A Comparison Between Two Change Theories for Implementing Evidence-Based Practice (EBP) Interventions
Evidence-based practice or EBP is the philosophy that holds that interventions used on patients must have evidentiary backing from scholarly research that has been peer-reviewed and published. This is what has become the best practice. But EBP knowledge is not static but dynamic. New efficacious interventions are unearthed every day all over the world by scholarly research. How this is achieved is determined by levels of clinical inquiry which is the source of knowledge for EBP. Clinical inquiry uses the PICOT paradigm to direct clinical inquiry and get specific studies that provide evidence for particular interventions (Melnyk & Fineout-Overholt, 2019). But after getting the required EBP recommendations and disseminating the findings to the concerned healthcare professionals, the final task is implementing the change to these new interventions and incorporating them into day-to-day clinical practice. This final task requires the utilization of one of several change theories to direct the practice change by providing the theoretical framework. This discussion paper compares and contrasts two of these change theories in the form of Kurt Lewin’s Change Management Model and Rogers’ Innovation Diffusion Theory. Comparison Between Two Change Theories for Implementing Evidence Essay Discussion Paper
Kurt Lewin’s Change Management Model
Kurt Lewin’s model of change involves the three steps of unfreezing, changing, and refreezing (Hussain et al., 2018; Šuc et al., 2009; Udod & Wagner, n.d.). The figure above is a conceptual representation of the model as applied to change implementation for patient falls. However, in this case the implementation is of Covid-19 interventions at Kingston Healthcare in California. In the first phase, the current practice that needs to be changed to EBP is reviewed and dismantled by pointing out its inefficiencies and limitations. A search for evidence is carried out for a better evidence-based alternative and change recommendations are made. Then in the next phase of ‘Change’, the actual implementation of the new intervention takes place. If successful, the new intervention in clinical practice is adopted as part of EBP and incorporated into institution and practice procedures and policies. This is the third step of ‘Refreeze’ (Hussain et al., 2018; Šuc et al., 2009; Udod & Wagner, n.d.). Lewin’s change theory is simplistic and lacks in detail when compared to Rogers’ Diffusion of Innovation’s (DOI) theory. Comparison Between Two Change Theories for Implementing Evidence Essay Discussion Paper
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Rogers’ Diffusion of Innovations (DOI) Theory
In contrast to Kurt Lewin’s model of change implementation, Rogers’ DOI is more specific, detailed, and unambiguous. It involves five distinct steps that handle every phase of the change process. These steps are as follows (Dearing & Cox, 2018; Pashaeypoor et al., 2016; Udod & Wagner, n.d.):
- Knowledge: Education about the proposed change is provided.
- Persuasion: Interest is aroused and implementers actively seek information about the change.
- Decision: The advantages and disadvantages of the change are taken into account.
- Implementation: The change is implemented and tailored to fit the setting.
- Confirmation: The final decision is made to incorporate the change into practice permanently.
Between the two, Rogers’ DOI makes the most sense in implementing my EBP intervention of Covid-19 interventions at Kingston Healthcare. This is because it is exhaustive and clear in terms of what happens at each phase of the change implementation. Indeed, my preceptor has used both models with varying results. They are in concurrence with me on the choice of Rogers’ DOI theory
Dearing, J.W. & Cox, J.G. (2018). Diffusion of innovations theory, principles, and practice. Health Affairs, 37(2), 183-190. http://dx.doi.org/10.1377/hlthaff.2017.1104
Hussain, S.T., Lei, S., Akram, T., Haider, M.J., Hussain, S.H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Pashaeypoor, S., Ashktorab, T., Rassouli, M., & Alavi-Majd, H. (2016). Predicting the adoption of evidence-based practice using “Rogers Diffusion of Innovation Model”. Contemporary Nurse. https://doi.org/10.1080/10376178.2016.1188019
Šuc, J., Prokosch, H.-U. & Ganslandt, T. (2009). Applicability of Lewin’s change management model in a hospital setting. Methods of Information in Medicine, 48(5). http://dx.doi.org/10.3414/ME9235
Udod, S., & Wagner, J. (n.d.). Common change theories and application to different nursing situations. Pressbooks. https://leadershipandinfluencingchangeinnursing.pressbooks.com/chapter/chapter-9-common-change-theories-and-application-to-different-nursing-situations/
Comparison Between Two Change Theories for Implementing Evidence Essay Discussion Paper