Change Theories

Change Theories Application in Healthcare Organizations

Healthcare organizations can use change theories like Kurt Lewin’s models of change and Burrowes and Need’s Contemporary Adaption and Lewin’s model, complexity science and adaptive system, and Edward Lorenz’s Chaos Theory to implement effective change in order to adapt to the changing healthcare system. The paper will also address important aspects of implementing change such as the role of the change agent. These theories can be applied in healthcare settings to promote effective change. Healthcare is always changing. It is important to be able to understand the different theories and factors that influence change. Understanding when change is needed to improve patient satisfaction and employee satisfaction is essential to maintaining a successful organization.

Types of changes

Both planned change and change by drift can be seen in organizations as well as throughout a person’s life. Before the mid-1900s people were often unsure if they should intervene in a particular situation or just let nature do its thing. The change by drift method of changing was more popular before this. In which you have no control over the outcome of any change and can’t make changes, there was less to be done. Intentional or planned change can be considered accidental, while it is called intentional change.

During planned changes, the skills and knowledge of leaders are used to influence and implement organizational change (Marquis & Huston, 2017). The 1950s saw a shift in people’s views on change and how to handle it. Instead of wondering if the intervention was necessary to effect change, people now question the best way to plan for that change. “Progress became a concept that mandated science be used in service of humanity and that experts should address people’s needs according to how they perceive them” (Tiffany & Johnson Lutjens, 1998). This was a time when healthcare organizations were growing and technology was improving. The patient population was changing and so were the needs. These organizations needed to not only understand the need for change but also plan and implement changes.

Who is a Change Agent

A change agent is someone who can plan and implement planned change. A change agent can be defined as someone who is skilled in the theory and implementation of planned change. Sometimes, the agent may be an external source. You must also be able to plan, assess, and manage the implementation of the change.

8 steps change model theory by John Kotter

John Kotter (a professor of organizational sciences) is well-known as the inventor of the eight-step change model. This model can be used to direct organizational change. He developed the 8-step model in 1995. It was what he believed was necessary for organizational change to be successful. Kotter’s method will help organizations create the right environment to promote change. There are many things that can happen, but Kotter is able to show that there are some things that can be done. Kotter recommends that organizations respond quickly to events that lead to the need for change. Once the problem has been identified it is time for an organization to form a team that includes a change agent. This will help to facilitate and implement change. Research has repeatedly highlighted the importance of leadership and a leadership style in order to successfully implement organizational change. This is our third step. The vision will be developed by the team. The vision will then become a shared document with all those affected. The fifth step of the process is empowerment. This is done by leaders who encourage risk-taking as well as non-traditional ideas and efforts. Short-term victories are generated by the change agent and team leaders. These short-term victories can be easily seen and encouraged to change. This will allow the team continues to move forward to step 7, in which they will be reminded of their need to never stop trying. Positive outcomes are essential to building momentum on the path of change. The last step is essential to making the change stick. The change agent, along with the team, will remain involved to keep the changes going and to provide. This eight-step approach can be used by organizations to implement successful change.

Kurt Lewin Change Model

Kurt Lewin, a German American psychologist, is considered to be the founder and pioneer of modern social psychology. Lewin’s research focused on group dynamics, experimental learning,g and action research. Lewin’s original three-phase model, which was first developed in the 1950s to help plan change, is still being used today. This model helps to explain how striving forces are working together to change the status quo. Lewin identified three phases in this model of change: movement, unfreezing and refreezing.


Lewin and his research show that for organizations to successfully implement change, they must plan it. This requires unfreezing the system. When the change agent emphasizes that there is a need for change and persuades the group, the process of unfreezing takes place. This stage is sometimes called discontent because it is when the change agent triggers such a response from others that they can see that change in their lives is possible. It can be internal or exterior discontent that is needed to bring about change. The change agent must be able to set aside competing priorities and stress the need to bring about change. A change agent must be able and willing to work with people who are afraid of change. People who resist change experience more stress, and they need comfort. This puts greater pressure on the change agent. Motivation declines when this happens.


Lewin’s theory moves to the next phase, the movement phase. Because they have to address the stress all people affected by the changes feel, the role of the change agent in the movement phase is to inspire, set goals and build trust.


Lewin’s final stage is called refreezing. This is to enable the change agent and stabilize the system. Failure here will make change ineffective. Pre-change behavior continues.

Kurt Lewin’s model of transformation is applicable to many healthcare situations. The Theory of Change has been driving positive change in the field of health care since 1950.

Theory of Driving and Restraining forces

Kurt Lewin expanded the scope of his theory to include force field analysis. Kurt Lewin extended his theory to include “force-field analysis.” These can include beliefs, values, and expectations, as well as cultural norms and experiences. When assessing driving power and restraining ability, the change agent must consider many factors.

You can apply this theory to healthcare. Both the patient and the team need to be able to recognize and address the driving factors and restraining factors that could affect patient care. For example, if the patient was offered transportation or payment based on their income, they might consider seeking assistance.

Modern Adaptation of Lewin Model

Nina Burrowes and Adrian Needs came up with a modern adaptation of Lewin’s model. This stage is where an individual or company contemplates changing their behavior. This means that people who follow this model of change may go through multiple cycles before they achieve success.

Rehabilitation in healthcare relies heavily on the SCM model. These interventions could help increase willingness to change, improve resource utilization, and reduce dropout rates.

Theory of Effective Change

In 1969, Bennis, Benne $ Chinn developed three strategies that could be used to change people’s behavior (Sheaffer, Phillips, Donlevy, & Pietruch, 1998). Agents must be able to identify the positive behavioral benefits.

This is a rational/empirical mixture of psychological and behavioral strategies.

Peer pressure is used to implement change in the normative-reeducative strategies. This strategy is different from the power coercive strategy in that it does not use power. The change agent has no legitimate power over others in the normative-reeducative strategy. The change agent encourages the spouse and other family members to support the change agent during this phase. The power-coercive method is when the change agent has power and authority.

Complexity and complex adaptive systems change theory

Complexity science was born from the ever-changing technology, discovery, and application of quantum physics and subatomic worlds. Each patient can be customized to receive holistic medical care.

Complex Adaptive Systems theory, or CAS, is based upon complexity science.

Both complexity science and complex adaptive system theory can be extremely helpful in healthcare. Treatment plans can be unpredictable. Patients’ outcomes are not predictable. It is possible to evaluate each patient individually and see the whole picture to help you get the best outcome.

Theory of Chaos

Edward Lorenz (a meteorologist) attempted to improve weather predictions techniques during the 1960s. These techniques eventually became the basis of chaos theory. He discovered that even small changes in situations can have profound consequences.


Healthcare is constantly changing to meet the needs of patients. Individuals and organizations need to consider all factors. These include culture and knowledge, timing, the effectiveness of the change, and the best change theories to achieve the desired outcomes. Healthcare professionals should be able to understand the importance and theories of change, as well the role of a change agent.


Sheaffer, C. M., Phillips, C. Y., Donlevy, J. A., & Pietruch, B. L. (1998). Continuing education as a facilitator of change: Implementing a new nursing delivery model. The Journal of Continuing Education in Nursing29(1), 35-39.

Marquis, B. & Huston, C. (2017). Organizational structure. Leadership roles and management functions in nursing (9th ed.). 308-310. Philadelphia, PA: Wolters Kluwer.

Tiffany, C. R., & Johnson-Lutjens, L. R. (1998). Planned change theories for nursing: Review, analysis, and implications (1st ed.). Thousand Oaks, CA: Sage Publications. Retrieved from

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