Managing Change One Person at a Time Research Paper

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Nursing Forum

Hospital X is changing its documentation from one system of computerized charting to another. Your critical care unit has been selected to trial the new computerized documentation and make recommendations about its use. As the nurse manger, how would you proceed in this change process when your staff have openly expressed concerns about using a more sophisticated system for documentation? (6 points total possible)

I would frame my perspective from the standpoint of Rogers' Diffusion of Innovation, which has been applied to many change management situations in nursing. What I appreciate about Rogers' theory is that it begins with the assumption that people will adapt innovation at different rates and that a small minority will be non-adapters. Moreover, Rogers provides strategic approaches to bringing about organizational and individual change that acknowledge the social realm in which change occurs -- a factor that is particularly true in nursing where concern about the benefit to patients is the ultimate criterion.

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Rogers theory asserts that innovation is communicated across channels and among the members of an institution through the social system, in much the same way that influencers in Malcolm Gladwell's book The Tipping Point operate. Confident and enthusiastic first adopters influence their peers to give the innovation a try. Often, the motivating factor is that first adopters are recognized by leaders and well-regarded peers -- a factor that can give adoption a boost. Each person must work through decisions about the innovation in order for a full and beneficial adoption to occur. The pattern of adoption decisions develops along these lines (Rogers, 162): 1) Knowledge about the innovation; 2) Persuasion occurs that is either sufficient or insufficient to generate a positive attitude toward the innovation; 3) Decision is made, at….....

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