Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Suggested strategies for leading and sustaining change

Individual strategies
 -Seek input from frontline workers and engage them in the process
 -Recognize contributions to small steps of the change (Patrick et al., 2011)
 -Create shared values to anchor the change (Patrick et al., 2011)
 -Understand and acknowledge that the uptake of change varies from individual to individual
 -Work with colleagues in human resources, finance and quality improvement to get data to track outcomes of change
 -Conduct a stakeholder analysis to determine who can promote or inhibit change (Block, 1987; Shea, 2001)
 -Gather perspectives from stakeholders about how the change can be meaningful to them (Tourangeau et al., 2002)
 -Be patient and open to opportunities to advance change (Cummings & McLennan, 2005)
 -Develop a support network to sustain personal energy through the change process (McDowell, 2004)

Team and unit strategies
 -Engage nurses in building a vision
 -Share both the vision and the tactics of the change at open forums and through technology (McDowell, 2004)
 -Offer skills training for new tasks and focus on strengths to build team confidence about managing the change (Gil et al., 2005)
 -Discuss similar initiatives that were unsuccessful to identify what should be done differently (McDowell, 2004)

Organization strategies
 -Communicate at regular intervals using multiple methods and strategies (Ingersoll et al., 2001; Lowe, 2004; Rousseau & Tijorwala, 1999)
 -Link change to the organization’s strategic goals (Lowe, 2004)
 -Use communication strategies such as newsletters, meetings, open forums and one-on-one meetings between staff and leaders throughout the change process (Walston & Kimberly, 1997)
 -Consult early and often with staff and labour groups
 -Offer change-management workshops, including delegation and managerial skills (Walston & Kimberly,1997) and team-building skills (Gelinas & Manthey,1997; Ingersoll et al., 2001)
 -Use implementation manuals (McDowell, 2004) to increase consistency (Heller, 2003)
 -Use evaluation data from employee surveys and focus groups to track both processes and outcomes and inform decisions (Lowe, 2004)

Helping others cope with the effects of change
 -Listen to their concerns and be empathetic, not judgmental
 -Attend to the individual’s personal and work-related concerns
 -Focus on the event and the associated emotions
 -Help individuals to own their feelings rather than depersonalizing them by intellectualizing
 -Provide encouragement and thanks by sending a card or a small token such as flowers (Cummings & McLennan, 2005)

For a full list of references, please refer to the guideline at