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  1. White, Ann RN, MSN, CCNS, CEN


Nurse managers can usher in change successfully by focusing on evidence-based change concepts, such as selecting the right leadership skill, anticipating how people will respond to change, and choosing the correct implementation strategies.


"Leaders initiate change; followers survive it."1 As a nurse leader, it wouldn't be unusual for you to walk into work one morning and open the following e-mail messages:


"The nurse executive council has decided on the next step of the plan to achieve Magnet status," says the director of nursing. "Please place on your calendar the following meeting time to learn your role in its implementation."


"The process for point-of-care testing validation isn't successfully meeting the standards," says the laboratory director. "Please send a unit representative to a process-improvement task force meeting."


We're modifying the way we do things. We're frequently placed in the position of asking our staff to change. How can you multitask and manage so many changes at once with successful outcomes? Change has become constant, pervasive, and persistent in health care and can be defined as the process of making something different from what it was.2 Implementing a new patient care process requires significant change and attention to the change process. Often, success hinges on a carefully laid plan.


The task of changing a patient care process is no small feat. Key, singular processes involved with an outpatient visit or an inpatient stay with triage, admission, treatment, disposition, transfer, or discharge, are core to the functioning of the whole health care organization and are directly and indirectly connected to care outcomes and patient flow. From patients to the entire multidisciplinary team, the number of people affected is far reaching. Focusing on key concepts, such as your leadership skills, how people respond to change, and implementation strategies, will help you begin successful process improvement.