It's very interesting topic for everyone those peoples are studying management and important points covered in this slide.

1. Planning new venture

2. VENTURE PLANNING
Venture:
• Venture is often use for referring to a risky start up or
Enterprise Company.
• New venture is a business plan that gives an opportunity or
chance to set up a company / business on the basis of
innovative business ideas. It is a sort competition that offers
an excellent chance to turn innovative idea to start up
business into a solid business plan.
Planning:
• Planning means to decide in advance what is to be done.
• Venture Planning is a personal assessment of your feelings
and the feasibility of a venture. Venture Planning answers the
question, should I be doing this and why? The Venture
Feasibility process examines seven key factors in any venture.

3. Cont….
VENTURE PLANNING
• It is not about writing a Business Plan. Sometimes a business plan is not needed.
Venture Planning does not require detailed funding, source analysis, professional
opinions, entity formation or detailed market analysis. Venture Planning is
development of a means of comparing various business models, usually through
financial modeling to answer the following questions:
Which venture concept produces the most sales, the best margins, the highest net
profit and the lowest breakeven?
Which model requires the least investment by entrepreneurs and others?
Which concept requires equity as opposed to debt financing?
Which produces the highest "Return on Investment" and the best liquidity?
Which model requires the entrepreneur to give up the least equity?
Identify and quantify the risks involved with execution of each model.

4. Venture Formation involves all of the
following stages:
Idea - Concept Development - Venture Development - Monitoring
Progress - Initiating New Changes - Venture Feasibility Analysis -
Business or Operational Plan - Budget vs. Actual - New Plans.
There are four keys to good venture planning:
Focus on one venture at a time in one business area at a time.
Discover the opportunity first, and then evaluate how to exploit it.
Develop three cases good, bad & likely for each scenario of a
venture concept.
Identify what type of venture you want. Each type has an entirely
different model, implementation and end result. Each demands a
different entrepreneurial approach and each requires different
management and style.

5. Cont….
There Are 11 Keys to a Good First Venture
1) Founder's alignment with the mission.
2) Guaranteed or qualified customers.
3) Lifestyle of High Profit smaller business.
4) Routine concept.
5) Available product.
6) Advantageous Cash Flow.
7) Supportive local environment.
8) Neutral State and Federal Environment.
9) Equity Control.
10) Relevant Experience.
11) Low Overhead.

6. Cont….
• Emerging venture areas in nursing that needs
planning. There often occurs a crisis situation
in the healthcare set- up when nurses try to
defend existing models of practice instead of
embracing change. In order to gain successful
planning of good ventures, we should examine
the existing realities (traditional), and analyze
and adapt to the changing context of nursing
practice.

7. Cont….
Some of the traditional realities are;
Institution based care
Process oriented
Procedure driven
Based on mechanical and manual intervention
Provider driven
Treatment based
Reflective of late stage intervention
Based on vertical clinical relationships

8. Cont….
According to Porter-O’ Grady (2003), the emerging
realities for nursing practice for this century will be;
o Mobility based on multiple settings
o Outcome driven
o Best- practice oriented
o Emphasized by technology and minimally invasive
intervention
o User driven
o Health based
o Geared for early intervention
o Based on horizontal clinical relationships

9. Functions of good nurse manager
A nurse manager’s functions include the following;
The nurse administrator needs to know the plans and
programs of the health facility administrator and of other
departments in which personnel contribute to the joint
effort of providing health care services.
Should be a participatory, voting member of all committees
of the institution including those dealing with budgeting,
planning, credentialing, auditing, utilization, infection
control, patient care improvement, library or any other
committees concerned with nursing services, nursing
activities and nursing personnel.
Should develop a marketing operational plan based on the
overall view of the agency problems and activities.

10. Cont….
Marketing plan should include gathering and analysis of
data related to product or service
Operational plan consist of pinpointing possible
strengths, weaknesses, problems and opportunities.
Before launching a venture, a control plan is made to
measure performance of implementation of venture
within a time frame.
Selected and trained personnel will be assigned to
compare expected results with actual results for
making corrections in all elements of plan and its
implementation in future.

11. Practical planning actions
Practical day-to-day planning actions to the nurse
administrator include the following
1. At the beginning of each day make a list of actions to be
accomplished for the day
2. Plan ahead for meetings
3. Identify developing problems
4. Review the operational and management plan
5. Review the appropriate portions of the division operational
and management plan
6. Plan for discussion of ideas
7. Suggest similar practical planning actions to other nurse
managers

12. PLANNING FOR CHANGE
• Change occurs over time, often fluctuating
between intervals of change then a time of
settling and stability. Change management entails
thoughtful planning and sensitive
implementation, and above all, consultation with,
and involvement of, the people affected by the
changes. If you force change on people normally
problems arise. Change must be realistic,
achievable and measurable. These aspects are
especially relevant to managing personal change.

13. Definition
• Change: To change simply means to alter, to become different, or to
transform.
• Change refers to an alteration in a system whether physical, biological, or
social. These alterations come from as a result of internal forces or
external forces impinging on an individual or organization.
• Planning: “Planning refers to thinking ahead of time and formulation of
preliminary thoughts”. Planned change: “Planned change entails planning
and application of strategic actions designed to promote movement
towards a desired goal”.
• “Planned change is a change that results from a well thought out and
deliberates effort to make something happen. It is the deliberate
application of knowledge and skills by a leader to bring about a change”.
Tappen, 1995
• Change agent: “A change agent is one who generates ideas, introduces the
innovation, and works to bring about the desired change”.

14. Cont…
• Change agent:A change agent is someone who
deliberately tries to bring about a change or
innovation, often associated with facilitating change in
an organization or institution. To some degree, change
always involves the exercise of power, politics, and
interpersonal influence. It is critical to understand the
existing power structure when change is being
contemplated.
• A change agent must understand the social,
organizational, and political identities and interests of
those involved; must focus on what really matters;
assess the agenda of all involved parties; and plan for
action.

15. Cont…
The change agent should have the following qualities;
The ability to combine ideas
The ability to energize others
Skills in human relations
Integrative thinking
Flexibility modify ideas
Persistent, confident and has realistic thinking
Trustworthy
Ability to articulate a vision, and
Ability to handle resistance

16. Assumptions regarding change
Change represents loss. Even if the change is positive, there is a loss
of stability. The leader of change must be sensitive to the loss
experienced by others.
The more consistent the change goal is with the individual’s personal
values and beliefs, the more likely the change is to be accepted.
Likewise the more difficult the goal is from the individual’s personal
values; the more likely it is to be rejected.
Those who actively participate in change process feel accountable for
the outcome.
Timing is important in change. With each successive change in a
series of changes, individual’s psychological adjustment to the
change occurs more slowly. And for this reason the leader of
change must avoid initiating too many changes at once.

17. Cont…
The key principles driving the elements of the
Change Management are:
1. Targeted Commitment Levels
2. Executive Ownership
3. Visible, sustained sponsorship
4. Deployment/Implementation Support and
Monitoring
5. Employee Support
6. Post Deployment Preparation

18. STAGES OF PLANNED CHANGE
• Lewin (1951) identified 3 phases through which the change agent must
proceed before a planned change becomes part of the system. These
changes are;
• Unfreezing: - in this phase, the change agent unfreezes the forces that
maintain a status quo. It is the responsibility of the change agent- after
thorough and accurate assessment- to convince the people for the need to
change. It is also possible that the people themselves are discontented
and aware of a need to change.
• Moving: - in this phase agent identifies plans and implements appropriate
change strategies that the driving forces (that facilitates change and keep
it going, e.g. new technology, management support, knowledge,
competencies) exceed restraining forces (that impede the change
process). Whenever possible the change should be implemented
gradually.
• Refreezing: - in this phase, the change agent assists in stabilizing the
system change so that it becomes integrated and remains so.

19. PLANNED CHANGE
• Identify the problem or opportunity: - opportunities demand
change as the problems, but most managers overlook these
opportunities. Change is often planned to close performance gap, a
discrepancy between the desired and the actual state of affairs.
• Collect data: - once the problem or opportunity is clearly defined,
the change agent collects data needed. This step is important to the
later success in the planned change.
• Analyze data: - collecting good data is important, but it is as
important to analyze the data in to useful information to make
important decisions. Plan the change strategy: - anxiety about the
change should be minimized.
• There is a need to plan the resources required and establish
feedback mechanism to evaluate the progress in the change by
setting goals with specific time frames and identifying indicators for
evaluation.

20. Cont…
• Implement change: - the plans are put in to motion.
Interventions are designed to gain necessary
compliance. The change agent create supportive
climate, acts as energizer, obtain and provide feedback
and overcome resistance.
• Evaluate effectiveness: - the established operational
indicators are monitored and the extent of success and
failure is determined and explained.
• Stabilize the change: - to assure permanency of
change, though continuous feedback, reinforcement,
and providing the necessary policies, procedures,
standards, etc.

21. STRATEGIES FOR PLANNED CHANGE:In
general, three categories of change models exist: empirical-
rationale, power- coercive and normative-educative model.
(Bennis, Benne and Chin [1969], The planning of change)
• 1. Rationale- empirical: This strategy emphasizes reason
and knowledge. People are considered rational beings and
will adopta change if it is justified and in their self- interest.
Here the change agent’s role is communicating the merit of
the change to the group. If the change is understood by the
group to be justified and in the best interest of the
organization, it is likely to be accepted. This strategy is
useful when little resistance to change is expected. It is
assumed that once if the knowledge and rationales are
given, people will internalize the need for change and value
the result.

22. Cont…
2. Normative- re-educative: This is based on the assumption that
group norms are used to socialize individuals. The success of this
approach often requires a change in attitude, values, and/ or
relationships. This strategy is most used when the change is based
on culture and relationships within the organization. The power of
the change agent, both positional and informal, becomes integral to
the change process.
3. Power- coercive: This approach is based on power, authority, and
control. Desired change is brought about by political or economic
power. It requires that the change agent have the positional power
to mandate the change. The outcome of change is often based
either on follower’s desire to please the leader or fear of the
consequences for not complying with the change. This strategy is
effective for legislated changes, but other changes using this
strategy are often short- lived.

23. BARRIERS TO CHANGE AND
STRATEGIES TO OVERCOME
• It is important to identify all potential barriers
to change, to examine them contextually with
those affected by proposed change, and to
develop strategies collectively to reduce or
remove the barriers.
• Change requires movement, which as physics
indicates, is a kinetic activity that requires
energy to overcome resistance.

24. Barrier Discussion Strategy
Desire to remain in our
comfort zone
Those who become increasingly attached to a
familiar way of doing things (comfort zone)
often view change as an unwelcome disruption.
Rational- empirical
strategy.
Inadequate access to
information
Lack of information, inability to read and
understand the available resources
Rational- empirical
strategies
Lack of shared vision Lack of widespread involvement, input, and
ownership of change will cripple a change
effort.
Normative- re-
educative strategy
Lack of adequate
planning
Involving individuals in planning gives a sense
of control and decreases their resistance to
change.
Rational- empirical
and normative- re-
educative strategies
Lack of trust Trust in the change agent and ability of self to
bring about change is necessary.
Rational- empirical
and normative- re-
educative strategies
Resistance to change Co-operation and involvement of the whole
team will only bring effective and lasting
changes.
Introducing change
at a time when
people are ready to
change guarantees
success

25. Resistance to change Co-operation and involvement of the
whole team will only bring effective and
lasting changes.
Introducing
change at a time
when people are
ready to change
guarantees success
Poor timing or
inadequate time
planned
Poor timing and lack of planning can fail
to bring desired change.
Normative- re-
educative strategy
Fear that power,
relationships, or
control will be lost
Every change represents potential for loss
to someone
Normative- re-
educative strategy
Amount of personal
energy needed for
change may be great
Sometimes change is desired, but people
are not willing to do what is necessary to
effect the change.
Slow the change
process and give
time to catch- up
and energize

26. Types of changes
Hohn (1998) identified four different types of change: Change by
exception, Incremental Change, Pendulum Change and Paradigm
Change.
Change by Exception: This occurs when someone makes an
exception to an existing belief system. For instance, if a client
believes that all nurses are bossy, but then experiences nursing care
from a much modulated nurse, they may change their belief about
that particular nurse, but not all nurses in general.
Incremental Change: A change that happens so gradually, that an
individual is not aware of it.
Pendulum Changes: Are changes that result in extreme exchanges of
points of view.
Paradigm Change: Involves a fundamental rethinking of premises and
assumptions, and involve a changing of beliefs, values and
assumptions about how the world works.

27. Change Theories in Nursing
• Change theories are used in nursing to bring about planned
change. Planned change involves, recognizing a problem
and creating a plan to address it. There are various change
theories that can be applied to change projects in nursing.
Choosing the right change theory is important as all change
theories do not fit every change project. Some change
theories used in nursing are Lewin’s, Lippitt’s, and
Havelock’s theories of change. The characteristics of change
theories are;
Problem identification
Plan for innovation
Strategies to reduce innovation
Evaluation plan

28. KURT LEWIN’S CHANGE THEORY:
• The theoretical foundations of change theory are robust: several
theories now exist, many coming from the disciplines of sociology,
psychology, education, and organizational management. Kurt Lewin
(1890 – 1947) has been acknowledged as the “father of social
change theories” and presents a simple yet powerful model to
begin the study of change theory and processes.
• He is also lauded as the originator of social psychology, action
research, as well as organizational development.
• "Unfreezing" involves finding a method of making it possible for
people to let go of an old pattern that was counterproductive in
some way. In this stage, the need for change is recognized, the
process of creating awareness for change is begun and acceptance
of the proposed change is developed

29. Cont…
• "Moving to a new level" involves a process of
change--in thoughts, feelings, behavior, or all
three, that is in some way more liberating or
more productive. The need for change is
accepted and implemented in this stage.
• "Refreezing" is establishing the change as a new
habit, so that it now becomes the "standard
operating procedure." Without some process of
refreezing, it is easy to backslide into the old
ways.The new change is made permanent here.

30. Cont…
Lewin also created a model called “force field analysis” which offers direction
for diagnosing situations and managing change within organizations and
communities.
• According to Lewin’s theories, human behavior is caused by forces – beliefs,
expectations, cultural norms, and the like – within the "life space" of an
individual or society. These forces can be positive, urging us toward a
behavior, or negative, propelling us away from a behavior.
• “Driving Forces”- Driving forces are those forces affecting a situation that
are pushing in a particular direction; they tend to initiate a change and keep
it going. In terms of improving productivity in a work group, pressure from a
supervisor, incentive earnings, and competition may be examples of driving
forces.
• “Restraining Forces”- Restraining forces are forces acting to restrain or
decrease the driving forces. Apathy, hostility, and poor maintenance of
equipment may be examples of restraining forces against increased
production.
• “Equilibrium” - This equilibrium, or present level of productivity, can be
raised or lowered by changes in the relationship between the driving and
the restraining forces. Equilibrium is reached when the sum of the driving
forces equals the sum of the restraining forces.

31. Cont…
• LIPPITT’S PHASES OF CHANGE THEORY: Lippitt’s theory is based on
bringing in an external change agent to put a plan in place to effect
change. There are seven stages in this theory.
• The first three stages correspond to Lewin's unfreezing stage, the
next two to his moving stage and the final two to his freezing
change. In this theory, there is a lot of focus on the change agent.
The third stage assesses the change agent‟s stamina, commitment
to change and power to make change happen. The fifth stage
describes what the change agent‟s role will be so that it is
understood by all the parties involved and everyone will know what
to expect from him. At the last stage, the change agent separates
himself from the change project. By this time, the change has
become permanent.

32. Cont…
The seven phases shift the change process to include the role of a
change agent through the evolution of the change.
• Phase 1:Diagnose the problem
• Phase 2:Assess the motivation and capacity for change
• Phase 3:Assess the resources and motivation of the change
agent(commitment the change, power, and stamina)
• Phase 4:Define progressive stages of change
• Phase 5: Ensure the role and responsibility of the change agent is
clear and understood (communicator, facilitator, and subject matter
expert.
• Phase 6:Maintain the change through communication, feedback, and
group coordination
• Phase 7:Gradually remove the change agent from the relationship, as
the change becomes part of an organizational culture.

33. Cont…
HAVELOCK'S CHANGE MODEL:
• Havelock's change theory has six stages and is a
modification of the Lewin's theory of change. The six stages
are building a relationship, diagnosing the problem,
gathering resources, choosing the solution, gaining
acceptance and self-renewal.
• In this theory, there is a lot of information gathering in the
initial stages of change during which staff nurses may
realize the need for change and be willing to accept any
changes that are implemented. The first three stages are
described by Lewin's unfreezing stage the next two by his
moving stage and the last by the freezing stage.

34. Cont…
John P Kotter's 'eight steps to successful change' John Kotter's highly
regarded books 'Leading Change' (1995) and the follow-up 'The
Heart Of Change' (2002) describes a helpful model for
understanding and managing change. Each stage acknowledges a
key principle identified by Kotter relating to people's response and
approach to change, in which people see, feel and then
change.Kotter's eight step change model can be summarized as:
Increase urgency - inspire people to move, make objectives real and
relevant.
Build the guiding team - get the right people in place with the right
emotional commitment, and the right mix of skills and levels.
Get the vision right - get the team to establish a simple vision and
strategy focus on emotional and creative aspects necessary to drive
service and efficiency.

35. Cont…
Communicate for buy-in - Involve as many people as possible, communicate
the essentials, simply, and to appeal and respond to people's needs. De-
clutter communications - make technology work for you rather than
against.
Empower action - Remove obstacles, enable constructive feedback and lots
of support from leaders - reward and recognize progress and
achievements.
Create short-term wins - Set aims that are easy to achieve - in bite-size
chunks. Manageable numbers of initiatives. Finish current stages before
starting new ones.
Don't let up - Foster and encourage determination and persistence -
ongoing change - encourage ongoing progress reporting - highlight
achieved and future milestones.
Make change stick - Reinforce the value of successful change via
recruitment, promotion, and new change leaders. Weave change into
culture.

36. Theories
Planned change using linear approaches
• Theories for planned change
• Six phases of planned change
• Havelock (1973) is credited with this planned change model
• Key idea: Change can be planned, implemented and evaluated in six
sequential stages. The model is advocated for development of effective
change agents and use as a rational problem solving process. The six
stages are:-
• 1. Building a relationship
• 2. Diagnosing the problem
• 3. Acquiring relevant resources
• 4. Choosing the solution
• 5. Gaining acceptance
• 6. Stabilizing the innovation and generating self renewal
• Application to practice: Useful for low level, low complexity change.

37. Cont…
• Seven phases of planned change
• Lippitt, Watson and westly (1958) are credited with this planned change
model
• Key idea: change can be planned, implemented and evaluated in seven
sequential phases. Ongoing sensitivity to forces in the change process is
essential. The seven phases are:
• 1. The client system become aware of the need for the change
• 2. The relationship is developed between the client system and change
• 3. The change problem is defined
• 4. The change goal are set and options for achievements are explored
• 5. The plan for the change is implemented
• 6. The change is accepted and stabilized
• 7. The change entities redefine their relationship
• Application to practice: Useful for low level, low complexity change.

38. Cont…
• Innovation – decision process
• Rogers (1995) is credited with formulating this process.
• Key idea: Change for an individual occurs over five phases when
choosing to accept or reject an innovation/idea. Decision is to not
accept the new idea may occur at any five stages. The change agent
can promote acceptance by giving information about benefits and
disadvantages and encouragement. The five stages are:
• 1. Knowledge
• 2. Persuasion
• 3. Decision
• 4. Implementation and
• 5. Confirmation
• Application to practice: Useful for individual change.

39. Nonlinear change
Chaos theory
• Organization can no longer rely on rules, policies, and hierarchies to get work
accomplished in flexible ways. According to the chaos theory perspectives because
of rapidly changing nature of human and world factors health organizations cannot
control long term outcomes. The assertion of chaos theory are that ‗organization
are potentially chaotic‘(thietat and Forgues, 1995). In other words, ‗order
emerges through fluctuations and chaos‘. Organization will experience periods of
stability interrupted with periods of intense transformation.
Response to change / Human side of change
• The human side of the managing change refers to staff responses to change that
either facilitate or interfere with change process. Responses to all or part of the
change process by individuals and group may vary from full acceptance and willing
participation to open rejection. Responses may be categorized behaviorally or
emotionally. Some nurses may manifest their dissatisfaction visibly; others may
quietly accommodate the change. Some individuals consistently reject any new
thinking or way of doing things. The initial response to change may be, but not
always, reluctance and resistance. Resistance and reluctance are common when
the change threaten the personal security. Eg: -Changes in the structure of an
agency can result in changes of position for personnel.

40. Cont…
The change agent‘s recognition of the ideal and common patterns of the
individuals behavior responses to change can facilitate an effective change
process (Rogers 1983).
The responses and brief descriptions are as follows:
Innovators thrive on change, which may be disruptive to the unit stability.
Early adopters are respected by their peers and thus are sought out for
advice and information about innovations/changes.
Early majority prefer doing what has been done in the past but eventually
will accept the new ideas.
Late majority are openly negative and agree to change only after most
others have accepted the change.
Laggards prefer keeping tradition and openly express their resistance to
new ideas.
Rejecters oppose change actively.

41. Cont…
General characteristics of effective change agents
• Is a respected member of the organization
(insider) or community (outsider).
• Possesses excellent communication skills.
• Understands change process.
• Knows how group functions.
• Is trusted by others.
• Participates actively in change processes.
• Processes expert and legitimate power.

42. Principles characterizing effective
change implementation
The recipients of change feel they own the change.
Administrators and other key personnel support the proposed change.
The recipients of change anticipate benefit from the change.
The recipient of change participates in identifying the problem warranting a
change.
The change holds interest for the change recipients and other participants.
Agreements exist within the work group about the benefit of the change.
The change agents and recipients of change perceive a compatibility of
values.
Trust and empathy exist among the participants of the change process .
Revision of the change goal and process is negotiable.
The change process is designed to provide regular feedback to its
participants.

43. Challenges met by the change leaders
Mc Daniels (1996) advocates that change leaders in healthcare organizations
meet the challenges of managing by applying 12 recomendations:
1. Dispense with controlling and planning.
2. Operate on the margin between order and disorder.
3. Develop new organizations with the help of everyone.
4. Allow individual autonomy.
5. Encourage information sharing among staffs.
6. Promote staffs knowledge of others work.
7. Stimulate open learning through discussion generating ‗creative tension‘.
8. Considering the organization structure as dynamic.
9. Help staffs discover their goals.
10. Encourage cooperation not competition.
11. Approach work from smarter view, not harder.
12. Uncover values continuously to form organization wide visions.

44. General considerations for planning
change
Secure and maintain commitment to change
Define and communicate desired end state
Identify critical success factors
Establish targets and prioritize activities
Develop a theme
Understand why the change is desired/ required
General considerations for planning change
Secure and maintain commitment to change
Define and communicate desired end state
Identify critical success factors
Establish targets and prioritize activities
Develop a theme
Understand why the change is desired/ required

45. Nurse Leader (manager) as role model
for Planned Change
Implement a comprehensive and coordinated change
management program: Discover, develop, detect.
Identify “change agents” and engage people at all levels
in the organization.
Ensure the message comes from the top, and
executives and line managers are “walking the talk.”
Make change visible with new tools and/or
environment.
Ensure clear, concise, and compelling communication.
Integrate change goals with day-to-day activities, e.g.,
recruiting, performance management, and budgeting.

46. Cont…
Address short-term performance while setting high
expectations about long-term performance.
Help management avoid attempts to short circuit the
change management process.
Foster change in people’s attitudes first, then focus on
change in processes, then change in the formal structure.
Manage both supporters and champions, as well opponents
and possible detractors.
Accept that all people go through the same steps – some
faster, some slower – and it is not possible to skip steps.
Build a safe environment that enables people to express
feelings, acknowledge fears, and use support systems.
Acknowledge and celebrate successes regularly and publicly

47. Mistakes by a leader manager
Fail to provide visible support and reinforce the change with other
managers.
Do not take the time to understand how current business processes
would be affected by change.
Delayed decision-making, which leads to low morale and slow
project progress.
Are not directly or actively involved with change project.
Fail to anticipate the impact on employees.
Underestimate the time and resources needed
Abdicate ownership of the project to another manager.
Fail to communicate both the business reasons for the change and
the expected outcome to employees and other managers
Change the project direction mid-stream
Do not set clear boundaries and objectives for the project

48. INNOVATIONS IN NURSING
• Introduction Change is a natural social
process of individuals, groups, organizations
and society. The source of change originates
inside and outside health care organizations.
Change today is constant, inevitable, pervasive
and unpredictable, and varies in rate and
intensity, which unavoidably influences
individuals, technology and systems at all
levels of the organization.

49. Creativity and innovation
Creativity is defined as artistic or intellectual inventiveness.
• Innovation is defines as introduction of something new. These definitions
suggest that the terms are interchangeable. A person could say that
creativity is the mental work or action involved in bringing something new
into existence, while innovation is the result of that effort.
• A constant flow of new ideas is needed to procure new products, services,
processes, procedures and strategies for dealing with the change
occurring in every sphere of endeavour: technology social system,
government and everyday living. Innovation is the key to survival and
growth of health care and nursing.
• Change, innovation and creativity are comparison terms but can also be
differentiated. Changes occur when the system is disrupts; innovation uses
changes to create new and different approaches to resolve an issue and
develop new products or procedures. (Huber 1996).
• Systemic innovations according to (Drucker 1992) require willingness to
look on changes as an opportunity. Innovations do not create change.
Successful innovations are accomplished by exploiting the change not
forcing it.

50. Process of Innovation
The process of the innovation may include several steps. They are:
Assessment- It is the first step of process and it requires a look at both the strength
and problems. An administrator must focus on what is specific content
requirement the expected outcome. Specific content requirement changes often
in the health care, as new technologies and research bring new knowledge needs.
Defining objectives- It is the second step. The administrator should search for
research or technique that could address the identical needs. Asking the peers for
the suggestion is also helpful. This is the place where the creativity begins. It is
important to look at many different ways to address the learning objectives before
selecting one.
Planning- Once a strategy has been selected the third step, planning is important.
Understand who the stakeholders are and what their investment is in the status
quo or in change can be helpful in planning the strategies to bring them on board.
Many stake holders do not like the changes and will resist the new approaches.
Using the change theory it can assist in demonstrating the needs and provide
information that can make resistors more amenable to change. It‘s important to
take time to develop a support for the strategy. In more complex strategies it may
be important to bring other administrators.

51. Cont….
Gaining support for the innovation - Some strategies require little or
resources to implement where as others require significant physical and
financial resources. If resources are needed then gaining support for the
accusation of those resources are essential. Grants can provide good
funding sources but require time and effort to secure and may be for a
limited time. Administrative support may be required but administrators
may also be an excellent resource to tap to discuss the potential funding
or acquisitions of the physical resource.
Preparing faculty members for the innovation - Rehearsal time may be
required or additional education may be required. Planning sufficient for
those activities will increase everyone‘s comfort level with this process.
This is the time where everyone agrees how the strategy will be in run.
Use of perception, validate and clarification can be a valuable tool.

52. Cont….
Implementing the evaluation -In this step it is hope
that the things will be going well, but flexibility may be
required if problems arise. Sometimes unintended
consequences, such as surfacing of emotional issues
can occur. Administrator should be alert to the need for
the follow up or referral if problem arise.
Evaluating the outcome - It is the final step of the
process. It may be possible to measure short term
attainment goals. A strong evaluation process provides
an opportunity to evaluate the outcome of the change.
Sources of innovation Seven sources for innovative
ideas have been identified by (Drucker 1992)

53. Four sources are found internally
within the institutions are:
Unexpected outcomes: Situation presents themselves that
require different methods to be adopted. Knowing what is
happening in an institution allows an individual to prepare
for the impending changes.
Incongruous circumstances: Disruptions occur that require
change to be made discrepancies exists between the reality
as it is and reality as it is assumed to be.
Innovations made on the process needs: Procedures and
policies need to be altered to respond to the new
regulations, policies or law.
Changes in structure: Organizational changes require
changes in method of the operations.

54. Three sources are outside the
institutions:
Change in the demographics: Alteration in the community statistics such as
age and income levels affect the organizational operations.
New information or knowledge: New technological knowledge requires
change in practice.
Change in perception, taste and meaning: Shifts in demographics,
technologies and social needs create different ways of looking at the
situation.
Steps in Innovation adoption
Knowledge: Aware of new information and possible significance to practice.
Persuasion: Positive attitudes about importance and utility of new
knowledge.
Decision: Trial use of new information to test relevance to practice.
Implementation: Change of care setting to facilitate use of the innovations.
Confirmation: Gathering of evidence to confirm appropriateness of using
the innovations.