Setting Goals and Action Planning. Implementation Plan Utilizing Lippitt’s Phases of Change, (Mitchell, 2013)
Raising Awareness of The Need for Change
Create buy-in for the change process by appealing to direct and indirect victims of WRB. Build enthusiasm by drawing attention to commonalities and shared experiences.
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Multimedia approach incorporating;
Visual printed media to spark collaboration and create a dialogue
Initial email surveys to gain baseline data and identify areas of greatest need
Opening anonymous reporting channels to increase communication and involvement
Overcome technological hurdles is essential during this phase. Identifying and utilizing existing resources within the organization starts by reaching out to internal research, quality management, and information technology departments to secure support and time commitments for the development of infrastructure changes that facilitate reporting and data collection. This ties into the next phase of change.
Building a Relationship with The System
Presentation of a completed Change Proposal to nursing leadership and members of administration.
Clearly stating the evidence-supported physical, psychological, and financial costs to patients, staff members, and the organization at large
Accurately estimating the time and resource commitment necessary for program development and ongoing success
Building buy-in on an administrative level
Reaching out to unit managers to identify their perception of WRB and its prevalence on their individual work environments
Involvement of employee health/occupational medicine staff as partners in the reduction of workplace stressors through larger behavioral changes.
Further promotion of the WRB reduction initiative among staff members and identification of staff champions passionate about these changes.
Defining the Problem
What does WRB look like?
Where is WRB occurring in this work environment?
What is the direct impact to staff members?
How does WRB impact our patients?
What are the long-term ramifications of allowing WRB to go unaddressed?
Are there policies in place that address WRB? If so, do they need to be modified?
Setting Goals and Action Planning
Time sensitive goals create milestones and improve evaluation of program success. Program phases will be rolled out quarterly, with the relationship building and collaborative planning happening in the first quarter after program approval, followed by the initial campaign to raise awareness in the second quarter, and full program implementation on select units slotted for six months after approval. Evaluation of successful change will occur quarterly thereafter to measure program effectiveness, make changes, and incorporate new work areas.
Action planning should be interdisciplinary and tailored to the needs of individual work environments. Buy-in and early adoption of the program is essential to the success of this phase.
The operational model will be relationship-based and involve several components
Psychodynamic education based on cognitive behavioral models
Cognitive rehearsal training, i.e. role-play, universal anti-bullying phrases, resilience training
Policy enforcement training: building awareness and support for new or changed policies
Coaching: using the established reporting system to identify WRB trends and address areas of highest incidence (Balevre, Balevre & Chesire, 2018)
Weekly program updates with core program supporters and monthly meetings with staff champions will identify areas of success and areas in need of reevaluation.
Change program success depends on acceptance and sustainability
This means consistent administrative support through the enforcement of zero-tolerance policies that directly address WRB events in a timely and supportive fashion.
Ongoing evaluation of staff awareness and involvement in initiative. Monthly review of staff feedback and yearly retraining as part of core safety measures.
Maintaining program flexibility and changing delivery of training and monitoring strategies to best suit each work environment.
Redefine the Role of the Change Agent
Once the change process is initiated, the change agent works to keep others on track with program support and involvement.
Coordinate the feedback review efforts and continue to recruit interested staff members to act as program champions.
Liaise with administration members and continue to “bridge the gap” between program results and the impact on staff and patients.
Share program successes both within the organization and with the community.
Balevre, S., Balevre, P., & Chesire, D. (2018). Nursing professional development anti-bullying project. Journal for Nurses in Professional Development, 34(5), 277-282. doi: 10.1097/nnd.0000000000000470
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37. doi: 10.7748/nm2013.04.20.1.32.e1013