Planning new venture

VENTURE PLANNING

Venture:• Venture is often use for referring to a risky start up or Enterprise

Company. • New venture is a business plan that gives an opportunity or chance

to set up a company / business on the basis of innovative business ideas. It is a sort competition that offers an excellent chance to turn innovative idea to start up business into a solid business plan.

Planning:• Planning means to decide in advance what is to be done.• Venture Planning is a personal assessment of your feelings and the

feasibility of a venture. Venture Planning answers the question, should I be doing this and why? The Venture Feasibility process examines seven key factors in any venture.

Cont….VENTURE PLANNING • It is not about writing a Business Plan. Sometimes a business plan is not needed.

Venture Planning does not require detailed funding, source analysis, professional opinions, entity formation or detailed market analysis. Venture Planning is development of a means of comparing various business models, usually through financial modeling to answer the following questions:

Which venture concept produces the most sales, the best margins, the highest net profit and the lowest breakeven?

Which model requires the least investment by entrepreneurs and others? Which concept requires equity as opposed to debt financing? Which produces the highest "Return on Investment" and the best liquidity? Which model requires the entrepreneur to give up the least equity? Identify and quantify the risks involved with execution of each model.

Venture Formation involves all of the following stages:

Idea - Concept Development - Venture Development - Monitoring Progress - Initiating New Changes - Venture Feasibility Analysis - Business or Operational Plan - Budget vs. Actual - New Plans.

There are four keys to good venture planning: Focus on one venture at a time in one business area at a time. Discover the opportunity first, and then evaluate how to exploit it. Develop three cases good, bad & likely for each scenario of a

venture concept. Identify what type of venture you want. Each type has an entirely

different model, implementation and end result. Each demands a different entrepreneurial approach and each requires different management and style.

Cont….There Are 11 Keys to a Good First Venture 1) Founder's alignment with the mission. 2) Guaranteed or qualified customers. 3) Lifestyle of High Profit smaller business. 4) Routine concept. 5) Available product. 6) Advantageous Cash Flow. 7) Supportive local environment. 8) Neutral State and Federal Environment.9) Equity Control. 10) Relevant Experience. 11) Low Overhead.

Cont….

• Emerging venture areas in nursing that needs planning. There often occurs a crisis situation in the healthcare set- up when nurses try to defend existing models of practice instead of embracing change. In order to gain successful planning of good ventures, we should examine the existing realities (traditional), and analyze and adapt to the changing context of nursing practice.

Cont….

Some of the traditional realities are; Institution based care Process oriented Procedure driven Based on mechanical and manual intervention Provider driven Treatment based Reflective of late stage intervention Based on vertical clinical relationships

Cont….According to Porter-O’ Grady (2003), the emerging realities for

nursing practice for this century will be; o Mobility based on multiple settings o Outcome driven o Best- practice oriented o Emphasized by technology and minimally invasive intervention o User driven o Health based o Geared for early intervention o Based on horizontal clinical relationships

Functions of good nurse manager

A nurse manager’s functions include the following; The nurse administrator needs to know the plans and programs of

the health facility administrator and of other departments in which personnel contribute to the joint effort of providing health care services.

Should be a participatory, voting member of all committees of the institution including those dealing with budgeting, planning, credentialing, auditing, utilization, infection control, patient care improvement, library or any other committees concerned with nursing services, nursing activities and nursing personnel.

Should develop a marketing operational plan based on the overall view of the agency problems and activities.

Cont….

Marketing plan should include gathering and analysis of data related to product or service

Operational plan consist of pinpointing possible strengths, weaknesses, problems and opportunities.

Before launching a venture, a control plan is made to measure performance of implementation of venture within a time frame.

Selected and trained personnel will be assigned to compare expected results with actual results for making corrections in all elements of plan and its implementation in future.

Practical planning actions

Practical day-to-day planning actions to the nurse administrator include the following

1. At the beginning of each day make a list of actions to be accomplished for the day

2. Plan ahead for meetings 3. Identify developing problems 4. Review the operational and management plan 5. Review the appropriate portions of the division operational and

management plan 6. Plan for discussion of ideas 7. Suggest similar practical planning actions to other nurse managers

PLANNING FOR CHANGE

• Change occurs over time, often fluctuating between intervals of change then a time of settling and stability. Change management entails thoughtful planning and sensitive implementation, and above all, consultation with, and involvement of, the people affected by the changes. If you force change on people normally problems arise. Change must be realistic, achievable and measurable. These aspects are especially relevant to managing personal change.

Definition

• Change: To change simply means to alter, to become different, or to transform.• Change refers to an alteration in a system whether physical, biological, or

social. These alterations come from as a result of internal forces or external forces impinging on an individual or organization.

• Planning: “Planning refers to thinking ahead of time and formulation of preliminary thoughts”. Planned change: “Planned change entails planning and application of strategic actions designed to promote movement towards a desired goal”.

• “Planned change is a change that results from a well thought out and deliberates effort to make something happen. It is the deliberate application of knowledge and skills by a leader to bring about a change”. Tappen, 1995

• Change agent: “A change agent is one who generates ideas, introduces the innovation, and works to bring about the desired change”.

Cont…• Change agent:A change agent is someone who

deliberately tries to bring about a change or innovation, often associated with facilitating change in an organization or institution. To some degree, change always involves the exercise of power, politics, and interpersonal influence. It is critical to understand the existing power structure when change is being contemplated.

• A change agent must understand the social, organizational, and political identities and interests of those involved; must focus on what really matters; assess the agenda of all involved parties; and plan for action.

Cont…

The change agent should have the following qualities; The ability to combine ideas The ability to energize others Skills in human relations Integrative thinking Flexibility modify ideas Persistent, confident and has realistic thinking Trustworthy Ability to articulate a vision, and Ability to handle resistance

Assumptions regarding change

Change represents loss. Even if the change is positive, there is a loss of stability. The leader of change must be sensitive to the loss experienced by others.

The more consistent the change goal is with the individual’s personal values and beliefs, the more likely the change is to be accepted. Likewise the more difficult the goal is from the individual’s personal values; the more likely it is to be rejected.

Those who actively participate in change process feel accountable for the outcome.

Timing is important in change. With each successive change in a series of changes, individual’s psychological adjustment to the change occurs more slowly. And for this reason the leader of change must avoid initiating too many changes at once.

Cont…

The key principles driving the elements of the Change Management are:

1. Targeted Commitment Levels 2. Executive Ownership 3. Visible, sustained sponsorship 4. Deployment/Implementation Support and

Monitoring 5. Employee Support 6. Post Deployment Preparation

STAGES OF PLANNED CHANGE

• Lewin (1951) identified 3 phases through which the change agent must proceed before a planned change becomes part of the system. These changes are;

• Unfreezing: - in this phase, the change agent unfreezes the forces that maintain a status quo. It is the responsibility of the change agent- after thorough and accurate assessment- to convince the people for the need to change. It is also possible that the people themselves are discontented and aware of a need to change.

• Moving: - in this phase agent identifies plans and implements appropriate change strategies that the driving forces (that facilitates change and keep it going, e.g. new technology, management support, knowledge, competencies) exceed restraining forces (that impede the change process). Whenever possible the change should be implemented gradually.

• Refreezing: - in this phase, the change agent assists in stabilizing the system change so that it becomes integrated and remains so.

PLANNED CHANGE

• Identify the problem or opportunity: - opportunities demand change as the problems, but most managers overlook these opportunities. Change is often planned to close performance gap, a discrepancy between the desired and the actual state of affairs.

• Collect data: - once the problem or opportunity is clearly defined, the change agent collects data needed. This step is important to the later success in the planned change.

• Analyze data: - collecting good data is important, but it is as important to analyze the data in to useful information to make important decisions. Plan the change strategy: - anxiety about the change should be minimized.

• There is a need to plan the resources required and establish feedback mechanism to evaluate the progress in the change by setting goals with specific time frames and identifying indicators for evaluation.

Cont…• Implement change: - the plans are put in to motion.

Interventions are designed to gain necessary compliance. The change agent create supportive climate, acts as energizer, obtain and provide feedback and overcome resistance.

• Evaluate effectiveness: - the established operational indicators are monitored and the extent of success and failure is determined and explained.

• Stabilize the change: - to assure permanency of change, though continuous feedback, reinforcement, and providing the necessary policies, procedures, standards, etc.

STRATEGIES FOR PLANNED CHANGE:In

general, three categories of change models exist: empirical-rationale, power- coercive and normative-educative model. (Bennis, Benne and Chin [1969], The planning of change)

• 1. Rationale- empirical: This strategy emphasizes reason and knowledge. People are considered rational beings and will adopta change if it is justified and in their self- interest. Here the change agent’s role is communicating the merit of the change to the group. If the change is understood by the group to be justified and in the best interest of the organization, it is likely to be accepted. This strategy is useful when little resistance to change is expected. It is assumed that once if the knowledge and rationales are given, people will internalize the need for change and value the result.

Cont…2. Normative- re-educative: This is based on the assumption that group

norms are used to socialize individuals. The success of this approach often requires a change in attitude, values, and/ or relationships. This strategy is most used when the change is based on culture and relationships within the organization. The power of the change agent, both positional and informal, becomes integral to the change process.

3. Power- coercive: This approach is based on power, authority, and control. Desired change is brought about by political or economic power. It requires that the change agent have the positional power to mandate the change. The outcome of change is often based either on follower’s desire to please the leader or fear of the consequences for not complying with the change. This strategy is effective for legislated changes, but other changes using this strategy are often short- lived.

BARRIERS TO CHANGE AND STRATEGIES TO OVERCOME

• It is important to identify all potential barriers to change, to examine them contextually with those affected by proposed change, and to develop strategies collectively to reduce or remove the barriers.

• Change requires movement, which as physics indicates, is a kinetic activity that requires energy to overcome resistance.

Barrier Discussion Strategy Desire to remain in our comfort zone

Those who become increasingly attached to a familiar way of doing things (comfort zone) often view change as an unwelcome disruption.

Rational- empirical strategy.

Inadequate access to information

Lack of information, inability to read and understand the available resources

Rational- empirical strategies

Lack of shared vision Lack of widespread involvement, input, and ownership of change will cripple a change effort.

Normative- re- educative strategy

Lack of adequate planning

Involving individuals in planning gives a sense of control and decreases their resistance to change.

Rational- empirical and normative- re- educative strategies

Lack of trust Trust in the change agent and ability of self to bring about change is necessary.

Rational- empirical and normative- re- educative strategies

Resistance to change Co-operation and involvement of the whole team will only bring effective and lasting changes.

Introducing change at a time when people are ready to change guarantees success

Resistance to change Co-operation and involvement of the whole team will only bring effective and lasting changes.

Introducing change at a time when people are ready to change guarantees success

Poor timing or inadequate time planned

Poor timing and lack of planning can fail to bring desired change.

Normative- re- educative strategy

Fear that power, relationships, or control will be lost

Every change represents potential for loss to someone

Normative- re- educative strategy

Amount of personal energy needed for change may be great

Sometimes change is desired, but people are not willing to do what is necessary to effect the change.

Slow the change process and give time to catch- up and energize

Types of changes

Hohn (1998) identified four different types of change: Change by exception, Incremental Change, Pendulum Change and Paradigm Change.

Change by Exception: This occurs when someone makes an exception to an existing belief system. For instance, if a client believes that all nurses are bossy, but then experiences nursing care from a much modulated nurse, they may change their belief about that particular nurse, but not all nurses in general.

Incremental Change: A change that happens so gradually, that an individual is not aware of it.

Pendulum Changes: Are changes that result in extreme exchanges of points of view.

Paradigm Change: Involves a fundamental rethinking of premises and assumptions, and involve a changing of beliefs, values and assumptions about how the world works.

Change Theories in Nursing• Change theories are used in nursing to bring about planned

change. Planned change involves, recognizing a problem and creating a plan to address it. There are various change theories that can be applied to change projects in nursing. Choosing the right change theory is important as all change theories do not fit every change project. Some change theories used in nursing are Lewin’s, Lippitt’s, and Havelock’s theories of change. The characteristics of change theories are;

Problem identification Plan for innovation Strategies to reduce innovation Evaluation plan

KURT LEWIN’S CHANGE THEORY:

• The theoretical foundations of change theory are robust: several theories now exist, many coming from the disciplines of sociology, psychology, education, and organizational management. Kurt Lewin (1890 – 1947) has been acknowledged as the “father of social change theories” and presents a simple yet powerful model to begin the study of change theory and processes.

• He is also lauded as the originator of social psychology, action research, as well as organizational development.

• "Unfreezing" involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way. In this stage, the need for change is recognized, the process of creating awareness for change is begun and acceptance of the proposed change is developed

Cont…

• "Moving to a new level" involves a process of change--in thoughts, feelings, behavior, or all three, that is in some way more liberating or more productive. The need for change is accepted and implemented in this stage.

• "Refreezing" is establishing the change as a new habit, so that it now becomes the "standard operating procedure." Without some process of refreezing, it is easy to backslide into the old ways.The new change is made permanent here.

Cont…Lewin also created a model called “force field analysis” which offers direction for

diagnosing situations and managing change within organizations and communities.

• According to Lewin’s theories, human behavior is caused by forces – beliefs, expectations, cultural norms, and the like – within the "life space" of an individual or society. These forces can be positive, urging us toward a behavior, or negative, propelling us away from a behavior.

• “Driving Forces”- Driving forces are those forces affecting a situation that are pushing in a particular direction; they tend to initiate a change and keep it going. In terms of improving productivity in a work group, pressure from a supervisor, incentive earnings, and competition may be examples of driving forces.

• “Restraining Forces”- Restraining forces are forces acting to restrain or decrease the driving forces. Apathy, hostility, and poor maintenance of equipment may be examples of restraining forces against increased production.

• “Equilibrium” - This equilibrium, or present level of productivity, can be raised or lowered by changes in the relationship between the driving and the restraining forces. Equilibrium is reached when the sum of the driving forces equals the sum of the restraining forces.

Cont…• LIPPITT’S PHASES OF CHANGE THEORY: Lippitt’s theory is based on

bringing in an external change agent to put a plan in place to effect change. There are seven stages in this theory.

• The first three stages correspond to Lewin's unfreezing stage, the next two to his moving stage and the final two to his freezing change. In this theory, there is a lot of focus on the change agent. The third stage assesses the change agent‟s stamina, commitment to change and power to make change happen. The fifth stage describes what the change agent‟s role will be so that it is understood by all the parties involved and everyone will know what to expect from him. At the last stage, the change agent separates himself from the change project. By this time, the change has become permanent.

Cont…The seven phases shift the change process to include the role of a change

agent through the evolution of the change. • Phase 1:Diagnose the problem • Phase 2:Assess the motivation and capacity for change • Phase 3:Assess the resources and motivation of the change

agent(commitment the change, power, and stamina) • Phase 4:Define progressive stages of change • Phase 5: Ensure the role and responsibility of the change agent is clear

and understood (communicator, facilitator, and subject matter expert. • Phase 6:Maintain the change through communication, feedback, and

group coordination • Phase 7:Gradually remove the change agent from the relationship, as the

change becomes part of an organizational culture.

Cont…HAVELOCK'S CHANGE MODEL:• Havelock's change theory has six stages and is a modification

of the Lewin's theory of change. The six stages are building a relationship, diagnosing the problem, gathering resources, choosing the solution, gaining acceptance and self-renewal.

• In this theory, there is a lot of information gathering in the initial stages of change during which staff nurses may realize the need for change and be willing to accept any changes that are implemented. The first three stages are described by Lewin's unfreezing stage the next two by his moving stage and the last by the freezing stage.

Cont…John P Kotter's 'eight steps to successful change' John Kotter's highly

regarded books 'Leading Change' (1995) and the follow-up 'The Heart Of Change' (2002) describes a helpful model for understanding and managing change. Each stage acknowledges a key principle identified by Kotter relating to people's response and approach to change, in which people see, feel and then change.Kotter's eight step change model can be summarized as:

Increase urgency - inspire people to move, make objectives real and relevant.

Build the guiding team - get the right people in place with the right emotional commitment, and the right mix of skills and levels.

Get the vision right - get the team to establish a simple vision and strategy focus on emotional and creative aspects necessary to drive service and efficiency.

Cont… Communicate for buy-in - Involve as many people as possible, communicate

the essentials, simply, and to appeal and respond to people's needs. De-clutter communications - make technology work for you rather than against.

Empower action - Remove obstacles, enable constructive feedback and lots of support from leaders - reward and recognize progress and achievements.

Create short-term wins - Set aims that are easy to achieve - in bite-size chunks. Manageable numbers of initiatives. Finish current stages before starting new ones.

Don't let up - Foster and encourage determination and persistence - ongoing change - encourage ongoing progress reporting - highlight achieved and future milestones.

Make change stick - Reinforce the value of successful change via recruitment, promotion, and new change leaders. Weave change into culture.

Theories

Planned change using linear approaches • Theories for planned change • Six phases of planned change • Havelock (1973) is credited with this planned change model • Key idea: Change can be planned, implemented and evaluated in six sequential

stages. The model is advocated for development of effective change agents and use as a rational problem solving process. The six stages are:-

• 1. Building a relationship • 2. Diagnosing the problem • 3. Acquiring relevant resources • 4. Choosing the solution • 5. Gaining acceptance • 6. Stabilizing the innovation and generating self renewal• Application to practice: Useful for low level, low complexity change.

Cont…• Seven phases of planned change • Lippitt, Watson and westly (1958) are credited with this planned change model • Key idea: change can be planned, implemented and evaluated in seven

sequential phases. Ongoing sensitivity to forces in the change process is essential. The seven phases are:

• 1. The client system become aware of the need for the change • 2. The relationship is developed between the client system and change • 3. The change problem is defined • 4. The change goal are set and options for achievements are explored • 5. The plan for the change is implemented • 6. The change is accepted and stabilized • 7. The change entities redefine their relationship • Application to practice: Useful for low level, low complexity change.

Cont…• Innovation – decision process • Rogers (1995) is credited with formulating this process. • Key idea: Change for an individual occurs over five phases when choosing

to accept or reject an innovation/idea. Decision is to not accept the new idea may occur at any five stages. The change agent can promote acceptance by giving information about benefits and disadvantages and encouragement. The five stages are:

• 1. Knowledge • 2. Persuasion • 3. Decision • 4. Implementation and • 5. Confirmation • Application to practice: Useful for individual change.

Nonlinear change

Chaos theory• Organization can no longer rely on rules, policies, and hierarchies to get work accomplished in

flexible ways. According to the chaos theory perspectives because of rapidly changing nature of human and world factors health organizations cannot control long term outcomes. The assertion of chaos theory are that ‗organization are potentially chaotic‘(thietat and Forgues, 1995). In other words, ‗order emerges through fluctuations and chaos‘. Organization will experience periods of stability interrupted with periods of intense transformation.

Response to change / Human side of change • The human side of the managing change refers to staff responses to change that either

facilitate or interfere with change process. Responses to all or part of the change process by individuals and group may vary from full acceptance and willing participation to open rejection. Responses may be categorized behaviorally or emotionally. Some nurses may manifest their dissatisfaction visibly; others may quietly accommodate the change. Some individuals consistently reject any new thinking or way of doing things. The initial response to change may be, but not always, reluctance and resistance. Resistance and reluctance are common when the change threaten the personal security. Eg: -Changes in the structure of an agency can result in changes of position for personnel.

Cont…The change agent‘s recognition of the ideal and common patterns of the

individuals behavior responses to change can facilitate an effective change process (Rogers 1983).

The responses and brief descriptions are as follows: Innovators thrive on change, which may be disruptive to the unit stability. Early adopters are respected by their peers and thus are sought out for advice

and information about innovations/changes. Early majority prefer doing what has been done in the past but eventually will

accept the new ideas. Late majority are openly negative and agree to change only after most others

have accepted the change. Laggards prefer keeping tradition and openly express their resistance to new

ideas. Rejecters oppose change actively.

Cont…

General characteristics of effective change agents • Is a respected member of the organization

(insider) or community (outsider). • Possesses excellent communication skills. • Understands change process.• Knows how group functions. • Is trusted by others. • Participates actively in change processes. • Processes expert and legitimate power.

Principles characterizing effective change implementation

The recipients of change feel they own the change. Administrators and other key personnel support the proposed change. The recipients of change anticipate benefit from the change. The recipient of change participates in identifying the problem warranting a

change. The change holds interest for the change recipients and other participants. Agreements exist within the work group about the benefit of the change. The change agents and recipients of change perceive a compatibility of

values. Trust and empathy exist among the participants of the change process . Revision of the change goal and process is negotiable. The change process is designed to provide regular feedback to its

participants.

Challenges met by the change leaders

Mc Daniels (1996) advocates that change leaders in healthcare organizations meet the challenges of managing by applying 12 recomendations:

1. Dispense with controlling and planning. 2. Operate on the margin between order and disorder. 3. Develop new organizations with the help of everyone. 4. Allow individual autonomy. 5. Encourage information sharing among staffs. 6. Promote staffs knowledge of others work. 7. Stimulate open learning through discussion generating ‗creative tension‘. 8. Considering the organization structure as dynamic. 9. Help staffs discover their goals. 10. Encourage cooperation not competition. 11. Approach work from smarter view, not harder. 12. Uncover values continuously to form organization wide visions.

General considerations for planning change

Secure and maintain commitment to change Define and communicate desired end state Identify critical success factors Establish targets and prioritize activities Develop a theme Understand why the change is desired/ required General considerations for planning change Secure and maintain commitment to change Define and communicate desired end state Identify critical success factors Establish targets and prioritize activities Develop a theme Understand why the change is desired/ required

Nurse Leader (manager) as role model for Planned Change

Implement a comprehensive and coordinated change management program: Discover, develop, detect.

Identify “change agents” and engage people at all levels in the organization.

Ensure the message comes from the top, and executives and line managers are “walking the talk.”

Make change visible with new tools and/or environment. Ensure clear, concise, and compelling communication. Integrate change goals with day-to-day activities, e.g.,

recruiting, performance management, and budgeting.

Cont… Address short-term performance while setting high expectations about

long-term performance. Help management avoid attempts to short circuit the change

management process. Foster change in people’s attitudes first, then focus on change in

processes, then change in the formal structure. Manage both supporters and champions, as well opponents and possible

detractors. Accept that all people go through the same steps – some faster, some

slower – and it is not possible to skip steps. Build a safe environment that enables people to express feelings,

acknowledge fears, and use support systems. Acknowledge and celebrate successes regularly and publicly

Mistakes by a leader manager

Fail to provide visible support and reinforce the change with other managers. Do not take the time to understand how current business processes would

be affected by change. Delayed decision-making, which leads to low morale and slow project

progress. Are not directly or actively involved with change project. Fail to anticipate the impact on employees. Underestimate the time and resources needed Abdicate ownership of the project to another manager. Fail to communicate both the business reasons for the change and the

expected outcome to employees and other managers Change the project direction mid-stream Do not set clear boundaries and objectives for the project

INNOVATIONS IN NURSING

• Introduction Change is a natural social process of individuals, groups, organizations and society. The source of change originates inside and outside health care organizations. Change today is constant, inevitable, pervasive and unpredictable, and varies in rate and intensity, which unavoidably influences individuals, technology and systems at all levels of the organization.

Creativity and innovationCreativity is defined as artistic or intellectual inventiveness.• Innovation is defines as introduction of something new. These definitions

suggest that the terms are interchangeable. A person could say that creativity is the mental work or action involved in bringing something new into existence, while innovation is the result of that effort.

• A constant flow of new ideas is needed to procure new products, services, processes, procedures and strategies for dealing with the change occurring in every sphere of endeavour: technology social system, government and everyday living. Innovation is the key to survival and growth of health care and nursing.

• Change, innovation and creativity are comparison terms but can also be differentiated. Changes occur when the system is disrupts; innovation uses changes to create new and different approaches to resolve an issue and develop new products or procedures. (Huber 1996).

• Systemic innovations according to (Drucker 1992) require willingness to look on changes as an opportunity. Innovations do not create change. Successful innovations are accomplished by exploiting the change not forcing it.

Process of Innovation

The process of the innovation may include several steps. They are: Assessment- It is the first step of process and it requires a look at both the strength and

problems. An administrator must focus on what is specific content requirement the expected outcome. Specific content requirement changes often in the health care, as new technologies and research bring new knowledge needs.

Defining objectives- It is the second step. The administrator should search for research or technique that could address the identical needs. Asking the peers for the suggestion is also helpful. This is the place where the creativity begins. It is important to look at many different ways to address the learning objectives before selecting one.

Planning- Once a strategy has been selected the third step, planning is important. Understand who the stakeholders are and what their investment is in the status quo or in change can be helpful in planning the strategies to bring them on board. Many stake holders do not like the changes and will resist the new approaches. Using the change theory it can assist in demonstrating the needs and provide information that can make resistors more amenable to change. It‘s important to take time to develop a support for the strategy. In more complex strategies it may be important to bring other administrators.

Cont…. Gaining support for the innovation - Some strategies require little or

resources to implement where as others require significant physical and financial resources. If resources are needed then gaining support for the accusation of those resources are essential. Grants can provide good funding sources but require time and effort to secure and may be for a limited time. Administrative support may be required but administrators may also be an excellent resource to tap to discuss the potential funding or acquisitions of the physical resource.

Preparing faculty members for the innovation - Rehearsal time may be required or additional education may be required. Planning sufficient for those activities will increase everyone‘s comfort level with this process. This is the time where everyone agrees how the strategy will be in run. Use of perception, validate and clarification can be a valuable tool.

Cont…. Implementing the evaluation -In this step it is hope that the

things will be going well, but flexibility may be required if problems arise. Sometimes unintended consequences, such as surfacing of emotional issues can occur. Administrator should be alert to the need for the follow up or referral if problem arise.

Evaluating the outcome - It is the final step of the process. It may be possible to measure short term attainment goals. A strong evaluation process provides an opportunity to evaluate the outcome of the change. Sources of innovation Seven sources for innovative ideas have been identified by (Drucker 1992)

Four sources are found internally within the institutions are:

Unexpected outcomes: Situation presents themselves that require different methods to be adopted. Knowing what is happening in an institution allows an individual to prepare for the impending changes.

Incongruous circumstances: Disruptions occur that require change to be made discrepancies exists between the reality as it is and reality as it is assumed to be.

Innovations made on the process needs: Procedures and policies need to be altered to respond to the new regulations, policies or law.

Changes in structure: Organizational changes require changes in method of the operations.

Three sources are outside the institutions:

Change in the demographics: Alteration in the community statistics such as age and income levels affect the organizational operations.

New information or knowledge: New technological knowledge requires change in practice.

Change in perception, taste and meaning: Shifts in demographics, technologies and social needs create different ways of looking at the situation.

Steps in Innovation adoption Knowledge: Aware of new information and possible significance to practice. Persuasion: Positive attitudes about importance and utility of new knowledge. Decision: Trial use of new information to test relevance to practice. Implementation: Change of care setting to facilitate use of the innovations. Confirmation: Gathering of evidence to confirm appropriateness of using the

innovations.