DNP 835 Reflect on the “IHI Module QI 201: Planning for Spread: From Local Improvements to System-Wide Change.”  Re: Topic 5 DQ 1

NP 835 Reflect on the “IHI Module QI 201: Planning for Spread: From Local Improvements to System-Wide Change.” 

Re: Topic 5 DQ 1

According to Kurt Lewin to effect long-lasting change, people have to be loosened from their old way, transitioned, and then molded into their new way. This involves preparing people for change, managing the change, and then working to ensure that the change stays in place. The three stages of change are: Unfreezing: From Lewin’s perspective, the first stage in helping people adapt to change involves unfreezing or loosening their attachment to their current attitude or practice. That means helping them understand why change is necessary and clarifying how the change will be accomplished. When implementing a change in health care, this stage might include communicating with staff and sharing external research or internal data about the change. It may also focus on training or the distribution of resources that will help people understand the need for change. Change: In the second stage, the process of change actually occurs. This may be a difficult time for individuals affected by the change. These people will need lots of support as questions and frustrations arise. Freezing: Once the changes occur or something has transitioned to a new way of being, Lewin identifies a need to actively “re-freeze” the process in its new state so that it can continue to operate as designed. This ensures that people will not naturally return to the old way of doing things. This re-freezing may involve new protocols and procedures, periodic process checks to learn how the new process is working in relation to its design, and reinforcement through internal communications and other formats that remind people of the new process. (Berwick, D. M., et al, 2018).

Everett Rogers’ Diffusion of Innovation Theory is the process by which an innovation is communicated through certain channels over time among the members of a social system. Given that decisions are not authoritative or collective, each member of the social system faces his/her own innovation-decision that follows a 5-step process: Knowledge – a person becomes aware of an innovation and has some idea of how it functions,  Persuasion – person forms a favorable or unfavorable attitude toward the innovation,  Decision – person engages in activities that lead to a choice to adopt or reject the innovation,  Implementation – a person puts an innovation into use, Confirmation – person evaluates the results of an innovation-decision already made. The most striking feature of diffusion theory is that, for most members of a social system, the innovation-decision depends heavily on the innovation decisions of the other members of the system. In fact, empirically we see the successful spread of an innovation follows an S-shaped curve (Bennett, J., et al, 2018).

The IHI Framework for Spread provides a useful tool for assessing the current culture of an organization and determining how likely a new idea will spread. It is important to look at the factors that contribute to successful change, such as the degree of trust among staff, the level of communication, and the ability to take risks. Trust is a key factor in successful change, as it creates an environment where changes can occur. A high degree of trust among staff can help ensure that new ideas are discussed openly without fear of repercussions. Additionally, the level of communication among staff is important to ensure that new ideas are understood and accepted. Finally, the ability to take risks is essential to create a culture of experimentation and innovation (Weiner, B. 2019).

References

Bennett, J., & Bennett, L. (2018). A review of factors that influence the diffusion of innovation when structuring a faculty training program. Internet and Higher Education,6, 53-63.

Berwick, D. M., Nolan, T. W., Whittington, J., & Kirkpatrick, K. M. (2018). Spread of innovations in health care. The Journal of the American Medical Association, 299(11), 1372-1377.

Weiner, B. (2019). A theory of organizational readiness for change. Implementation Science, 5(67), 1-9.