How to Apply Lippitts Theory of Change in Nursing

Lippitt's change theory is based on bringing in an external change agent to put a plan in place to effect change. There are seven stages in this theory and they are diagnose the problem, assess motivation, assess change agent's motivation and resources, select progressive change objects, choose change agent role, maintain change, terminate helping relationships. This theory can be used in nursing to effect change.

Diagnose the problem. In this step, the nurse leader, staff nurse or health care personnel notices and diagnoses a problem. The need for change is then made known to other members of staff who will be affected, so that meetings can be held to decide on how to move forward. For example, administrators may conclude that a patient centered, coordinated care approach should be implemented to reduce patient complaints about impersonal treatment from hospital nurses.

Assess motivation. Find out if those that will be affected by the change are willing to let it happen or are opposed to it. Devise solutions that will address all possible problems that may be encountered on the road to change. Motivation will be higher if there is shared agreement on the root of the problem needing correction. For instance, administrators should first determine if patient complaints about impersonal nurses stem from inadequate staffing levels, which make it difficult for busy nurses to visit with patients.

A change agent is an individual responsible for championing the change process. Check to see if the change agent can do the job. Determine if the change agent hired from another firm has what it takes to do the job by way of stamina, experience, acceptance by the nurses and other staff, a genuine desire to see the change project succeed and the right personality.

Write a plan to implement the change. The plan should contain detailed steps that include timetables and deadlines. Responsibilities are then assigned to all parties involved in making the change happen. Duties of the change agent include providing coaching and training to help employees develop the dispositions and skills necessary to be successful and continue in their job.

Determine the role of the change agent. Let everyone working on the change project know what the role of the external change agent will be so that there will be no confusion as to what his job is, thus preventing misunderstandings or resentment.

Maintain the change. In this step of Lippitts's change theory, the change project is monitored for progress. All parties involved in the change project communicate with each other and the change agent to update themselves on the progress of their individual tasks.

Terminate the helping relationship. In this stage, the external change agent is let go by whoever hired him and supervised his work. Also, at this stage the change is made permanent by creating rules and policies that have to be followed.