Thriving in Change and Complexity By: Chantel Henderson Emily Petley-Jones Kari Knox & Leah MacNeil

“All over the world people are being overwhelmed by their work, the limitations on their time, and the endless advances on technology” (Porter-O’Grady & Malloch, 2003).

Objectives At the completion of the presentation the students will be able to: Assess three barriers to thriving with change and complexity in the health care setting. Explain the three steps to the change process. State two or more ways the health care team can deal with change.

Factors Affecting Change in Health Care Change is endless Information is readily available Knowledge is a utility Technology is changing (Porter-O’Grady & Malloch).

Definition Change: The process of becoming different. Complexity: is a broad term that can be thought of as a combination of new theories and concepts. (Carpenter & Speziale, 2007 )

Kurt Lewin’s Change Theory Is recognized as the founder of social psychology. He developed the three stage change process. -Unfreezing - Change - Refreezing ( Carpenter & Speziale, 2007)

Examples IM injection sites RNs role within the health care team Change within the nursing program at StFX Change within the nursing process The growing number of male nurses

Barriers to Change Kotter and Schlesinger identified basic causes of resistance to change: Self interest Individuals are more concerned with the implications for themselves Misunderstanding Communications problems Inadequate information Low tolerance of change Sense of insecurity Different assessment of the situation Disagreement over the need for change Disagreement over the advantages and disadvantages

Ten Principles for Leaders; Application for Change 1. Wholes are made up of parts 2. All health care is local 3. Adding Value to a part adds value to the whole 4. Simple systems make up complex systems 5. Diversity is a necessity of life (Porter-O’Grady & Malloch)

6. Error is essential to creation 7. Systems thrive when all of their functions intersect and interact 8. Equilibrium and disequilibrium are in constant tension 9. Change is generated from the center outward 10. Revolution results from the aggregation of local changes (Porter-O’Grady & Malloch)

1. Wholes are Made Up of Parts Wholes are made up of smaller units that are always interacting with each other to sustain the whole. In the health care setting there are a variety of different roles in which they communicate to sustain as a team. (Porter-O’Grady & Malloch)

2. All Health Care is Local The integration and effectiveness depends on local relationships not centralized authorities. Martin Buber says that all health services are provided within the context of the “I-Thou” Relationships. (Porter-O’Grady & Malloch)

3. Adding Value to the Part Adds Value to the Whole In a true system all activities and roles no matter how large or small have true functions. Careful selection of every role in the system is essential to the systems ability to thrive. (Porter-O’Grady & Malloch)

4. Simple Systems Make Up Complex Systems Complexity grows through the interconnecting of smaller, simpler systems called “chunking”. (Porter-O’Grady & Malloch)

5. Diversity is a Necessity of Life Diversity is essential for life. It is necessary for diversity to be present in order to thrive. (Porter-O’Grady & Malloch)

6. Error is Essential to Creation Errors are essential to the process of change. (Porter-O’Grady & Malloch)

7. Systems Thrive When All of Their Functions Intersect and Interact. There is nothing in this world that does not in some way interact with something else. (Porter-O’Grady & Malloch)

8. Equilibrium and Disequilibrium are in Constant Tension There has been constant tension between stabilizers and challenges. This tension is essential to life and reflects that disequilibrium (Challenges) is the universes natural state. (Porter-O’Grady & Malloch)

9. Change is Generated From the Center Outward Change moves from the center of a system to all other parts, influencing everything. Every system has a unique life that determines their meaning and value and gives it individual character. (Porter-O’Grady & Malloch)

10. Revolution Results From the Aggregation of Local Changes Most changes that occur are revolutionary, they happen over a steady regulated period of time. (Porter-O’Grady & Malloch)

How Change Benefits Nursing Change can produce positive benefits for the nurse as well as his/her clients Provides opportunities for personal change and development Provides new challenges Improves the quality of patient care Provides a stimulating work environment

Discussion Questions Have you ever experience planned change when working as a nursing student in the health care field? What was the change proposed? If so, how did the health care team deal with this change? Were the results worth the change? Do you feel there are any changing that need to occur to benefit the nursing program here at StFX?

“It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.” ~Author unknown