Capstone: Hospital Downsizing and Restructuring and How It's Impact on the Nurses



Capstone: Hospital Downsizing and Restructuring and How It's Impact on the Nurses

Overview of kotter's 8-step change model and Improvements

The change management at the hospital can be analyzed keeping in view the work of Kotter. Here are many theories about how to "do" change. Many of them come from John Kotter, a professor at Harvard Business School and a highly renowned expert on change.

Kotter presents his 8-step process to change in his book "Leading Change" ("Leading Change"), published in 1995.the eight steps of change management and leadership are (Kotter, 1996, 6-11):

Establishing a Sense of Urgency (Develop a sense of urgency)

Creating the Guiding Coalition (Creating a coalition of guides)

Developing a Vision and Strategy (Developing a vision and strategy)

Communicating the Change Vision (Communicating the change vision)

Empowering Employees for Broad-Based Action (Empower employees for a large share)

Generating Short-Term Wins (Generate short-term changes in winners)

Consolidating Gains and Producing More Change (Consolidate gains and produce more change)

Anchoring New Approaches in the Culture (Anchor the new measures in the corporate culture)

John Kotter (1996) provides a summary of lessons to be drawn from change efforts in corporate settings. These settings imply a hierarchy but the lessons he draws express process-centric approaches to leadership and synthesize other studies about change in politics, community, and civil society even though these latter settings have less hierarchy and more leadership without formal authority (Kotter,1996,6-11).

Keeping in view Kotter's view, it is also important to convince the nurse that change is necessary. This often involves strong leadership and visible support from key people within the organization. Managing change is not enough. It also has to lead it. Although speaking from corporate change experience, Kotter identifies a cardinal rule of community organizing: the importance of selecting an achievable issue that is part of a longer-term strategy. The issue's achievement provides some visible improvement for the people engaged in the change effort and gives them hope for more successful change (Kotter, 1996, 6-11). For example, winning extended hours for a public health clinic does not solve a neighborhood's health problems but it increases access to health care providers for its residents. Short-term wins come more easily if the process of change is seen as part of the change efforts. Thus, every indication that the group's sense of urgency is winning support and every person identified as important to the group's effort to mobilize resources that joins the guiding coalition becomes a short-term win.

The institution can find leaders of change within the company. To lead change, the leaders must assemble a coalition or team of influential people, whose power comes from a variety of sources, including their positions, status, experience and political importance (Kotter, 1996, 6-11). Effective leaders are willing to make tough choices. They consider evidence along with other objective information and make decisions that deliver results. Leaders with a laser-like focus on achievement value alignment of strategies toward results. They also demonstrate an unwavering discipline that keeps people and their work aimed at ...