NUR 631 Module 4 Change Analysis Example

Change Analysis: Why Brookfield's 2022 Staffing Pilot Faded and What Kotter's Model Says the Next Effort Needs

[Student Name]

Southern New Hampshire University

NUR 631: Strategic Skills for Nurse Executive Leaders

Module Four Change Analysis

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Change Analysis: Why Brookfield's 2022 Staffing Pilot Faded and What Kotter's Model Says the Next Effort Needs

Most hospitals have a history of staffing initiatives that began with enthusiasm and faded without anyone deciding to end them. Staff remember those efforts, and each one makes the next harder to launch. Before Brookfield Regional Medical Center introduces a new staffing strategy, its leaders should understand why the last one disappeared. This paper applies John Kotter's eight-step change model to Brookfield's 2022 resource nurse and self-scheduling pilot. It argues that the pilot failed not because the ideas were poor but because the change process skipped steps that would have built support and made the changes permanent, and it translates those gaps into rules for the next effort.

The 2022 Pilot

In spring 2022, the director of medical-surgical nursing announced by email that two units would pilot a resource nurse on each day shift, an experienced nurse without a patient assignment who would help with admissions, rapid responses and new graduates, along with self-scheduling through the existing staffing software. The pilot was funded from a one-time pandemic grant. Within five months, the resource nurse was routinely given a patient assignment whenever the unit was short, which was most days, and self-scheduling reverted to manager-built schedules after conflicts over holidays. No evaluation was published, and when the grant ended, the pilot was not mentioned again. Staff on both units now describe it as "that thing they tried."

Applying Kotter's Eight Steps

Kotter's model, first described in 1995 and developed in his book, sets out eight stages that successful change tends to pass through. Leaders first make the need feel pressing, assemble a group with enough credibility to steer, write a picture of the future and spread it widely. They then clear the barriers that stop people acting on it, arrange early visible successes, use those successes to push further and finally build the new way of working into the organization's routines and culture (Kotter, 2012). Mapping the pilot against these steps shows where it broke.

Urgency was never built. Staff were not shown turnover or agency figures, so the pilot looked like one more initiative rather than a response to a problem they shared. The guiding coalition consisted of the director and two managers; no staff nurses, schedulers, physicians or finance representatives were involved. The vision was a sentence in an email about "better support," without measures. Communication was a single message and one staff meeting. Obstacles were not removed: the staffing software could not handle self-scheduling rules, and no policy protected the resource nurse from taking patients, so the first short day ended the role in practice. No short-term wins were identified or celebrated, although a few new graduates later said the resource nurse helped them through their first rapid response. Gains could not be consolidated because the funding was temporary and no one was accountable for results. Nothing was anchored in policy, job descriptions or the budget.

The pilot was not without value, and a fair analysis records what worked. The resource nurse, on the days the role survived, reduced the time new graduates waited for help during rapid responses, according to the unit educator's informal log. Several experienced nurses volunteered for the role and said they enjoyed teaching. Self-scheduling produced fewer last-minute call-offs in its first two months, before holiday conflicts arose. These signals suggest that the ideas matched real needs; what was missing was the structure to protect them. That distinction matters for the next effort, because staff who remember the pilot fondly can become early supporters if they see that this time the role has protection, funding and measures.

What the Research Adds

Kotter's model is widely used, but it deserves scrutiny. A review of the model found that its steps are consistent with much of the change literature but that it has limited direct empirical testing, and it noted criticism that the steps are presented as linear when real change often loops back (Appelbaum et al., 2012). The popular claim that seven in ten organizational changes fail, often repeated alongside Kotter's work, is also weaker than it sounds; a review of its sources found no valid empirical evidence for any single failure rate (Hughes, 2011). The more useful finding for Brookfield comes from research on sustainability. A review of studies of new health programs found that full sustainability was uncommon, that partial continuation was more typical and that factors such as fit with the organization, leadership support, funding and the ability to adapt the program were associated with whether programs lasted (Wiltsey Stirman et al., 2012). The 2022 pilot lacked stable funding, leadership accountability and a way to adapt when units were short, the conditions the review associates with programs that fade.

Design Rules for the Next Change

The analysis yields six rules for Brookfield's new staffing strategy. First, share the numbers: present turnover, agency spending and the link between staffing and patient outcomes to every unit before asking for change. Second, build a coalition that includes staff nurses from each unit, a scheduler, a physician leader and a finance partner, with a named executive sponsor. Third, state the vision in measures, such as first-year turnover and agency spending targets, and report them monthly. Fourth, remove obstacles before launch, including software configuration and a written policy that protects new roles from being absorbed into patient assignments except in defined emergencies. Fifth, plan short-term wins, such as a 90-day report on new graduate experience, and share them. Sixth, fund the change from the operating budget with a planned reinvestment of agency savings, and write the new roles into job descriptions and policy so that they outlast any single leader.

Conclusion

Brookfield's 2022 pilot faded because urgency was not built, the coalition was narrow, obstacles were left in place and nothing was anchored in budget or policy. Kotter's model, used as a diagnostic tool and read alongside research on sustainability, turns those failures into design rules. Following them will not guarantee success, but ignoring them would almost guarantee a repeat.

References

Appelbaum, S. H., Habashy, S., Malo, J.-L., & Shafiq, H. (2012). Back to the future: Revisiting Kotter's 1996 change model. Journal of Management Development, 31(8), 764-782. https://doi.org/10.1108/02621711211253231

Hughes, M. (2011). Do 70 per cent of all organizational change initiatives really fail? Journal of Change Management, 11(4), 451-464. https://doi.org/10.1080/14697017.2011.630506

Kotter, J. P. (2012). Leading change. Harvard Business Review Press.

Wiltsey Stirman, S., Kimberly, J., Cook, N., Calloway, A., Castro, F., & Charns, M. (2012). The sustainability of new programs and innovations: A review of the empirical literature and recommendations for future research. Implementation Science, 7, Article 17. https://doi.org/10.1186/1748-5908-7-17