Combining the work of John Kotter and William Bridges, this is Change Leadership applied to Nursing; shared at the 2018 NH Nurses Association Nursing Leaders event.

1. Change Theory and
Implementation
Kris Mailepors
Bushido Leadership LLC
Northwestern Medical Center
Ph (802)-342-8735
kris@bushidoleadership.com
Tw: @bushidoleader

2. Change Theory and
Implementation
SESSION OBJECTIVES
1. Describe the three phases of transition
2. Develop flexible strategies to adapt to the
varying needs a clinical team
3. Identify new ways to communicate change
effectively

5. WHATDOESTHISTELLYOUABOUTCHANGE?

6. Two Things to Consider
1. What makes handling change so challenging?
2. What does this quote mean to you:

7. What’s Different about change?
Stability was the norm, and we had
episodic change
Continuous change is the norm

8. Changes just keep coming!!!
From outside…
• Market conditions
• New technologies
• New software
• New regulations
From inside…
• New Managers
• New team structures
• New policies
• Reduced budgets
• New or unclear expectations

9. What’s your change?
What keeps you up at night?
From outside…
• Market conditions
• New technologies
• New software
• New regulations
From inside…
• New Managers
• New team structures
• New policies
• Reduced budgets
• New or unclear expectations

10. Change is good…is it?
…Change usually benefits the organization by
solving a problem or creating greater efficiency
however…
…It pays much more attention to the finances,
strategy, and technology than to the people who
have to make it work
THERE IS THE ISSUE

11. Change vs. Transition
Change is …
– Situational; something starts or stops.
Transition is …
– The gradual process of psychological adjustment
that happens inside us as we adapt…
It is the TRANSITION, not the change, that people resist

12. Change vs Transition

13. The Three Phases of Transition

14. Why is transition resisted?
• People have a personal connection to how
they work; people are giving up a part of their
personality
• Fear of the unknown; doing and being what
they have never done or been before

15. The Three Phases of Transition

16. What has ended…what is lost?
• Turf
• Status
• Power/influence
• Autonomy
• Relationships
• Memberships
• Routine/structure
• Meaningful work
• Control of work
• Personal Identity
• Competence
• Personal Future
• Trust in employer or
manager

17. Doing a Loss Analysis
Note on the grid who is losing what

18. Dealing with an ending?
Denial
Anxiety
AngerBargaining
Sadness/
Depression

19. Handling those dealing with endings
and loses
Behaviors: Flip attitude, evasion, skepticism,
refusal to accept the reality of the situation
Actions:
– explain the change and the reasons
– Give examples of peers who are changing or
learning
– Give examples of the need for this new
(system/approach/technology)

20. Handling those dealing with endings
and loses
Behaviors: Resentment, rumor mongering,
nervousness or stress, decreased productivity
and effectiveness
Actions:
– Encourage talking and listen carefully
– Don’t talk them out of feelings; offer a different point
of view if you have one
– Give positive feedback on their progress, if genuine
– Offer accurate information to dispel rumors

21. Handling those dealing with endings
and loses
Behaviors: Grumbling, irritation, rage, mistakes,
aggressiveness, foot dragging, vandalism,
indignation
Actions:
– Listen and acknowledge anger
– Don’t talk them out of it
– Don’t assume blame for their anger
– Don’t collude/agree with them
– Recommend involving HR if extreme

22. Handling those dealing with endings
and loses
Behaviors: Attempts to get out of the situation, attempts
to make deals or promises relating to the old way,
negotiation
Actions:
– Keep realistic plan in sight
– Don’t be swayed by promises or negotiations
– Reinforce situation as it is
– Don’t get into problem solving or bargaining with them
– Gently remind them of reality

23. Handling those dealing with endings
and loses
Behaviors: Silence, “down,” or disheartened, tearfulness
Actions:
– Acknowledge, sympathize and reach out.
– Initiate conversation and ask questions to draw them out
– Encourage talking and sharing feelings either one-on-one
or in small supportive groups
– Promote supportive group events, interaction, or
impromptu fun
– Recommend to HR if appropriate

24. The Three Phases of Transition

25. Critical part: THE NEUTRAL ZONE
Emotions of the Neutral Zone:
–Confusion
–Apprehension
–Detachment
–Interest/Eagerness

26. Communication during transition feels risky…
There cannot be too much communication during
the Neutral Zone.
It is the difference between a bearable situation
and a disaster.
Two main kinds of communication in this zone:

27. 1. Communication designed to show
CONNECTION and CONCERN.
2. Communication that clarifies the PURPOSE,
the PICTURE, the PLAN, and the PART.

28. 1. Communication designed to show CONNECTION and
CONCERN
MANAGERS and leaders must keep
communicating not just for more information
but to show that they care. Isolation can be
easily amplified during a time of transition.

29. 2. Communication that clarifies the PURPOSE, the
PICTURE, the PLAN, and the PART.
Purpose
The “why’s” of the change. Purpose can serve to clear
up confusion and help people see through obstacles
Picture
Vision of the outcome; the light at the end of the
tunnel, a destination. (use an analogy—1st day)

30. 2. Communication that clarifies the PURPOSE, the
PICTURE, the PLAN, and the PART.
Plan
beyond just the destination, this is the roadmap
that leads there. These are step-by-step actions
to get through the Neutral Zone.
Part
Successful transition depends on the people
involved. They all play a part. Know yours, know
theirs, make sure they know theirs.

31. The Three Phases of Transition

32. What are the basics of communication during a
transition?
YOU CAN’T OVER
COMMUNICATE!

33. What are the basics of communication during a
transition?
1. Repeat the message 6 times (really?)
2. Vary the medium
3. Ensure 2-way communication

34. What are the basics of communication during a
transition?
4. Consider timing
5. Ensure consistency
6. People trust behavior over words
7. Understanding is more important than
agreement

35. What are the basics of communication during a
transition?
8. Listening is twice as important as talking
9. Tell the truth, the good news and the bad
10. People usually complain before they create

36. Creativity & Learning
1. Encourage experimentation and risk taking
2. Expose individuals and groups to new &
diverse perspectives
3. Provide the workforce with stimulating and
interactive settings
4. Use feedback mechanisms
5. If appropriate, help people revise their career
plan within the new change

37. The Three Phases of Transition

38. Getting to the
…
1. Provide people with a low-risk opportunity to
practice or gain familiarity
2. Work collaboratively
3. Focus on efforts and achieve a few “quick
successes”
4. Build RESPONSIVENESS and FLEXIBILITY into
your routine; adjust!

39. Getting to the
…
Change’s Nemesis: REVERSION
How can you prevent reversion?
Cycle:
Promote – individual love – measure
Promote/
train
1-1
Attention
Measure

40. Things to remember!
1. You have to end before you begin:
o People go through transition at different speeds
o People may be affected by different things
2. Between the end and the new beginning,
there is a hiatus: that hiatus can be creative
3. *Most* organizations are running a deficit in
transition management

41. Change Theory and
Implementation
SESSION OBJECTIVES
1. Describe the three phases of transition
2. Develop flexible strategies to adapt to the
varying needs a clinical team
3. Identify new ways to communicate change
effectively

42. People May Hate Change…
…But they love
Progress
Reference: www.wmbridges.com; www.linkageinc.com