The handwriting on the wall: program transformations utilizing effective change management strategies

Historically, there have been indications that we need to change the way we work and think about our health care processes. Yet, with the urgency to keep abreast of the changing needs of our patients, have we seen these signs? Moreover, how do we respond to the inevitable change processes that must occur? In 2010, St. Michael's entered into a five-year partnership with Baxter Canada. The overall goal is to improve the quality of care and life for people living with chronic kidney disease. This initiative was undertaken in response to concerns identified internally related to existing health care delivery processes within the renal program. As in any work environment, the depth and breadth of inevitable changes evoke a variety of responses that are based on the individual's attitudes regarding change. As we embarked on this journey, the nursing leadership team and staff within the program were encouraged to review their usual responses toward change utilizing the book, Who Moved My Cheese? (Johnson, 1998). It is imperative to identify the attitudes of those people involved in change processes. This awareness facilitates the use of specific strategies to enhance the effectiveness of their engagement in the process and the outcome of the initiative. Reading the writing on the wall prepares people to participate in and embrace changes that promise to benefit those for whom we provide professional care.