HIMSS News

Key Principles of 21st Century Change Management

By June Kaminski, RN, MSN, PhD Candidate
Clinical Informatics Insights, April 2011

The 21st century is an age of perpetual or continuous change, a fact that can daunt the most progressive leader. To meet the challenge of on-going change successfully, insight and strategies that support change management initiatives at all organizational levels are needed. A myriad of change management models, theories, tactics, and processes exist to help leaders plan and implement change. After working with many of these within healthcare practice, education and research, I have narrowed effective change down to six distinct principles – principles that all leaders should keep in mind as they manage change within their organizations.

These key principles are: transparency, agency, readiness, adaptation, voice and sustenance. The application of these change principles can guide huge time-intensive changes such as implementing electronic health records as well as less intense yet continuous changes such as adapting to new versions of tried and true software.

Transparency
One of the most powerful ways of initiating any change is to be totally transparent with all who are involved in the process. Openness, being informative and involving teams and individuals in the process right from the start are critical for raising the energy and know-how needed to move a change through to completion. Changes that are planned behind closed doors, and then announced as a fete de complete often meet with resistance and lukewarm reception from those expected to implement the change. It is far wiser to find ways to involve everyone affected by the change to prepare them for action.

Agency
A skilled leader knows how to tap the strengths of those they work with, to ignite a sense of agency, which naturally leads to the desire to act. Setting people at ease, welcoming their ideas and input, and creating an atmosphere that sparks cooperative and collegial action are important ways to develop agency for change within an organization.

Readiness
Before people can adapt to a change, whether grand, small or continuous, they need to feel ready. Readiness implies the people involved with the change are prepared to take action, to adapt, and to implement the change fully and completely. It is a fine art to lead an organization through the process to a state of readiness, but once it is accomplished, a strong momentum develops. Once readiness is present, people are open to learn, to experiment and to begin the real work involved to successfully cooperate with the change process.

Adaptation
All change requires flexibility and adaptation from those involved in it. Each person in an organization has a unique capacity for adaptation, and this uniqueness should be kept in mind. However, there are ways that leaders can support them to move to a higher level of adaptation. First and foremost, provide enough time and resources to support the change. These are critical to the adaptive process. Education, support personnel, allowing room for experimentation and trial and error are all significant and empowering ways to promote adaptation in a cohesive and meaningful way.

Voice
It is important to create an environment where all of the people involved feel comfortable about sharing any concerns, questions, confusion and ideas about the change in a receptive manner. Sometimes being heard is all that is needed to move someone from a stance of resistance through to the process of adaptation. Provide safe mechanisms for communication, using a variety of methods including verbal, written, electronic, in person meetings, brainstorming sessions, networks and suggestion boxes to provide venues that suit the needs of all involved.

Sustenance
To fully empower people in an organization, on-going support, encouragement, education, dialogue and accessible resources are needed to maintain a high level of sustenance. When people feel supported, they often also feel safe to explore the waters, to try new ideas and are able to stay adaptable. This is critical for dealing with the continuing change often present, where every day can bring fresh new challenges and the need to find different ways of doing things.

Change agency in the 21st century is challenging and often draining, but it is also an expected capacity in organizational leaders. It is hoped that these six principles offer some useful guidance to help leaders to effectively lead their organization through the potential chaos of change in an empowering and fruitful way.

More Resources:

June Kaminski, RN, MSN, PhD Candidate, is the founder of Nursing-Informatics.com, editor and chief of the Canadian Journal of Nursing Informatics, and chief senior editor of the Online Journal of Nursing Informatics.