Study: Change Management in the ICU

Relocating an ICU can involve not only a physical move but changes to work practices. Relocation should be planned with a systematic change management strategy, dedicated leadership, and a communication strategy, according to a study published in Australian Critical Care.  

Frances Fenghzhi Lin, RN, PhD, from the Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia, and colleagues conducted an ethnographic study with staff in an Australian tertiary hospital ICU to explore the challenges and issues associated with relocation to a new hospital and a single room ICU. This was part of a project to implement strategies to support nursing service delivery during the relocation of the ICU.

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Focus groups and interviews were held with nurses, doctors, allied health professionals and support staff. The themes identified were understanding of the relocation plan, preparing for the uncertainties and vulnerabilities of a new work environment and acknowledging the need for change and engaging in the relocation process. From the data gathered, it was apparent that perceptions differed about the amount and frequency of communication about the ICU relocation between the relocation project team and the ICU staff. Staff were also anxious about the change in the work environment associated with the change to single rooms.  

Lin et al. suggest that a systematic change management strategy, dedicated change leadership and expertise and a communication strategy are important factors for managing ICU relocation. They recommend developing work processes and models of care for the new single room setting, which can be developed in simulated settings. This is a good way of preparing staff for the change, they suggest.

A relocation management strategy should be underpinned by a change management theory or model, write Lin et al. Examples include Kotter’s eight steps to change, Bridges’ transition model and Lewin’s change management model, all of which focus on engaging early on the people affected by the change. Change management models are many, but should be chosen suitable to the unique needs of the situation.