Theoretical Matrix Use Appendix a (Attached) Create

THEORETICAL MATRIX Use Appendix A (attached) create a matrix theoretical change models. Include theoretical change models matrix. The matrix include model: • Name theoretical model • Description theoretical model 200 words • Description type change situation theoretical model applies 200 words.

Matrix of Theoretical Models

Theoretical Change Model

Description of Theoretical Model

(200 words each box)

Type of health care change situation where model best applies

(200 words each box)

Systems theory

Systems theory suggests that organizations are complex, adaptive systems greater than the sum of their parts. Organizations cannot always be logically analyzed in terms of their ability to accept or reject change. Organizational behavior is hard to predict. Systems are in dialogue with the environment, and changes in the environment can produce changes in the system but "some type of [exterior] energy is required" otherwise organizations grow static (Iles & Sutherland 2001). Also, "players within a system have a view of that system's function and purpose and players' views may be very different from each other" (Iles & Sutherland 2001). This can also complicate change, since managers' perspectives may be different than employees' perspectives.

The theory is flexible to some degree because it promotes two types of change. "Hard Systems promote a sequential, staged approach to change. The stages are numbered and the sequence provides the orderliness, characteristic to this methodology" (Iles & Sutherland 2001). When the need for change is agreed upon, this approach is acceptable. In contrast, Soft Systems approaches are used when there is a great deal of disagreement about how to deal with the change. Soft systems approaches are less sequential in nature and are highly dependent upon building consensus (Iles & Sutherland 2001). They are more appropriate when human-focused decisions are necessitated.

One of the most serious problems in healthcare today is that of recruitment and retention of new nurses, to address the nursing shortage. Many healthcare environments are severely understaffed, and understaffing is linked to nursing burnout and a spike in employee attrition. There are a number of complex environmental reasons that there is a nursing shortage. First and foremost, many nursing educational programs are understaffed, so even when there are many prospective students desiring to enter the program (such as now, given that there are many career-changers as well as new undergraduates seeking a stable profession) there are not enough instructors to teach new students. Also, many older nurses will be retiring in the next decades, and as they age out of the profession even more nurses will be needed. Understaffing creates a vicious cycle, in which new nurses are reluctant to stay in the profession, because they find themselves overburdened. Highly stressed older nurses take out their frustrations on younger nurses, compounding the problem of retention. Using a systems approach suggests dealing with the systematic problems that are at the heart of the nursing shortage. Creating a closer relationship between healthcare institutions and educational programs can enable young nurses to be mentored while they are still new students. This can also contribute to an environment where workplace bullying is reduced by improving emotional relationships between old and new nurses. This addresses some of the human-based problems and environmental problems causing the shortage.

2.Complexity theory

Complexity theory promotes a model of change which reflects the complex, dynamic nature of modern organizations. "In reality, change, especially large scale change, defies logical rules and simple management actions. Complexity theory and a view of organizations as 'complex adaptive systems', attempts to consider some of those realities and arguably provide a better model for change in an education setting" (Complexity theory, 2012, JISC Info Net). Organizations are complex because they are composed of both human and bureaucratic elements that defy logical predictive patterns. Some changes may be resisted by employees, others may not. Organizations are paradoxes, not straight, up-and-down hierarchies. "They are pulled towards stability by the forces of integration, maintenance controls, human desires for security and certainty and adaptation to the environment on the one hand. They are also pulled towards the opposite extreme of unstable equilibrium by the forces of division and decentralization, human desires for excitement and innovation and isolation from the environment" (Complexity theory, 2012, JISC Info Net). They consist of feedback loops that are non-linear and often based in emotions. There is also a push-pull element -- organizations need some structure to avoid chaos, but if they are overly rigid they are incapable of change (Complexity theory, 2012, JISC Info Net). Every organization must find a positive sense of equilibrium.

One of the most serious problems facing America today is that of the obesity crisis. Healthcare organizations have been called upon to address this problem by creating obesity-prevention programs. But there are still many factors which can inhibit effective treatment of obesity within the healthcare system. Doctors and nurses who are overweight themselves may fear bringing up the issue with overweight patients because they may be overweight themselves; because they fear scaring the patient away from the healthcare system; or because they may simply believe that such a great lifestyle change is beyond the patient's capabilities. Providers must be made more aware of the need to bring up the subject, and healthcare institutions must offer more specific programs (such as nutrition and exercise education programs) to address the issue. Not all healthcare providers have a background in nutrition, even those who deal with obesity-related complaints such as heart disease and diabetes. Those who do not must be educated about factors which can prevent patients from following a healthy regime (such as low incomes that inhibit healthy eating habits or a lack of safe space and time to exercise). Advice can be framed in a compassionate manner that is effective, but it must take into consideration the human element of weight loss. Obesity prevention requires bureaucratic changes but also human changes in providers' approaches.

3.Contingency theory

Contingency theory suggests that "there is no one best way of leading and that a leadership style that is effective in some situations may not be successful in others. An effect of this is that leaders who are very effective at one place and time may become unsuccessful either when transplanted to another situation or when the factors around them change" (Straker 2005). Leaders who are effective in military-like organizations with clear chains of command and organizational hierarchies that are highly defined may falter in situations in which buy-in by followers is required, or which require more creative and flexible approaches. Aspects of the situation which may affect leadership capacity include the experience level of followers, the complexity of the task, the time frame upon the need for change and the relationship between leader and followers.

Contingency theory is similar to situation-based theories of leadership. However, "the main difference is that situational theory tends to focus more on the behaviors that the leader should adopt, given situational factors (often about follower behavior), whereas contingency theory takes a broader view that includes contingent factors about leader capability and other variables within the situation" (Straker 2005).