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DNP 805 A Informatics Theory in Technology

DNP 805 A Informatics Theory in Technology

DNP 805 A Informatics Theory in Technology

DNP 805 A Informatics Theory in Technology

Select one informatics theory from the areas of Communication Theories, Change Theories, or Human Factors. Discuss how the application of the theory you select can guide the use of technology in advanced practice. What strengths does the theory possess that would make it useful to the DNP-prepared nurse? What weaknesses does the theory present that might prevent its use? Keep in mind the Christian worldview when preparing your submission.

Theory is an important component of robust nursing informatics knowledge, a fact that is sometimes overlooked in both education and practice. The novice to expert model was featured in my editorial in our last issue, Volume 5, Number 4. A theory focus continues in this issue with a look at the oldest, simplest, yet robust and applicable change management theory, Kurt Lewin’s Change Theory.

Kurt Lewin’s Change Management Theory, is a time-tested, easily applied field theory that is often considered the epitome of change models, suitable for personal, group and organizational change. Kurt Lewin, (1890 – 1947) a Gestalt social psychologist, has been acknowledged as the “father of social change theories” since several contemporary models are at least loosely based on Lewin’s work. He is also lauded as the originator of social psychology, action research, as well as organizational development.

Lewin’s change theory is a ‘planned change’ guide that consists of three distinct and vital stages:

Unfreezing Stage
Moving to a New Level or Change Stage
Stages of Lewin’s Change Theory

The first stage involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way. This is the stage where the desire to change occurs, or at least the recognition that change is needed. An example is moving from a paper based documentation system to an electronic system, in an organization where paper trails have become unmanageable and archaic.

Unfreezing the present Forces that maintain current behavior are reduced through analysis of the current situation. Imperatives for change are realized through dialogue and re-educational activities such as team building, personal development, and brain-storming. The more transparent and inclusive the process is, the more readily people move through the unfreezing stage.

Moving to a new level or Change
The second stage involves a process of change–in thoughts, feelings, behavior, or all three, that is in some way more liberating or more productive than doing things the old way. During this stage, the people involved (change target group) are convinced that the new way is better than the old.

Having analyzed the present situation, new structures and processes are put in place to achieve the desired improvements. This is the most time-consuming, costly, yet productive stage as far as tangible results go.

The third and final stage consists of establishing the change as a new habit or process, so that it now becomes the “standard operating procedure” or status quo. Without some process of refreezing, it is easy to backslide into the old ways of doing things. Rewards, support, and champion leadership continue to be important through this stage, which is essentially ongoing until the next major change is needed.

The changes implemented are ‘frozen’ in place to ensure that they become part of normal working procedures. This is done by establishing supportive mechanisms such as policies, rewards, ongoing support, and a solid orientation to the new system for incoming personnel.

Force Field Analysis
Lewin extended his theory by including “force field analysis” which offers direction for diagnosing situations and managing change within organizations and communities. Lewin assumed that in any situation there are both driving and restraining forces that influence any change that may occur. According to Lewin’s theory, human behavior is caused by forces – beliefs, expectations, cultural norms, and the like – within the “life space” of an individual or society. These forces can be positive, urging us toward a behavior, or negative, propelling us away from a beneficial behavior as illustrated in Figure 1.

Figure 1: Lewin’s Force Field Analysis

Figure 1: Lewin’s Force Field Analysis

Driving Forces
Driving forces are forces that influence a situation, pushing in a particular direction: they tend to initiate a change and keep it going. In terms of improving productivity in a work group, pressure from a supervisor, incentives, frustration with the current way of doing things (such as paper documentation) and competitive or social demands are examples of potential driving forces.

Restraining Forces
Restraining forces are forces that act to restrain or decrease the driving forces – they make it difficult to move a change forward. Apathy, prohibitive cost, hostility, technology illiteracy and poor maintenance of equipment are examples of restraining forces which can inhibit change and may restrict productivity.

Equilibrium is the status quo or the present level of productivity, and can be disrupted or fortified by changes in the relationship between the driving and the restraining forces. Equilibrium is reached when the sum of the driving forces equals the sum of the restraining forces.

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DNP 805 A Informatics Theory in Technology

DNP 805 A Informatics Theory in Technology

So before a change occurs, the force field is in equilibrium between forces favourable to change and those resisting it. Lewin spoke about the existence of a quasi-stationary social equilibrium, which needed to be shifted during the change process, but then reestablished at a new level once the change had been refrozen.

For change to happen the status quo, or equilibrium must be upset – either by adding conditions favorable to the change or by reducing resisting forces.

Kurt Lewin proposed that whenever driving forces are stronger than restraining forces, the status quo or equilibrium will change. Successful change is achieved by either strengthening the driving forces or weakening the restraining forces.

The force field analysis integrates with Lewin’s three stage theory of change as one works towards unfreezing the existing equilibrium, moving towards the desired change, and then freezing the change at the new level so that a new equilibrium exists that resists further change.

The goal of the change agent(s) is to support the driving forces to move beyond equilibrium and outweigh the impact of any restraining forces. This provides support in moving through the unfreezing – changing – refreezing stages of change.

Figure 2 illustrates a model adapted from Keller (2005) that applies Lewin’s change theory stages to the process of implementing information systems and technologies. Although Lewin’s change management theory was developed decades ago, it continues to offer a reliable and viable model for informatics-related changes.

Figure 2: Lewin’s Change Theory and Technology Integration
Figure 2: Lewin’s Change Theory and Technology Integration

Keller, C. (2005). “Virtual learning environments: three implementation perspectives.” Learning, Media and Technology 30(3): 299-311.

Lewin, K. (1935) A dynamic theory of personality. New York: McGraw-Hill.

Lewin, K. (1936) Principles of topological psychology. New York: McGraw-Hill

Lewin, K. (1948) Resolving social conflicts; selected papers on group dynamics. Gertrude W. Lewin (ed.). New York: Harper & Row, 1948.

Lewin, K. (1951) Field theory in social science; selected theoretical papers. D. Cartwright (ed.). New York: Harper & Row.

Lewin, K. and Lippitt, R. (1938) ‘An experimental approach to the study of autocracy and democracy. A preliminary note’, Sociometry 1: 292-300.

Lewin, K., Lippitt, R. and White, R. (1939) ‘Patterns of aggressive behaviour in experimentally created “social climates”’, Journal of Social Psychology 10: 271-99.

Lewin, K. and Grabbe, P. (1945) ‘Conduct, knowledge and acceptance of new values’ Journal of Social Issues 2.

Kaminski, J. (Winter, 2011). Theory applied to informatics – Lewin’s Change Theory. CJNI: Canadian Journal of Nursing Informatics, 6 (1), Editorial.