Lippit’s Change Theory

1
Lippits Change Theory

• Candace Creese
• Wilmington University

2
Lippitts, Watson and Wesley-1958

• The Seven phases of change elaborated on Lewin's
  Three Step Change Theory
• The seven step theory is to focus on the role as
  a change agent throughout the evolution of change
• The key to change is having the right person to
  be the voice of change and the support for the
  change empowering the process.

3
Lewins Three Step Change Theory

• The process of changing the behaviors of an
  individuals resistance to a change in any
  situation.
• Unfreeze- shifting the push-pull relationship
  of opposing forces to status quo.
• Movement- the status quo is the equilibrium and
  this step is to increase the level of
  equilibrium.
• Refreezing- after the implementation of change,
  this step is necessary to make the change stick

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Seven Phases of Change

• These phases shift the change process to include
  the role of a change agent through the evolution
  of the change.
• Phase 1Diagnose the problem
• Phase 2Assess the motivation and capacity for
  change
• Phase 3Assess the resources and motivation of
  the change agent(commitment the change, power,
  and stamina)
• Phase 4Define progressive stages of change
• Phase 5Ensure the role and responsibility of the
  change agent is clear and understood
  (communicator, facilitator, and subject matter
  expert.
• Phase 6Maintain the change through
  communication, feedback, and group coordination
• Phase 7Gradually remove the change agent from
  the relationship, as the change becomes part of
  an organizational culture.

5
Research

• Psychiatric nurses were asked to self-reflection
  on orientation of action toward change
• Results yielded an outcome that nurses were
  either enthusiastic, hesitant, or withdrawn about
  changing practices to patient-centered care on
  the admission unit of a psychiatric hospital.
• Chief executive officers of hospitals were
  surveyed on the process of change at their
  facilities to reduce cost and maintain quality
  care within the organization.
• With the economic crisis we are in today, many
  hospitals are facing the same concern. Although
  the research yielded some limitations with the
  research, it showed the need for the change
  process to relieve the financial burden on
  hospitals to maintain high quality care on a
  budget.

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Research

• It has been used to enhance scope of practice in
  nurses at a time when there is a workforce
  shortage in the healthcare profession. The need
  to ensure organizational readiness for change to
  broaden practice roles.
• Public health nurses seem to take on larger roles
  and responsibilities because of the heavy work
  load to meet the needs of ill population,
  workforce demands and expectations.

7
Nursing Practice

• Nursing leadership and management is the
  effective change agent needed for the
  evolvement of change in the nursing profession.
  Lippitts phases can be used in nursing practice
  especially with the advancement in technology,
  the nature of healthcare organizations, and
  professional standards. The style, policies,
  procedures, relationships with subordinates and
  behaviors of a nurse manager have to be evaluated
  to suit the new breed of nurses. Although we
  experience change everyday, nurses have a
  difficult time embracing planned change.
  Nursing leadership must be a person who is
  influential to support and encourage success is
  the process of change.

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Nurse Leadership and Management

• Phase 1Envolving all parties involved in the
  change that will occur (scheduling, charting,
  standards for practice, etc.)
• Phase 2Discussing the pros and cons and the
  process of the change, conducting small group
  activities to assess the motivation of the
  participants. (this can predetermine the possible
  confrontation or conflict involved and allow the
  change agent to modify the approach of the
  change.
• Phase 3 the manager must have the desire to
  improve the situation and the approach to the
  process. (open mindedness and personal acceptance
  of the change)
• Phase 4detailed planning, timetables and
  deadlines must be addressed, and designating
  responsibilities to implement the change that
  will occur.
• Phase 5handeling personal conflicts and
  confrontation, from employees, about the change.
• Phase 6 Providing communication and feedback
• Phase 7 this phase is when the change is
  implemented and the procedures and policies are
  written to assure compliance with the change, and
  a termination date for the change agent is
  determined. The change agent will remain
  available for advice and reinforcement of the
  change but will turn over the responsibility of
  the change to the employees or participants.

9
My Practice

• As nurses we often experience continual change
  especially as the profession of nursing advances.
  The change to computerized charting was met with
  resistance by many nurses, as we strived to
  validate how the process would falter to justify
  keeping things the way they are. The change was a
  smooth success and as I reflect back, I can
  recall the phases.
• P1 Every employee was notified of the change and
  how it would affect them.
• P2 Each unit had a meeting to discuss how they
  felt about the change
• P3 It was evident that the change agent (for me
  was my manager and educator) was dedicated to the
  change being successful.
• P4 Responsibilities were designated to staff to
  be super users, well educated about the system
  to support the staff in the change.
• P5 My manager addressed all concerns of the
  nurses on the unit and advocated for the system
  to be personalized to our unit to enhance
  functionality for the population of patients we
  care for.
• P6 Continually surveying the staff to see what
  we do/do not like about the system and adjusting
  screens and tabs to make the charting easier.
• P7 For the first six weeks we had tech support
  and the builders of the program on hand , on
  every unit. Now they are reachable by telephone
  if help is needed.