Abstract

Purpose: Healthcare settings continue to experience unique challenges in maintaining healthy working environments while keeping patient care and quality a top priority (Campbell, 2020). Leaders in healthcare strive to develop and maintain healthy working environments and patient outcomes but continue to fall short of these goals (Pechacek et al., 2022). The Kotter Change Model (KCM) provides an organized process that leaders can use to inform and guide healthcare teams during change implementation (Kotter, 1995). Managing change implementation in healthcare settings is no easy task, especially in areas of high stress and staffing shortages. Organized change processes, like KCM, can improve workplace environments and patient outcomes (Lindsay, 2023; Campbell, 2020; Pechacek et al., 2022; Harrison et al., 2021; Carman et al., 2019). This presentation describes how KCM can be used in healthcare settings to cultivate healthy workplaces and improve patient outcomes.

Methods: KCM was implemented in a 170-bed long term care and rehabilitation center in the southeast United States. Implementation targeted several members of the Quality Assurance Performance Improvement (QAPI) team as they were adopting framework revisions to improve outcomes and sustainability. Three focus areas within the framework include: 1) creating the climate for change, 2) engaging and enabling the organization, and 3) implementing and sustaining change (Cusick, 2018). Eleven members of the facility’s QAPI team were chosen by convenience sample to participate in an on-site presentation utilizing PowerPoint and a case study. The presentation described recent facility assessments and deficiencies while focusing on how their current change implementation framework could be revised. The KCM was utilized as the framework for the project.

Results: Project evaluation was measured through post implementation surveys following the presentations. Printed surveys were given to each participant to promote engagement. Survey participants were required to agree or disagree regarding site adoption of a revised change implementation framework. The post survey had 100% participation and results obtained from the surveys reflected 100% support for site adoption of the revised framework for future QAPI efforts.

Conclusion: Change implementation in healthcare often results in failed or non-sustaining outcomes. Healthcare teams, leaders, and staff benefit from interprofessional tools and evidence-based approaches that guide change efforts. Through this project, there are many positive impacts on nursing practice and patient outcomes. This project provides healthcare leaders an example of how the KCM can be utilized for change implementation that promotes healthy working environments and improves patient outcomes.

Notes

References:   Campbell, R. J. (2020). Change management in health care. The Health Care Manager, 39(2), 50–65. https://doi.org/10.1097/hcm.0000000000000290
Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). A change-management approach to closing care gaps in a federally qualified health center: A rural Kentucky case study. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180589
Cusick, J. J. (2018). Organizational design and change management for IT transformation: A Case Study. Journal of Computer Science and Information Technology, 6(1), 10-25. https://doi.org/10.15640/jcsit.v6n1a2
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13(8), 85–108. https://doi.org/10.2147/jhl.s289176
Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 85(1). https://hbr.org/1995/05/leading-change-why-transformation-efforts-fail-2
Lindsay, M. (2023). A shared governance approach to nursing documentation redesign using Kotter’s change management model. Nursing Management, 54(3), 15-20. https://doi.org/10.1097/01.NUMA.0000922912.97477.7b
Pechacek, J., Anderson, D., Lund, R., & Drill-Mellum, L.D. (2022). Healthy work environments: An interprofessional partnership model to promote positive workplace culture. Interdisciplinary Journal of Partnership Studies, 9(2), 1-31. https://doi.org/10.24926/ijps.v9i2.4978

Description

Change implementation in healthcare often results in failed or non-sustaining outcomes. Healthcare leaders that adopt the use of change implementation models, like Kotter's Change Model, can improve working environments and patient outcomes. Kotter's change model provides realistic phases that are proven to empower and engage leaders and staff.

Author Details

Jacquelyn Smith, DNP, RN; Brandy L. Simpler, DNP, RN; Kasey Chance, DNP, FNP-BC

Sigma Membership

Gamma Eta

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Implementation Science, Work Environment, Outcomes (Health Care)

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-19

Click on the above link to access the slide deck.

Share

COinS
 

Optimizing Workplaces and Patient Outcomes: Implementing Kotter’s Change Model

Washington, DC, USA

Purpose: Healthcare settings continue to experience unique challenges in maintaining healthy working environments while keeping patient care and quality a top priority (Campbell, 2020). Leaders in healthcare strive to develop and maintain healthy working environments and patient outcomes but continue to fall short of these goals (Pechacek et al., 2022). The Kotter Change Model (KCM) provides an organized process that leaders can use to inform and guide healthcare teams during change implementation (Kotter, 1995). Managing change implementation in healthcare settings is no easy task, especially in areas of high stress and staffing shortages. Organized change processes, like KCM, can improve workplace environments and patient outcomes (Lindsay, 2023; Campbell, 2020; Pechacek et al., 2022; Harrison et al., 2021; Carman et al., 2019). This presentation describes how KCM can be used in healthcare settings to cultivate healthy workplaces and improve patient outcomes.

Methods: KCM was implemented in a 170-bed long term care and rehabilitation center in the southeast United States. Implementation targeted several members of the Quality Assurance Performance Improvement (QAPI) team as they were adopting framework revisions to improve outcomes and sustainability. Three focus areas within the framework include: 1) creating the climate for change, 2) engaging and enabling the organization, and 3) implementing and sustaining change (Cusick, 2018). Eleven members of the facility’s QAPI team were chosen by convenience sample to participate in an on-site presentation utilizing PowerPoint and a case study. The presentation described recent facility assessments and deficiencies while focusing on how their current change implementation framework could be revised. The KCM was utilized as the framework for the project.

Results: Project evaluation was measured through post implementation surveys following the presentations. Printed surveys were given to each participant to promote engagement. Survey participants were required to agree or disagree regarding site adoption of a revised change implementation framework. The post survey had 100% participation and results obtained from the surveys reflected 100% support for site adoption of the revised framework for future QAPI efforts.

Conclusion: Change implementation in healthcare often results in failed or non-sustaining outcomes. Healthcare teams, leaders, and staff benefit from interprofessional tools and evidence-based approaches that guide change efforts. Through this project, there are many positive impacts on nursing practice and patient outcomes. This project provides healthcare leaders an example of how the KCM can be utilized for change implementation that promotes healthy working environments and improves patient outcomes.