Managi ng Change
ESSENTIALS OF NURSING MANAGEMENT Titles in the series Barbara Scammell: Communication Skills Communication in society The communications continuum: forms and skills The communications continuum: coaching and counselling Planning and organising Staffing Co-ordinating Communication in nurse management at the point of service delivery Communication in nurse management in different areas of medical care Verena Tschudin with Jane Schober: Managing Yourself 'Know thyself' Valuing yourself Motivating yourself Asserting yourself Stressing yourself Supporting yourself Celebrating yourself Your career - making the choices Sheila Marson et al.: Managing People The science and function of management Team building: a practical approach Leadership Creating a climate for learn ing Quality and its control Annabel Broome: Managing Change, 2nd edition Principles of complex change Leadership and creating change from within Imposed change The nurse as a change agent Identifying training and development needs Appendix A: Managing your own change project Appendix B: Health of the organisation questionnaire Appendix C: Role effectiveness profile - tool for self-assessment Appendix D: Challenge and support Diana Sale: Quality Assurance, 2nd edition An introduction to quality assurance Total quality management Standards of care Clinical audit Clinical protocols Monitoring of providers by purchasers: the Dorset Health Commission's approach
ESSENTIALS OF NURSING MANAGEMENT Managing Change 2nd Edition Annabel Broome MACMILLAN
Annabel K. Broome 1990, 1998 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London WIP 9HE. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The author has asserted her right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act 1988. First edition 1990 Reprinted five times Second edition 1998 Published by MACMILLAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 6XS and London Companies and representatives throughout the world ISBN 978-0-333-67736-0 DOI 10.1007/978-1-349-14291-0 ISBN 978-1-349-14291-0 (ebook) A catalogue record for this book is available from the British Library. This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. 10 9 8 7 6 5 4 3 2 1 07 06 05 04 03 02 01 00 99 98
Contents Acknowledgements vii Introduction 1 Chapter 1 Principles of complex change 11 Defining the present state 11 Describing the desired future state 14 Diagnosis 14 Leverage 17 Defining the work to be done 19 The transition plan 20 Readiness to change 31 Chapter 2 Leadership and creating change from within 36 Leadership 36 The role of leadership in initiating change 40 Developing teamwork 44 Creating change from within 45 Evaluation - Is it working? 51 Chapter 3 Imposed change 68 Diagnosis of readiness to change 69 The pain of change for the individual 70 Unplanned change 77 Assessing readiness to change 79 Chapter 4 The nurse as a change agent 83 The nurse in the system 83 v
Stress, strain and coping 84 What is a change agent? 87 Change project: An example 93 Chapter 5 Identifying training and development needs 103 Management style 103 The self-assessment tool 104 Management arenas 112 Women in management 114 Appendix A Managing your own change project 120 Appendix B Health of the organization questionnaire 125 Appendix C Role effectiveness profile - tool for self-assessment 129 Appendix D Challenge and support 133 Index 136 vi
Acknowledgements Every effort has been made to trace all the copyright-holders of material used in this book, but if any have been inadvertently overlooked the publishers will be pleased to make the necessary arrangement at the first opportunity. vii