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Change Theories for Implementing EBP Intervention

Several change theories have been put forth to guide effective change processes in organizational settings. When implementing the evidence-based practice (EBP) intervention, two of the change theories that change managers should look to for guidance are Lippitt’s seven-phase theory and Lewin’s three-stage change model. Each of these theories focuses largely on preparing people in the organization for the proposed change in order to reduce or prevent resistance to the change initiative and ultimately ensure a successful transition to the new practice (Porter-O’Grady & Malloch, 2003).

The Lippitt seven-phase theory prepares staff and the overall organization for the change initiative (new practice) by taking them through seven distinct but interrelated stages. The first stage is to diagnose the problem by identifying all possible outcomes, determining those who will be affected by the change, identifying the appropriate management personnel to fix the problem, and taking measures to ensure that to be affected by the change will support its implementation. The subsequent stages/phases include evaluating the motivation and capacity for change; assessing the motivation and resources of the change agent; planning and selecting the progressive change objectives; specifying the change agent’s role; maintaining change by facilitating communication, feedback, and collaboration; and terminating the agent’s helping relationship gradually (Lippitt, Watson, & Wesley, 1958).

In comparison, Lewin’s change theory is grounded on the premise that human behavior is a dynamic balance between driving and inhibiting forces. Driving forces reinforce proposed change by incentivizing employees to act in support of the change whereas the inhibiting forces push employees to resist the change. Adopting Lewin’s change theory streamlines the overall change process by taking employees other people to be affected by the change through three stages: unfreezing, moving, and refreezing. The first step, unfreezing, is meant to overcome possible resistance and achieve conformity by agitating the status quo. On the other hand, the ‘moving’ stage transitions employees to the new practice and helps them see the change from a new perspective, while ‘refreezing’, which is the last stage helps the employees to attain equilibrium with the desired behaviors and integrates the new outcomes into the organization (Lewin, 1951).

Of the two change theories describes above, one that makes the most sense when it comes to implementing an EBP project is Lippitt’s seven-step change theory. This is because, unlike Lewin’s change theory, it specifies the role of the change agent (nurse leader) in the change process (Kritsonis, 2005). Moreover, by guiding the EBP implementation through seven stages, Lippit’s change will certainly ensure that all the issues that are likely to inhibit the implementation process are adequately addressed. As such, it’s no surprise that my mentor has used this theory on various occasions to successfully guide and instill desired behaviors and outcomes in our team.

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