Using Kotter's Change Framework to Implement and Sustain Multiple Complementary ICU Initiatives

This article describes the planning, implementation, and outcomes of 2 complementary quality initiatives, bedside handoff and nurse-initiated interdisciplinary bedside rounds, in a 24-bed medical/surgical intensive care unit. Systematic approaches such as Kotter's change model and unit-based champions were used to redesign care processes and standardize daily communication and workflows. Active partnership with the patient and the family during these changes promoted a strong intensive care unit culture of patient- and family-centered care.