Lecture 2 Change

Question 1

Planned change

Answer 1

1. Change that results from a well thought-out and deliberate effort to make something happen.
2. The deliberate application of knowledge and skills by a leader to bring about a change.

Question 2

Change by drift

Answer 2

Unplanned or accidental change.

Question 3

Change agent

Answer 3

1. A person skilled in the theory and implementation of planned change.
2. The ability of this person (i.e., the behavior of the manager) is often the determining factor in whether a change will be successful.

Question 4

Regardless of the type of change, all major change brings feelings of _

Answer 4

Achievement, pride, loss, and stress.

Question 5

3 good reasons for change

Answer 5

1. Change to solve some problem.
2. Change to make work procedures more efficient.
3. Change to reduce unnecessary workload.

Question 6

Lewin’s 4 rules for implementing change (1951)

Answer 6

1. Change should only be implemented for good reason.
2. Change should always be gradual.
3. All change should be planned, and not sporadic or sudden.
4. All individuals who may be affected by the change should be involved in planning for the change.

Question 7

Lewin’s 3 phases of planned change (1951)

Answer 7

1. Unfreezing.
2. Movement.
3. Refreezing.

Question 8

Unfreezing

Answer 8

When the change agent convinces members of the group to change. (If a nurse is told or ordered to do something, this is not really unfreezing.)

Question 9

Movement

Answer 9

When the change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces.

Question 10

Refreezing

Answer 10

When the change agent assists in stabilizing the change so that it becomes integrated into the status quo. If refreezing is incomplete, the change will be ineffective.

Question 11

Change should never be attempted unless the _ can make a commitment to be available until the change is complete.

Answer 11

Change agent.

Question 12

Driving forces

Answer 12

Forces that propel a system toward the change.

Question 13

Restraining forces

Answer 13

Forces that divert a system from change.

Question 14

A change needs at least _ before it will be accepted as part of the system (refreezing phase).

Answer 14

3 to 6 months.

Question 15

Most 21st century health care organizations find themselves undergoing continual change directed at _

Answer 15

1. Organizational restructuring.
2. Quality improvement.
3. Employee retention.

Question 16

Management functions related to change

Answer 16

1. Forecasting.
2. Recognizing the need for change.
3. Periodically assessing for signs of organizational aging and planning renewal strategies.

Question 17

_ is the natural and expected response to change.

Answer 17

Resistance.

Question 18

Individuals’ resistance to change typically depends on _

Answer 18

1. Their flexibility to change.
2. Their evaluation of the immediate situation.
3. The anticipated consequences of the change.
4. Their perceptions of what they have to lose and gain.

Question 19

Resistance can be counteracted by _

Answer 19

Encouraging subordinates to speak openly so that options can be identified to overcome objections.

Question 20

Perhaps the greatest factor contributing to the resistance encountered with change is a _ between the employee and the manager or the employee and the organization.

Answer 20

Lack of trust.

Question 21

Chaos theory

Answer 21

1. Postulates that while change appears to be random, there is actually an underlying order.
2. Even small changes in conditions can drastically alter a system’s long-term behavior (the butterfly effect).

Question 22

For a change to become part of the organization, staff must _

Answer 22

Internalize the change - understand how the change is related to the outcomes.

Question 23

Complex adaptive systems (CAS) theory

Answer 23

Change theory suggesting that the relationship between elements and agents within any system is nonlinear and that these elements are the key players in changing settings or outcomes.

Question 24

_ changes encounter less resistance than changes that are perceived as social or that are contrary to established customs or norms.

Answer 24

Technological.

Question 25

Historically, many of the changes that have occurred in nursing or have affected the profession are the results of _

Answer 25

Change by drift.