Change theories and stages

The Case Manager often has the task of facilitating change. Whether they are assisting with lifestyle changes, dietary changes or changes in family dynamics the change principles are the same. Below is an overview of Lewin’s Change Model and Kotter’s 8 Step Change Model.

Lewin’s Change Management Model-Unfreeze, Change, Refreeze

Unfreeze-The first step in change is helping the patient understand that change is necessary. This can be done by education on why what they are currently doing needs to change.
Change-In this stage changes in thoughts, feelings and/or behaviors occurs.
Refreeze-Sustaining the change by establishing it as a new habit.

Kotter’s 8 Step Change Model

Step 1:  Create Urgency- A sense of urgency is created when a crisis or potential crisis, such as hospitalization occurs. Urgency can also be created when there is a major opportunity.
Step 2:  Form a Coalition- The patient, patient care team, family or support group, can be part of the group that works together to accomplish the change.
Step 3: Create a Vision and Strategy for Change- What does the patient want the outcome to be?
Step 4: Communicate the Vision
Step 5: Remove Obstacles: As obstacles to the change arise, they need to be addressed and eliminated.
Step 6: Create Short Term Wins- Acknowledge and celebrate progress.
Step 7: Build on the Change- Use the momentum of the positive effects of the change to build on.
Step 8: Anchor the Change- Review the relationship between the changes and the positive outcome to cement the change.