Kotter’s 8 stages of change: implementation of clinical screening protocols for assessing patients for COVID-19 – a review of an academic medical centre’s preparedness

Abstract

BackgroundCOVID-19 screening protocols rapidly evolved as a result of changing Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CDPH) recommendations. These protocols led to operational improvements at one large academic medical centre using change management methods explained in Kotter’s 8-stage change model.MethodsWe reviewed all iterations of clinical process maps for identifying, isolating and assessing COVID-19 infections in paediatric and adult populations within one emergency department (ED) from 28 February 2020 to 5 April 2020. We incorporated CDC and CDPH criteria for the various roles of healthcare workers in ED patient assessment.ResultsUsing Kotter’s 8-stage change model, we outlined the chronological evolution of basic screening criteria, as well as how these were reviewed, modified and implemented during the onset and through the time of greatest uncertainty of COVID-19 in the USA. Our results demonstrate a successful creation, and subsequent execution, of rapidly changing protocols across a large workforce.ConclusionWe effectively applied a business change management framework to the hospital management response during a pandemic; we share these experiences and challenges to inform and guide future operational decision making during times of rapid change.

Riding the wave of change: Providing solid ground to support nursing with patient transitions to novel haemophilia therapies

“…His steps include 1) establishing a sense of urgency; 2) forming a powerful guiding coalition; 3) creating a vision; 4) communicating the vision; 5) empowering others to act on the vision; 6) planning for and creating short‐term wins; 7) consolidating improvements and producing still more change; and 8) institutionalizing new approaches 3 . This model has proven useful in healthcare where change is needed, especially in the areas of changing practices and protocols 6 …”