Luiking, M. L., van Linge, R., Bras, L., Grypdonck, M., & Aarts, L. (2015). Intensive insulin therapy implementation by means of planned versus emergent change approach. Nursing in critical care.
Prospective comparative study introducing a new insulin protocol in an ICU in the Netherlands. Measurement of compliance within two teams of nurses.
Looks at Emergent Change (EC) implementation versus Planned Changed (PC) implementation.
- EC-implementation involves a new working method protocol with the nursing team driving improvements and change.
- PC-implementation involves a new working method driven by management in a centrally directed “top-down” manner.
EC-implementation change process had improved nurse compliance and shorter time to achieve treatment objective.
- Translation of evidence base into practice and that nurses frequently need to change working practices.
- Organisational culture of change.
- Transformative change.
- Engagement of the team is required for effective change implementation.
- The team find ways to achieve goals and standards.
For those interested in the glucose control and insulin discussion, I would advise reviewing NICE-SUGAR and VISEP trials for current evidence based approach. This article was used for its fantastic change management merits.
Facilitating Emergent Change in a Healthcare Setting: Dr. Peter Dickens