Change: Are you Swimming
Staying Afloat, or Sinking?
Jane Brandes RN MSN
Twilla Harrington RN BSN CHPN WCC
Providence Hospice
September, 2014
Objectives
• On completion participants will understand their own
personal change attributes
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Participants will be able to recognize how their change
attributes impact change
• Participants will be able to utilize change theory as tool
to successfully implement change
Change
–noun
• a transformation or modification; alteration
• the substitution of one thing for another
–verb
• to become different
• to become transformed or converted
• to substitute another or others for; exchange for something else,
usually of the same kind
Strive for Balance
Change and Loss make people
feel out of balance
Change Personality Style
What animal did you pick ?
Why?
What personality attributes do you feel you
have in common with your animal?
Change Personality Style
The Embracer/Activator
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Moves toward the change
Manages multiple tasks
Likes to be busy
Learns quickly and adapts rapidly
Thrives on uncertainty
Becomes board easily – restless
Needs a great deal of freedom
Thinks “big picture”
Often overlooks details
Can be a controller
Change Personality Style
The Aggressor
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Fights the Change (actively or passively)
Often has “us vs. them” attitude
Does not do well in new social situations
Not motivated by recognition
Will resist change on behalf of others
Does not like uncertainty
Usually has a committed group of friends
Can be very black and white in thinking
Change Personality Style
The Denier/Avoider
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Moves away from change
Is a creature of habit
Makes lists for lists
Does not like uncertainty
Can easily be swayed by the aggressor
Does not like conflict
Able to focus on the same task for long periods
Often very detail oriented
Using Change Personality for
Practice Improvement
• Time of Death Visits
• Background
• Project Goals
Types of Change
• 4 types of change: transformational, incremental,
remedial, and developmental (McNara, 2006).
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Application of Kotter's Approach to Change
Kotter’s 8 Stage Change
Process
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4.
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8.
Establish a sense of urgency
Creating a guiding coalition
Developing a vision and strategy
Communicating the change vision
Empowering employees for broad based action
Generating short term wins
Consolidating gains and producing more change
Anchoring change
Establishing a
sense of
urgency
•Key change in leadership and staff
•Feedback from family
•Regulatory Climate
•Attending 33% of TOD visits
•Key time to engage the
denier/avoider and aggressor change
personality
Creating a
guiding
coalition
•Developing a team charter
•Charter members were leadership,
staff, and supervisors
•Purposeful recruitment of all change
personality styles
Developing a
vision and
strategy
Vision: To increase visits at time
of death.
Strategy:
•Improving team communication
•Data collection
•Survey reviews
•Education
Having a diverse team with
differing change personalities
helped to develop a more
comprehensive vision and
strategy.
Communicating
the change
vision
•Newsletter
•Staff Meetings
•State of the union
“To provide the best possible care for our
patients and families our goal is to attend
100% of TOD visits”
Empowering
for action
•Newsletter articles focusing on the
importance of TOD visits
•Lunch and Learn for peer to peer
discussion of best practices at TOD visits
•Staff handout that covers the therapeutic
effect TOD visits can have on the grief
process
The key to this step was having staff with
different change personalities engaging
other staff.
Generating
short term
wins
•Ongoing feedback to staff on how
our TOD visit completion rate
•Our TOD visit rate had doubled
from 33% to 60%
•Continued reinforcement through
discussion at meetings and the
newsletter on the “urgency” of
making this change
Consolidating
gains and
producing
more change
•TOD visits consistently at 60% still
needed a 40% improvement to meet
the charter goal
•Charter team decided to re-message
and create more urgency
•After re-messaging TOD visits has
jumped to 98-100%
Anchoring
change
•Celebrate success
•Ongoing reports to monitor success
•Continue sharing stories of how TOD
visits impact families
Conclusion
Identification of your change agent style
can help you understand your reaction
to change
Using a model for change can help
integrate change in a consistent
successful way
References
• Kotter, J. (1996). Leading Change. Harvard Business
School.
• McNara, C. (2006). Field Guide to Consulting and
Organizational Development: A Collaborative and Systems
Approach to Performance, Change and Learning.
Authenticity Consulting.