Maintaining Change in Practice

Maintaining Change in Practice

  1. Consider the change you have proposed in your project. (Lack of proper education on
    patient with type 2 diabetes)
    Which principles of planned change will help its’ success?
  2. Please refer to KOTTER AND COHEN’S 8 STEPS TO CHANGE in their change theory
    and apply these steps to the change you are describing.
  3. End your paper with a serious reflection on how your understanding of planned change
    will help you proposed change in the clinical setting you are currently working (Dr. Office).
    Please use pear review articles to support your proposal remember that they cannot be
    more than 5 years old.

Maintaining Change in Practice

Fostering and maintaining change in practice can be a daunting task if the right strategies
are not adopted for change management. In reference to my proposal ‘Lack of Proper Education
on Patient with Type 2 Diabetes’, there are various principles of change that I intend to
implement as a clinical at the Dr. Office in a bid to promote knowledge among patients with
diabetes and hence improve management of the disease. This is a discussion of the principles that
will fuel this change, including a discussion on the eight steps of change by Kotter and Cohen.

Principles of Planned Change

The realization of change in the management of Type 2 diabetes will only be actualized if
certain principles of planned change are implemented. These include starting from the top,
involving staff at all levels, communicating the change process, creating ownership, and
understanding that change is a process (Ray and Breland, 2011; Whelan-Berry and Somerville,
2010). As a clinical at the Dr. Office, I will play an important as part of the staff, working with
other team members to achieve change. Creating ownership ensures that I take the change
process as a part of my responsibility. This will ensure training of patients about type 2 diabetes
is made part of the treatment process, thus fueling the change process. In doing this, there is need
to realize that change cannot be achieved instantly and that it is a process that will take a while.


8 Steps to Change

In their change theory, Kotter and Cohen put forth eight steps to change that companies
must adhere to for an effective change process. These can be related to the proposed changes and
I will contribute to their achievement as discussed below.
The first step involves creation of a sense of urgency (Murray, 2013). In promoting
knowledge about type 2 diabetes, there is need to create advocacy that will excite members of
the medical community as well as the community on the need to increase awareness on diabetes,
including self-care and self-medication. I will work with the team at Dr. Office, to promote
change urgency through encouraging others to join the change process.
The second step involves developing a guiding coalition. This involves assembling a
power group to support the change process (Stragalas, 2010). In this regard, a group consisting of
nutritionists, nurses and doctors specializing in diabetes at Dr. Office will form a team for
promoting knowledge among patients and within the community.
Forming a strategic vision and accompanying initiatives is the third step, which involves
the development of strategic initiatives to promote achievement of the vision (Murray, 2013).
The lack of knowledge among type 2 diabetes patients is highly dangerous for their health and
the vision would be to create a vision of ensuring that they have adequate information to help
them manage their conditions through self-medication, proper nutrition and lifestyle changes.
This would be achieved through regular trainings sessions with the patients and outreach services
to the community.
The next step according to Kotter and Cohen is to enlisting a volunteer army, consisting
of a creating a large power team, which is ready to urgently drive change (Stragalas, 2010). I will
consolidate a power team within the clinic that is willing to work even beyond working hours


and who are devoted to diabetes care and management. This would especially consist of people
who have been directly affected by the disease, either personally or through relations.
The fifth step is about eliminating obstacles that may distract the change process
(Murray, 2013). This is known as enabling action by eliminating barriers, which in this case will
be achieved through fighting inaccurate information that people with diabetes have access to. It
is notable that patients receive all manner inaccurate information from relatives, friends and
other unprofessional sources. By providing the right information, this can be effectively
The sixth step is generation of short-term wins. Every achievement is considered as an
important and thus celebrated and correlated with results (Anders and Cassidy, 2014). For every
person trained on type 2 diabetes, this will be considered a great achievement for the fraternity.
The next step is to sustain acceleration by using the organization’s growing credibility to
eliminate structures that jeopardize the change process and promoting best practices, new
themes, volunteers and projects among other developments. By this time, the team at Dr. Office
will have played a great role in promoting education on diabetes. Challenges and areas of
improvement will also have been identified and corrective measures to promote the objectives of
the change can therefore be taken.
The last step is to institute change. This is the process of connecting the new behaviors
with the entity success. It also involves creating a way to ensure development of leadership and
succession is achieved (Ates and Bititci, 2011). It is imperative that the efforts put into executing
the changes in the management of knowledge of type 2 diabetes are not wasted and that the
impact continues to be felt. In this relation, systems will be put in place to ensure that the focus
of the change process is maintained through creating a reliable leadership team.


Personal Reflection

Based on this understanding of planned change, I expect that I will be in a better position
to execute the proposed change while working as a clinical at the Dr. Office. I believe that I will
understand the purpose of change in a more effective manner and thus be in a position to execute
the desired actions. Most importantly, I understand that change is a process and should be
undertaken gradually.


Anders, C. & Cassidy, A. (2014). Effective organizational change in healthcare: Exploring the
contribution of empowered users and workers. International Journal of Healthcare
Management, 7(2), 132-151.


Development Journal, 31(4), 27-35.
Ray, M. D., & Breland, B. D. (2011). Methods of fostering change in the practice model at the
pharmacy department level. American Journal of Health-System Pharmacy, 68(12),
Whelan-Berry, K. S., & Somerville, K. A. (2010). Linking Change Drivers and the
Organizational Change Process: A Review and Synthesis. Journal of Change
Management, 10(2), 175-193. 1