Applying change model to practice problem
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Introduction
The practice problem, obesity, portends a grave public health risk to the community served by the healthcare provider under discussion. While it is mainly manifest in lower-income parts of the population, its effects are enormous on the general public health scene in the community. For there to be a concrete change in the way the healthcare institution, and the community in general handles obesity, there needs to be a fundamental change in the way that the nursing personnel process and deploy interventions for patients.
Applying Lewin’s theory to the practice problem
Nursing has more professionals providing direct care to the patients than any other medical profession. It is necessary then, to ensure that nurses are given easy access to new evidence as it comes, to offer better medical services (Curtis, Fry, Shaban, & Considine, 2017). This requires the adoption of change models that will facilitate speedy translation of evidence into practice. The change model should appreciate that change is not always linear, but can also be cyclical. For this change therefore, Lewin’s model will be applied, but with reference to later revisions, specifically Havelock’s (White, Dudley-Brown, & Terhaar, 2016).
Havelock’s model involves six steps, starting with the establishment of a relationship with the process that needs to change, diagnosis of the problem, resource mobilization, selecting the solution, monitoring the change, and stabilizing the new status quo.
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Appraising the evidence
As (Michaud, You, Wilson, Su, Mcguire, Almeida, Bayer, & Estabrooks, 2017) show, there is a direct economic and social benefit when obesity levels are brought down. This is even better when the means are tailored for specific communities and individuals. In the fourth stage of Havelock’s model, the change agents need to examine the relevant evidence, and come up with a solution that fits the community best. The solution is informed by evidence that is unlikely to be implemented by existing methods of controlling obesity. The model aims to change the narrative, so that individualized interventions to obesity are regularly and quickly identified, and where possible, coopted into the care process. As the process moves to the monitoring stage, the model has a potent way of dealing with resistance to change, by ensuring the active participation of all people involved in carrying out the change. This also enables the accomplishment of radical changes involving new evidence, without seriously jeopardizing the chances of the new change happening.
Stakeholder involvement
Throughout the change process, stakeholders are involved, such that, as new evidence of dealing with obesity in the local community emerges due to the relationship with the system and patients is considered, and steps to change are put in motion. While the nursing department will be key in driving the change, other aspects are equally important and as instrumental in achieving the new way of doing things. The important element of the model is that it realizes the nature of change as a never-ending process, rather than something that has a start and end date. It involves the interrogation of other methods associated with the process under review and establishing how they need to change to accommodate the new way of doing things.
Identifying barriers to change
As with other forms of change models, resistance, and barriers to change are inevitable, even with Lewin’s force field model, and its advanced relative, the Havelock model. To counter this, the model has a few methods of identifying the barriers and dealing with them proactively (Wojciechowski, Pearsall, Murphy, & French, 2016). For instance, resistance from employees can be effectively curbed by involving them in the process from the onset. Charges of lack of funds amidst a global pandemic can easily be countered by showing the enormous benefits that will accrue to both the community and the healthcare provider, should the change be supported (Mcechern et al, 2020).
References
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of clinical nursing, 26(5-6), 862–872. https://doi.org/10.1111/jocn.13586
Michaud, T. L., You, W., Wilson, K. E., Su, D., McGuire, T. J., Almeida, F. A., Bayer, A. L., & Estabrooks, P. A. (2017). Cost effectiveness and return on investment of a scalable community weight loss intervention. Preventive medicine, 105, 295–303. https://doi.org/10.1016/j.ypmed.2017.10.011
White, K., Dudley-Brown, S., & Terhaar, M. (2016). Translation of Evidence Into Nursing and Health Care. Springer Publishing Company.
Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. Online Journal of Issues in Nursing, 21(2).
