Promotion for Successful Changes to EBP

What about when change is resisted? We have all experienced this, yes? Historically, development and dissemination of new practices was expected to progress from controlled trials to real-world effectiveness studies and then natural uptake by practice communities, but it has been recognized that this expectation is unrealistic (Fixsen et al., 2009; Proctor et al., 2009; Weisz et al., 2004). There can be a lag of as much as 15-20 years to integrate research findings into actual practice (Balas & Boren, 2000).

Questions to validate the goals and benefits of implementing a proposed change

• Will the change improve clinical outcomes?
• Will it allow tracking of those outcomes?
• Will it help to more accurately identify areas for improvement?
• Will it increase the safety of care delivery?
• Will it make delivery more efficient?
• Will it resolve process barriers?

You can become a champion for the project or the change agent!

First, assess the workplace climate for their attitude toward change.

Change Theories

There are theorists who have spent quite a bit of time developing change theories. Knowledge of the science of change theory is critical to altering organizational systems. Being conversant with various change theories can provide a framework for implementing, managing, and evaluating change within the context of human behavior. Change theories can be linear or non-linear; however, even linear theories do not unfold in a systematic and organized pattern. In the following section, we identify the role of leader and the typical pattern of events that occur in a change event (Wagner, 2018).

In Lewin’s Change Theory, the process of “Unfreezing, Moving, and Refreezing” is explored. Kurt Lewin’s change model is a simple and easy-to-understand framework to humanize the change management process. These three distinct stages of change (unfreeze, change, and refreeze) allow you to plan & implement the required change. Lewin’s theory proposes that individuals and groups of individuals are influenced by restraining forces, or obstacles that counter driving forces aimed at keeping the status quo, and driving forces, or positive forces for change that push in the direction that causes change to happen (Roussel et al., 2018).

References

Balas, E.A., & Boren, S.A. (2000). Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT, (Eds.), Yearbook of medical informatics 2000: Patient-centered systems (pp. 65-70). Schattauer Verlagsgesellschaft mbH.

Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation research: A synthesis of the literature. Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.

Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health, 36(1), 24–34. https://doi.org/10.1007/s10488-008-0197-4

Roussel, L., Harris, J. L., & Thomas, P. L. (2018). Management and leadership for nurse administrators (8th ed.). Jones & Bartlett Learning.

Weisz, J. R., Chu, B. C., & Polo, A. J. (2004). Treatment dissemination and evidence-based practice: Strengthening intervention through clinician-researcher collaboration. Clinical Psychology: Science and Practice, 11(3), 300–307. https://doi.org/10.1093/clipsy.bph085