Problem Solving and Solution Finding in Nursing Protocol

Workplace Change Using Lewin's Framework

The change plan communicated to the hospital staff will clearly articulate the stages of change in Lewin's framework. The first stage is unfreezing, which requires thoughtful articulation of the need for the proposed change to the stakeholders in the workplace. The motivation for implementing the change plan will necessarily come from the recognition, in this scenario, that the bureaucratic response to a lack of paperwork was ill timed and poorly focused with respect to the priorities of triage. A first step in the communication is to help stakeholders recall that the paperwork procedures are there to serve the staff and patients and not the other way around. Standard operating procedures should reflect the best possible solutions for addressing a problem or situation. A more expedient and agile means of communicating rapid changes in patient status and care needs must be developed, however, this will only take place if there is clear recognition of the problem and the need for different procedures.

The development of new attitudes and behaviors in the change phase requires progression through several problem identification and solution-finding steps. Problem identification and definition will be most expedient if it is based on data. An action plan can be developed from the problem diagnosis and relevant data. Implementation and follow-up should go hand-in-hand with an end goal of stabilization of the new changes. Periods during which implantation and the stabilized situation are evaluated are important for institutional learning. This is the phase in which stakeholders must be both steadfast followers and innovative leaders. The watchwords are empowerment and agility as responses to the problem and the solutions must be flexible and open in order for the people to learn new ways of accomplishing the work. Individual change is critical to successful organizational change. This means that the staff must communicate clearly and honestly about what they value in the old protocols and how they envision improvements. New attitudes and new behaviors will need to move to the forefront of professional interactions and practice. It is expected that this change phase will be characterized by iterations that encompass and emphasize either attitudes or behaviors according to where staff are in the change process. Stakeholders must have time to process the change and all the ramifications of the implemented change, and they must free to speak their minds in order to identify barriers and roadblocks to change so they may be collaboratively addressed in a spirit of problem solving.