Wednesday, March 4, 2015

Roadmap for Implementing NCP

"Good ideas are not adopted automatically. They must be driven into practice with courageous impatience. Once implemented they can be easily overturned or subverted through apathy or lack of follow-up, so a continuous effort is required.“
-- Admiral Hyman Rickover (1900-1986)
The Academy of Nutrition and Dietetics Nutrition Care Process and Standardized Language Committee reviewed change management literature from 2003 to 2008.  One reference used was the book Leading Change.  John Kotter of Harvard Business School published steps in implementing organizational change that have been used to guide teams of dietitians as they implemented the Nutrition Care Process and standardized language.  Kotter's eight stage process can easily apply to teams of dietitians implementing the nutrition care process in medical organizations.

Kotter's Eight Stage Process used to lead successful change is:

1-Establishing a Sense of Urgency
Examine the circumstances leading to the decisions to implement, identify and discuss crises, potential problems or major opportunities

2-Creating the Guiding Coalition
Put together a group with enough power to lead the change and get the group to work together as a team

3-Developing and Vision and Strategy
Create a vision to help direct the change effort and developing strategies for achieving that vision

4-Communicating the Change Vision
Use every way possible to communicate the new vision and strategies and have the leadership demonstrate the behavior expected of others in the organization,  

5-Empowering Employees for Broad-Based Actions
Eliminate obstacles, change structure or systems that undermine the vision and encourage risk taking, nontraditional ideas, activities and actions.  

6-Generating Short-Term Wins
Plan for visible improvements in performance, create those wins and visibly recognize and reward people who make the wins possible.

7-Consolidating Gains and Producing More Change
Use newly developed successful processes/products to change all systems, structures, and policies to be consistent with new vision.  Develop the capacity of people who CAN implement the vision and re-imagine the process with new projects, themes, and change agents.
8-Anchoring New Approaches in the Culture
Create better performance through focused, leadership, management; articulate the connections between the new behaviors and organizational successes, ensure leadership development and succession.

Read more examples of implementation through published journal articles.  For example, the Journal of the Academy of Nutrition and Dietetics has special feature called "collections".  One of the collections that have been gathered is a group of articles published on the Nutrition Care Process and standardized language.  If you log on to the Journal page, the "collections" tab is the second tab on the navigation bar.  You will find several articles that summarize various methods use to implement the NCP and standardized language.  

Kotter, J.P.  Leading Change, Harvard School Press 1996

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