I2E2 Leading Lasting Change, Jayne Felgen. Minneapolis, Minn, Creative Nursing Management, 2007. 181 pages, soft cover, $24.95, http://www.chcm.com.

Who is not leading a large-scale change effort right now? And of those change efforts, how many are occurring at high speed in an environment of uncertainty? What if you could put a leading change book in your pocket? Jayne Felgen's new book on leading change is a 7 in. x 5 in., light to carry but heavy book on insight, including case studies, appendices, and a Gantt chart. I2E2 is the model Creative Nursing Management uses, particularly in implementing relationship-based care. And the model works internationally as well. This does not mean you must hire Creative Nursing Management. It does mean that they are confident enough in their approach that they will share it with you. You can use it for your internal change team, your internal change team with a consultant (and often major change projects do include consultants), or however you find it helpful.

Jayne's main focus is creating a formula for sustained and successful change, using Creative Nursing Management's formula: I2E2. The first I is for "inspiration." The second I is for "infrastructure." The first E is for "education" and the second E for "evidence." The book is divided into 4 parts:

1. Philosophies of Effective Change (31 pages)

* Make Every Inquiry "Appreciative"

* We Have Influence

* Experience Exuberance

* Believe in Your Abundance

* Be Clear

* Embody the Change

* We Get What We Pay Attention To

* Patients and Families Come First

2. Fundamentals of I2E2 (taken from Appendix A, 175 pages)

* Vision: What do you intend to change for yourself, your team, your patients, and families? In present tense and concrete terms.

* Inspiration: How might you inspire others to share your vision?

* Infrastructure: What changes in your daily practice would increase the likelihood that this vision could live? What are the implications for roles, rituals, systems, standards, norms, and your practice?

* Education: What knowledge and skill building is needed for yourself and others to initiate and sustain the desired vision?

* Evidence: How will you demonstrate or measure a persistent focus on your vision, as well as the actual impact and outcomes?

3. Reflection: The BIDMC (Boston Beth Israel and New England Deaconess)

* Merger

* Powerful Case Study

4. I2E2 in Practice

* Asking the Right Questions

* The Relationship-Based Care Scenario

* Strategies for Sustaining Change

Minimally, this book is a pocket-size guide for a major change leader who in the middle of a project may think it is all falling apart. Will this change happen under my leadership? A quick reread of the contents will help leaders focus on where they need to direct their energy. Those leaders who find the formula logical and comprehensive will value the book, as it provides a model for change to be formally adopted by leadership. If others on your executive team are using John Kotter's Leading Change (with his 8 stages of successful change; Harvard Business Press, 1996), you may want to compare and contrast both approaches. Likewise, do the same if your executive team is using Norton and Kaplan's Strategy Maps (Harvard Business Press, 2004). They are not contradictory but complimentary. Remember, Felgen's book fits in your pocket and has her own unique holistic approach to leadership.