planned change

planned change Order Description Identify a problem, in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inefficiency, or issue within" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in a specific department/unit. Describe a specific, realistic change that could be made to address the issue. Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards. Identify a change model or strategy to guide your plannin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing for implementin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the change. Provide a rationale for your selection. Outlin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ine the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy. Explain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in who would be in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">involved in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and managin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing this change. Describe the skills and characteristics that would be necessary to facilitate the chaLewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s Theory of Planned Change as a Strategic Resource Shirey, Maria R. PhD, MBA, RN, NEA-BC, FACHE, FAAN Author Information Author Affiliation: Associate Professor, Doctor of Nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing Practice Program, College of Nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and Health Professions, University of Southern Indiana, Evansville. The author declares no conflict of in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">interest. Correspondence: Dr Shirey, College of Nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and Health Professions, University of Southern Indiana, 8600 University Blvd, HP-2044, Evansville, IN 47712 ([email protected]). Abstract This department highlights change management strategies that may be successful in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in strategically plannin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and executin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing organizational change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiatives. With the goal of presentin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing practical approaches helpful to nurse leaders advancin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing organizational change, content in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">includes evidence-based projects, tools, and resources that mobilize and sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in organizational change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiatives. In this article, the author explores the use of the Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with a discussion of its strengths, limitations, and targeted application. The American Organization of Nurse Executives identifies 5 nurse executive competencies to in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">include communication, knowledge, leadership, professionalism, and busin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">iness skills.1 Within" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the category of leadership is the requirement that nurse executives demonstrate proficiency with change management. Most often, successful change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiatives use change theory or a planned approach to implement organizational shifts. Change management relates to the “process, tools, and techniques to manage the people side of change to achieve a required busin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">iness outcome.”2(p2) Although there are a multitude of change theories to frame the change process, nurse leaders must understand the nuances related to appropriate theory selection to apply, lead, and manage sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inable change. Shanley 3 argues that nurse leaders should not dismiss change management theory as unnecessary. Those responsible for organizational success must appreciate the different approaches to managin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change and match these approaches to their particular circumstances optimizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the best strategy for success.3 Graphic Figure. No caption a... This article explores the use of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s Theory of Planned Change (TPC)4,5 as a strategic resource to mobilize the human capital aspect of change. An overview of the theory is provided along with a discussion of strengths, limitations, and targeted application. Back to Top Overview of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC Back to Top Background Kurt Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in, a social psychologist of the early 20th century, is known as a pioneer in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the study of group dynamics and organizational development. Among his many accomplishments is the early development of force field analysis (FFA) as a framework for identifyin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and examin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the factors or forces in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">influencin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a situation.4,5 Force field analysis “maps out the totality and complexity of the field in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in which the behavior takes place”6(p311) and then uses this in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">information to guide actions. An FFA specifies forces as either drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing (helpin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces) or restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing (hin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inderin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces) movement toward a goal. Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s approach postulates that behavior is a function of the group environment or field.6 Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s view is “that if one could identify, plot and establish the potency of (drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing) forces, then it would be possible not to only understand why in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">individuals, groups and organizations act as they do, but also what forces would need to be dimin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inished or strengthened to brin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing about change.”6(pp981-982) This important FFA framework forms the foundation of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s 3-stage TPC commonly referred to in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the phases of unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing (or transitionin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing), and refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing.5 Back to Top Elements Unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, the 1st stage, in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">involves gettin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing ready for change. This stage entails a change agent such as a nurse leader recognizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a problem, identifyin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the need for change, and mobilizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing others to see the need for change. Unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing may begin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in with nurse leaders conductin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a gap analysis illustratin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing discrepancies between the desired and current state. Creatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a sense of urgency for change is part of unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing. A solution is then selected, and preparation for movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing away from a current reality or equilibrium ensues. This stage is the basis of what Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in calls the FFA,5 which requires identifyin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the factors for and again" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inst change. Successful change necessitates strengthenin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces and/or weakenin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces. Movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing or transitionin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, the 2nd stage of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory, entails lookin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing at change as a process rather than an event. Transitionin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing is the in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inner movement that in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">individuals make in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in reaction to change and requires unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing or movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing to a new way of bein" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing. This stage necessitates creatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a detailed plan of action and engagin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing people to try out the proposed change. Often, this stage is difficult because it has uncertain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inty and fear associated with change. The transition stage in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">involves coachin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing to overcome fears and clear communication to avoid losin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing sight of the desired target, which is a new and improved reality. Refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, the 3rd stage of the theory, demands stabilizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the change so that it becomes embedded in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">into existin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing systems such as culture, policies, and practices. In refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the change, nurse leaders consider the FFA to accentuate the drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces facilitatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change and counteract the restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces gettin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the way of change. With refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the new change, this dynamic produces a new equilibrium, which is then recognized as the new norm or higher level of performance expectation. This 3rd stage is important because lockin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in or in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">institutionalizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change will be crucial to its sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inability over time. Back to Top Evidence Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC has traditional application in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the social sciences and organizational development. A brief review of the literature demonstrates that the theory is also used extensively in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in clin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inical nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing practice,7,8 nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing education,9,10 educational admin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inistration,11 nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing research,12 and healthcare operations.13 The structure and processes of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory assist in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in avoidin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the common pitfalls that thwart change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiative success 9 and offer a framework to guide change. The use of FFA concepts provides for a better understandin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing of how to design detailed action plans and decision matrices for change. Much of the literature that addresses Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s 3-stage theory focuses on unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing. To a lesser extent, however, the change management literature speaks to Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing stage, which deals with sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inability. In a synthesis paper on sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inability, the authors 14 conclude that sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inability is dependent on multiple factors, at different levels of analysis, and in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">include in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">individual, managerial, fin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inancial, leadership, organizational, cultural, political, procedural, and contextual. These factors are significant because before in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change, they cannot always be determin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ined. Tools to assess staff perceptions of change sustain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inability are available in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the literature,15 as are measures to determin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ine readin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">iness for change.16 Back to Top Strengths The strengths of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC are that it is versatile, practical, simple to use, and easy to understand. Because the theory represents one of the oldest change management models in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in existence, there is much experience with this framework. Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s work, particularly the field theory element, contin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inues to be relevant today.17 The theory is considered most effective when used in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in a top-down approach to change. In this scenario, senior members of an organization and other formal leaders drive and support change. The literature suggests that change to be successful requires champions to drive it.3 Back to Top Limitations Although Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory is a commonly used change management theory, it may not always be appropriate. The theory is criticized for bein" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing too simplistic, quain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">intly lin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inear, and framed from a static perspective.6 Positions vary from “for” to “mixed” to “again" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inst” regardin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the perceived lin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inear aspects of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory.6 Some postulate that today’s healthcare systems are nonlin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inear and dynamic; thus, change happens more quickly than Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory accommodates. Others argue that complexity theories are more dynamic and emergent than the TPC.6 However, some in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">indicate careful in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">interpretation of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s origin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inal theoretical work is a back-to-the-future experience that illustrates Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s propositions as consistent with those of more contemporary complexity theorists.6 Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC is considered a rational-lin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inear change management model. Because change is often complex and unpredictable, it is not always possible to frame it from an unfreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, refreezin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing perspective. Desirable change may not be driven from a top-down perspective and may need to be more organic and bottom-up to be accepted and in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">internalized. Back to Top Targeted Application of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC Back to Top Exemplar To apply Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC, Figure 1 shows targeted use of the theory. In this hypothetical example in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">involvin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the creation of a leadership development program for a successful 200-bed community hospital, the change project is top-down driven. The change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiative resulted from identification of a future need to grow in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">internal nurse leaders and address succession plannin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the nurse manager role. Figure 1 represents the use of an FFA to identify pertin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inent drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing and restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces needed to pursue the goal of a ready future leader pipelin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ine. Concurrent with the FFA, senior leaders and current middle managers developed a detailed plan of action to engage potential charge nurse participants. They held town hall meetin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ings with staff nurses to describe the anticipated nurse manager needs for the hospital’s next decade of operations and beyond. Graphic Figure 1 Usin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing Figure 1, the drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces for the desired change in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">include anticipated retirement of nurse managers over the next 5 to 10 years, competition from larger hospitals for nurse manager talent, and higher costs associated with recruitin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing external talent as compared with usin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a growin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing your own approach. The identified restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces are lack of staff nurse motivation to assume formal nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing leadership roles, resistance of nonnursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing departments for allocatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing leadership development resources to nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, and noncompetitive nurse manager compensation when compared with larger competitors in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the marketplace. Usin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s framework and understandin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing these forces in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in this application, nurse leaders should strengthen the drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces and weaken the restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces. To strengthen the drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces, nurse leaders enlist a team of collaborators to develop a detailed plan of action emphasizin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing communication. The plan focuses on creatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing a sense of urgency for why the leadership development program is needed. Senior leaders may present a grid and graphs documentin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing an agin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing workforce and the anticipated demands for fillin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the nurse manager role given projected organizational growth in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in services. Documentation could also be shared to demonstrate that in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">internally developed candidates stay with the organization longer, have lower turnover costs, and can be productive more quickly than in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">individuals not familiar with the in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">institution and the culture. To weaken the restrain" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing forces, nurse leaders provide support structures in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the nurse manager role to make it more desirable for staff nurses to aspire to these positions. In addition, clarification is given to other departments that the leadership development program is bein" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing pilot tested in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the nursin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing division, with full anticipation that it can also be implemented in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in other departments after the trial period with nurses. Lastly, the nurse leader engages the human resources department to examin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ine management wages relative to competitors in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in the marketplace and based on identified in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inequities moves to adjust the nurse manager salary structure as needed. Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC is selected for this example because it is best used in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in highly stable environments (eg, hospital is currently successful) when there is time to implement deliberate, small-scale changes (eg, not addressin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing urgent situation and havin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing time for plannin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing). In highly unstable environments and under emergency situations, groundin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change usin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s theory may be counterproductive. In this hypothetical hospital’s top-down approach to succession plannin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing, the senior leaders are the champions drivin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the change. The senior leaders, in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in response to staff feedback for more leadership development opportunities, conceive an in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiative that coin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">incides with their workforce development efforts (eg, win" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in-win" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in situation for nurses, leaders, and hospitals). Back to Top Other Considerations Usin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change management models facilitates the people side of change. Approachin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing change management without also in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">incorporatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing project management activities needed to monitor change can be compared with navigatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing without oversight and controls. Regardless of the change management theory or framework, any change to processes, systems, organizational structures, and/or job roles requires both a technical side and a people side.2 Positionin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing for successful change also requires effective leadership and sponsorship.2 Back to Top Conclusion This article explores the use of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s TPC as a strategic resource to mobilize the people side of change. Robust evidence exists regardin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the efficacy of Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s 3-stage theory.17 Although this theory dates back to the early 20th century, the premises still apply today and form the foundation for other more modern change management frameworks. Understandin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing the theory along with strengths and limitations is important for its targeted application. Lewin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">in’s framework is best used with change that is planned, where the in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">initiative starts as a top-down effort, and when there is stability and time to produce change. Movin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing an organization to a future desired state also requires in" rel="nofollow">in" rel="nofollow">in" rel="nofollow">incorporatin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">ing both change management and project management prin" rel="nofollow">in" rel="nofollow">in" rel="nofollow">inciples.nge effort.