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Planned Change 2013
Planned Change 2013
Planned Change 2013
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Box 1 Comparison of change theories Box 2 Lippitt’s theory compared with the nursing process
Unfreezing Awareness Phase 1. Diagnose the problem Assessment* Phase 1. Diagnose the problem
(Adapted from Roussel 2006) (Lewin 1951, Lippitt et al 1958, Pearson et al 2005)
evaluation stages (Box 2, phases 6 and 7). At this implementation and evaluation (Pearson et al 2005).
point, the change has been successfully integrated Throughout the remainder of the paper, Lippitt’s
in the system and strategies are developed to prevent theory is therefore used to demonstrate how
a return to previous practices. Lippitt’s stage of managers can implement planned change.
‘maintaining the change’ is crucial because successful
change can often regress to former, outdated Leadership styles
practices (Carney 2000, Cork 2005). Before embarking on change, managers may first
While the three change theories described consider their strengths and weaknesses in terms
above are similar problem-solving approaches to of their leadership skills, because these can greatly
implementing planned change, they are also subtly affect the outcome of a change project (Cutcliffe
different. It is up to nurse managers to select the and Bassett 1997). As various authors point out,
most appropriate model based on the specific good leadership is not a prerequisite of management
circumstances of their work environment. It is also (Gerrish 2003, Outhwaite 2003, Salter et al 2009).
worth noting that, although these three theories The literature suggests that leadership, effective
are the most widely used, there are many others, communication and teamworking are among the most
including Reddin (1989), Havelock (1995) and Leavitt important elements for planned change (Hewison and
(Leavitt and Bahrami 1988). Stanton 2003, Jooste 2004, Schifalacqua et al 2009a).
Burnes (2004b) acknowledges the relevance The role of leaders is multifaceted. Schifalacqua
of Lewin’s work half a century on, but highlights et al (2009a) state that an ‘impassioned champion’ is
that his three-tiered approach attracts major essential in all change models, because they provide
criticisms. It is argued, for example, that it is only inspiration, vision and support to everyone involved.
suitable for small change projects, that it ignores Murphy (2006), meanwhile, suggests that leaders
organisational powers and politics, that it is top should be seen as team players with the same goals
down and management driven, and that it assumes as the rest of their team, rather than as stereotypical
that organisations operate in stable states. organisational leaders.
Lippitt’s work is more detailed. While it requires Jooste (2004) sets out attributes of
a greater level of understanding of change theory, it is effective leadership:
likely to be more useful to nurse managers because it ■■ Influence: leaders have an enormous role to play
incorporates a more detailed plan of how to generate in influencing followers in the right direction,
change and it is underpinned by the four elements and shortcomings in leaders’ characteristics
of the nursing process: assessment, planning, can lead to problems among followers.
■■ Clarity: are workers clear about their tasks?
Box 3 Characteristics of three leadership styles ■■ Commitment: what do workers need from
their leaders?
Autocratic Democratic Laissez-faire
■■ Self-image: do followers know their own abilities,
what they can and cannot accomplish?
Strong control Less control maintained. Little or no control.
■■ Price: what is the price followers pay or the
maintained over group.
rewards they receive for working well.
Others motivated by Economic and ego awards Motivated by support ■■ Behaviour: does the leadership style promote
coercion. are used to motivate. when requested. positive and effective behaviours among followers?
There are various leadership styles, including
Others are directed by Others are directed through Provides little or no autocratic, democratic and laissez-faire (Marquis and
commands. guidance and suggestions. direction. Huston (2008) (Box 3), and whichever one is adopted
will affect the change in question.
Communication flows Communication flows up Uses upward-downward
downward. and down. communication. Autocracy Autocratic leadership is regarded as
predictable, with a high level of productivity, but
Decision making does Decision making involves Disperses decision making
often with low motivation, creativity and morale
not involve others. others. throughout the group.
(Marquis and Huston 2008). However, it can be useful
Emphasis on different Emphasis is on ‘we’ rather Places emphasis on group. in crisis situations and is frequently seen in large
status (‘you’ and ‘I’). than ‘you’ and ‘I’. bureaucracies. Autocracy is applicable when change
is demanded, for example through the use of a top-
Criticism is punitive. Criticism is constructive. Does not criticise. down approach, while democratic leadership is more
appropriate for groups working together and where
(Adapted from Marquis and Huston 2008)
autonomy is promoted (Rycroft-Malone et al 2002).
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