November 11, 2012
Appendix A: Matrix of Theoretical Models
Theoretical Model| Description of Theoretical Model| Type of health care change situation where model best applies| Satir Change Model| The Satir Change Model is derived from family psychology more than 30 years ago. The model was later adapted for understanding organizations and larger systems (Smith, 2010). Satir Chaos Model focuses not just on systems and technology but also on individual people. This multi-staged model describes how a human system might experience, react to, and then adjust to change over time (Smith, 2010). The components of this Model of change consist of six stages: the first stage: old status quo is the current norm, the second stage: foreign element is something happens that interrupts the familiarity of the status quo, the third stage: chaos is the reaction to a foreign element that throws you into chaos, the fourth stage: transforming ideas gives you a new understanding of what to do, you begin to see a way out of the chaos, the fifth stage: practice and integration: you start to try your new idea or new behavior. The last stage new status quo: the new norm. According to Emery, (2012) “it is the nature of individuals to resist change and cling to familiar ways of doing things”. The Old Status Quo the group is at a familiar place. The performance pattern is consistent. Stable relationships give members a sense of belonging and identity. Members know what to expect, how to react, and how to behavior (Smith, 2012).Foreign Elements in this sage something happens that shatters the familiarity of the old status quo. A significant event that is internal or external seeking change that threatens the stability of familiar powers. Chaos the foreign elements throw you into chaos. In this stage, you are suddenly in unfamiliar waters where your things are unpredictable, and your usual pattern behaviors do not work. Your performance is affected and people around you may not act in unusual ways (Emery, 2012). Transforming ideas eventually the group transforms. You create lots of new ideas when you are in Chaos. Transforming ideas gives the group a new understanding of why’s, what and how’s. They began to see a way out of the chaos (Emery, 2012).Integration and Practice is the period of assimilation, you are transforming ideas into your operation, and a new status quo begins. You learn quickly and make progress. You make lots of mistakes, and every now and then your progress slips back to old status quo. You learn what works and what doesn’t. You have become more skilled and your performance is back up. You sense you are moving towards a new status quo (Emery, 2012). The New Status Quo your performance began to level off as you master your new skill. You start to feel good about your rapid learning. With time, the newness fades, and the “new status quo” become the “old status quo” (Emery, 2012).| Satir’s change model can be applied to any organization large or small. Hospital information is changing rapidly affecting clinicians both in ambulatory and primary care practice settings who are struggling to keep up with the pace of emerging technology. The demand for improvement in hospital safety, quality and performance reporting has made it necessary for this clinical transformation of its care practice process. Switching from paper to electronic medical record is one technological demand driven by Medicare and Medicaid coverage and reimbursement policies Transition from paper to computer documentation is still a challenge in health care (Straube, 2005). The process for documenting patient care was formalized during the years of Florence Nightingale’s practice the old status quo. Older nurses are having difficulty adapting to this change because their generation was driven by paper so they didn’t have to use the computer whereas the younger nurses have been exposed to...