Change Theories Model


ChangeTheories Model

ChangeTheories Model

Themeaningful use metric being introduced is an electronic recordssystem (E.H.R) and registries for diseases so as to ensure thatnurses can track and monitor the number of patients. The electronicheath system and the disease registry will also enable nurses toaccess the lifetime health records of outpatients as opposed to a oneinstance kind of care that occurs in an inpatient case(Campbell, 2008). The E.H.R to be implemented will be longitudinal nature so thatnurses and other relevant officers in Medicare and Medicaid centerscan generate accurate and effective reports over a period of time.The implementation process will involve the support services of ITprofessionals that help nurses and doctors to leverage on the needsof project. All departments will have a direct first contact to theeach of the IT professionals(Yoon-Flannery et al. 2008). Directcontact with nurses and doctors will enable the IT professionals todetermine when they need external support to make the E.H.R systemmore effective.

TheChange Model

Thechange to be applied during the implementation process is TheKotter’s 8-Step Change Model. Basedon the theory, three-quarters of staff and management of the Medicareand Medicaid center must support the change to be brought about bythe implementation of the E.H.R system(Kotter &amp Cohen, 2012).The choice to use Kotter’s8-Step Model isbased on its process-like nature that allows for differentstakeholders to absorb and embrace the new technology upon learningabout its benefits in improving the quality of patient care as wellas patient outcomes.


Implementingchange through adopting an E.H.R system has several strengths,weaknesses, opportunities, and threats.The diagram below describessome of the most important effects as far as the SWOT analysis of theadopting an E.H.R system is concerned:


  1. It creates an engaged and motivated nursing staff.

  2. It enhances executive leadership inside the organization.

  3. It will enhance the level of patient safety.

  4. It will act as a strong basis for physician empowerment.


  1. It is likely to have a low physician support unless deliberate efforts to seek their support are adopted during the implementation process.

  2. A new IT team must be created or outsourced to oversee the entire implementation process

  3. It will cost extra dollars to rain staff to use the new E.H.R system

  4. All nurses will have to go through training so that they can have the capacity to train future nurses.


  1. There are a few lessons that were learned for other health care institutions that could be applicable in this project.

  2. The health care industry is shifting towards E.H.R-oriented trends.


  1. There are high expectation from government and other stakeholders about meeting the criteria for meaningful use.

  2. There are strict timelines to meet the regulatory meaningful use requirements.



Thecommunication plan for this project involves: the purpose of thecommunication, stakeholders and goals, the communication matrix,project meetings, project reporting, and project approval.

Purposeof communication-The purpose of communication at each stage of the implementationprocess will be stated concisely through departmental briefs.

Stakeholdersand goals-Eachstakeholder will be aware of the set goals throughout theimplementation process.

Budgetrequirements and implications

All the important components of project are also main budget items.They include:

  1. Cost of individual application modules.

  2. Compensation for physicians that will be part of the roll-out process.

  3. The cost of addition production staff.

  4. Research costs for the required interfaces.

  5. Planning costs for data conversion.

  6. The cost of servers and infrastructure hardware.

  7. Cost of software licenses.

  8. The cost of a backup plan.

Stepsto ensure staff compliance

  1. A Pre-implementation survey will be conducted to gather information about staff concerns, expectations, goals, or objectives.

  2. Training simulation and rehearsals using staff members as mock patients will help verify skills and test the processes of using the E.H.R system.

  3. IT consultants will guide staff when they face any difficulties in retrieving data from E.H.R system.

TheDecision-making Process

TheKotter’s 8-Step mode has eight steps through which the E.H.Rimplementation process. The model facilitates effectivecommunication, create focus, and empower the nursing staff to improvethe quality of care through meaningful use.



Step. 1

Create a sense of urgency

A sense of urgency will be created by convincing the management to understand the effects of lacking an E.H.R system.

Step. 2

Establish a guiding coalition.

The coalition will comprise members of the executive management, departmental heads, nursing leaders in the institution, and IT specialists.

Step. 3

Creating a change vision

Creating a shared change vision will involve communicating the potential benefits of an E.H.R to all nurses and stakeholders

Step. 4

Coining persuasive communication statements.

The chief goal is to make a majority of stakeholders to accept and support the implementation process

Step. 5

Empowering a comprehensive action

To eliminate potential obstacles such as structures that are likely to undermine the shared vision of adopting an E.H.R

Step. 6

Generate short-term wins from the project.

Adopt clear plans for short-term achievements that will be visible throughout the implementation process.

Follow-up to reward employees whose efforts led to the achievements.

Step. 7

Not letting up to pressure

Ensure that all systems, policies, and structures are aligned to overall vision of the project.

Hire, develop, or even promote employees that can advance the shared vision.

Introduce new change agents and themes to invigorate the implementation process.

Step. 8

Merging the E.H.R system into the culture of the institution

By explaining and implementing the changes brought about by the E.H.R in relation to organizational success.

Develop a way to ensure that continued leadership is developed to allow for a smooth succession process.


Campbell,R. J. (2008). Change management in health care.&nbspThehealth care manager,&nbsp27(1),23-39.

Kotter,J. P., &amp Cohen, D. S. (2012).&nbspTheheart of change: Real-life stories of how people change theirorganizations.Harvard Business Press.

Yoon-Flannery,K., Zandieh, S., Kuperman, G., Langsam, D., Hyman, D., &amp Kaushal,R. (2008). A qualitative analysis of an electronic health record(EHR) implementation in an academic ambulatory setting.&nbspJournalof Innovation in Health Informatics,&nbsp16(4),277-284.