, and the relapse phase. In the pre-contemplation stage, the individuals do not consider the change at that moment, and they are not ready for a change. The people do not predict change soon, and they are not aware that their current behavior has a problem. In the contemplation phase, people are uncertain about change. They do not know whether to or not accept the change.

 

In the preparation stage, individuals start experiencing some change, and they are ready for it. They begin planning to act for one month. They also intend on taking the necessary action in the immediate future, and they start taking some steps towards the change of behavior. In the action phase, people are already practicing the new behavior for between 3-6 months. They have modified their problem behavior or have abandoned their old unhealthy behavior. In the maintenance stage, people continue to show ongoing commitment in the new practice sustenance. They have sustained behavior for not less than six months and are striving to avoid relapse. This phase begins post six months to 5 years after the initial behavior change. In the relapse phase, people start resuming to their old behaviors if there is the lack of enough motivation. Trans-theoretical Model is utilized widely to bring behavior change in many organizations.

Role of Change Agent

A change in behavior cannot occur if there is no competent change agent. A change agent acts as a guide and director of the desired behavior change. In this case, a nurse supervisor wants to change a staff members’ shift from a 12-hour shift to an 8-hour shift. During the meeting, the members of the staffs express concerns and disappointment as it would require them to make new arrangements for elder or child care. The nurse supervisor has several roles to play in the pre-contemplation stage. At first, he or she communicated the change in the staffs’ hours of working shift. This change was faced by concerns and disappointments from the members of the staffs due to the need of unexpected adjustments in their daily schedules.

The nurse supervisor first confirms their lack of readiness for this change because people at this stage lack awareness for change and they do not even see its need soon (within six months). The nurse supervisor clarifies the need for an 8-hour shift in the organization and leaves them to decide. A leader should never impose change on to the people as they can reject it entirely. He or she then encourages them to re-evaluate the convenience of the current 12-hour shift to both the staffs and the patients. The nurse supervisor then encourages self-exploration but not taking the action. Here, the supervisor can advise them to consider the advantages and disadvantages of remaining with the 12-hour shift and changing to an 8-hour shift. The last role in this stage is to explain and individualize the risk. He or she encourages them to make mindful decisions and embrace the benefits that an 8-hour shift could bring. He or she clarifies to the staff members that the hospital would give them enough time to make new arrangements for their elder or childcare.

The Next Steps in the Change Process

In the pre-contemplation stage, the staff members reveal that they are not ready for this change in their working shift hours. The lack of staffs’ readiness for this change requires the nurse supervisor to utilize his or her skills effectively to convince them to accept the change in the next steps of the change process. Lack of readiness can have negative impacts on the change process if not addressed adequately. In the contemplation phase, the nurse supervisor still confirms their lack of readiness because this is the period within the next one month after communicating the change when people are uncertain about the change. He or she then clarifies the pros and cons of the change but leave them to make their decision. The nurse supervisor then assists them in the evaluation of challenges and benefits of the change. He or she then helps them to identify and enhance their knowledge about the need for a change. In the preparation phase, the nurse supervisor encourages the staffs to act within one month. This phase represents the time when they should start making some small steps towards the change. The nurse supervisor encourages them to communicate to their families and friends that they want to change their working shift hours to help in the adjustments process. The nurse supervisor encourages any small steps made towards achieving the desired change.

In the action stage, the staff members would have accepted the 8-hour shift change more the six months ago. The nurse supervisor encourages them to remain committed in following the 8-hour shift. He or she assists them to avoid challenges that can affect the change negatively. In the maintenance stage, the staffs would have changed into an 8-hour shift for more than six months ago. The nurse supervisor closely monitors the change to ensure it does not relapse. He or she helps the staffs to cope with the new change. In the relapse stage, which occurs post five years after the change, the nurse supervisor evaluates the triggers for relapse. He or she reassesses the staff's motivation and barriers to the change. The nurse supervisor employs stronger coping strategies to reduce chances of a relapse.

Conclusion

The trans-theoretical model of the change process improves collaboration and impact of change. This change model explains the need for change in a logical and practical manner that enables people to realize the necessity of abandoning their old ways of doing things. Unlike other change models, this model outlines the period under which every step of the change process should take. In this case, the nurse supervisor can monitor the level of change in all stages of the change process. The staff members collaborated with the nurse supervisor to effect change in the working shift hour after they recognized the benefits of the change. Trans-theoretical model of the change process has a positive impact on the change process if effectively applied.

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