Mission Possible: Using Kotter's Change Model to Drive Sustainable Change, a Case Study

The presentation demonstrated the benefits of utilizing John Kotter’s Change Theory when implementing a multi-modal hand hygiene initiative in a community hospital. The benefits included a decrease in hospital associated infections. The problem was deficiencies of hand hygiene compliance. According to the Joint Commission, hand hygiene compliance should be at 90%. If a hospital is not at 90% compliance, then an action plan is required and an increase in compliance must be demonstrated.  In this oral presentation, the hand hygiene process is addressed via John Kotter’s eight steps of Model of Change. The eight steps are summarized in three components comprising of preparation, implementation, and management. First a sense of urgency is established. The urgency is lack of compliance with the Joint Commission’s standards. Next an interdisciplinary hand hygiene taskforce was developed including key stakeholder, nurse leaders, and staff nurses. The taskforce met weekly for six months.  The vision was created based on the Joint Commission standard. Evaluation of baseline was created using a SWOT analysis and staff surveys to determine barriers. The vision was communicated with staff members via meetings, emails, and newsletters. Obstacles were removed, such as adding additional alcohol based hand rub at the point of patient care.  Short wins were celebrated to reinforce positive behavior. The short wins were celebrated with pizza parties at the unit level for reaching the compliance goal. Finally, the project was weaved into the culture of the organization and sustainable change was demonstrated. The new process was included in new employee orientation. Sustainability was maintained through monthly audits, peer reviews, and secret shoppers. The data was disseminated through all levels of the organization. The final result was accomplishing the Joint Commission’s standard of 90% compliance with hand hygiene and a decrease in hospital associated infections. The result was the creation of culture of attention to patient and health-care works safety within the institution.