mission possible: using kotter’s change model to drive ......sustainable change – ... creating a...
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Mission Possible: Using Kotter’s Change Model to Drive Sustainable Change –
A Case Study Beverly A. Bokovitz, MSN, RN, NEA-BC
Chief Nursing OfficerSt. Anthony’s Medical Center
St. Louis, Missouri
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Faculty Disclosure Faculty Name: Beverly A. Bokovitz, MSN, RN, NEA-BC
Conflicts of Interest: None
Employer: St. Anthony’s Medical Center
Sponsorship/Commercial Support: None
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Goals and Objectives• Session Goal
- Steps to improve an organization’s hand hygiene compliance rate by using J. Kotter’s change model as a framework for success
• Session Objective - Participant will have an understanding of how to
implement a sustainable quality initiative using J. Kotter’s change model
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Why Change? Why Kotter?
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“Where are we going?”Overarching goals of hand hygiene improvement plan:• Improve hand hygiene observation
rate to 90% or better• Improve HAI rates
Objectives of hand hygiene improvement plan:• Utilize a multi-modal strategy as
outlined by the World Health Organization (WHO)
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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“It’s a priority!”In 2014, identified hand hygiene improvement as a priority due to:
• Low hand hygiene compliance rates as noted by The Joint Commission during the 2013 survey- standards state “ must show improvement”
• Candid observational data reveals a compliance rate less than 70%
• Lack of an evidence-based hand hygiene strategy
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Forming A Guiding Coalition• Who are your key stakeholders?• Who are your formal and informal leaders?• Who can help support the team’s efforts?
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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What’s The Vision?• Where do you want to be?• Show improvement?• Have a target?
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Communicating The Vision
• Staff meetings• Newsletters• 1:1 meetings• Using EVERY opportunity• Senior leaders involved
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Empowering Others To Act• Everyone must own the issue and feel part of the solution• Ideas should be shared and encouraged• Remove obstacles
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Creating And Celebrating Short Term Wins
• Reinforces the behavior• Positive feedback• Food, personal cards, monthly pizza
parties• Senior leader acknowledgement
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Consolidating Improvement Plans
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Kotter’s 8 Stages of Organizational Transformation:1. Establishing a sense of urgency2. Forming a powerful guiding coalition3. Creating a vision4. Communicating the vision5. Empowering others to act on the vision6. Planning for and creating short-term wins7. Consolidating improvement plans and producing still more change8. Institutionalizing new approaches
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Cementing The Changes: Sustainability
• Weave the change into the culture
• Policy changes• Regular updates and
communications• Staff evaluations
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Kotter/Hand Hygiene
4) Nurses Week, staff participation in committee
3) SWOT analysis, GAP analysis ,staff survey
2) Formation of a multi-disciplinary team
1) Sharing data
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Kotter/Hand Hygiene
8) Senior leadership and communication
7) New employee orientation
6) Unit pizza parties
5) Secret Shopper model & peer review process
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Results2014: Hand Hygiene Compliance- Consistently below 70 % compliance- Initiative started April, 2014
2015: Improvement to 90%
2016: Improvement to 92%
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Questions???