Most organizations have viewed change as sequential and linear occurring in a step-by-step fashion. However, nursing has begun to explore non-linear models as a way of guiding more unpredictable change, as these models do not follow an orderly and predictable pattern.
Chaos theory, considered to be a subset of complexity science, emerged from the early work of Edward Lorenz in the 1960s to improve weather forecasting techniques. Non-human-induced responses in the environment indicate there is some predictability in random patterns (Thietart & Forgues, 1995; Wagner & Huber, 2003). Lorenz found that even small changes of randomness in a system that constantly changes can dramatically affect the long-term behaviour of that system and make it difficult to predict future outcomes. Interestingly, this non-linear model refers to a controlled randomness, which may be associated with recognizable and somewhat predictable patterns.
Chaos theory may be another way to structure change processes in a highly complex and evolving health care environment. Despite the best of intentions to improve organizational function and improve quality and safety of patient care, contextual factors may not be fully explored or considered in the change process. For example, instituting a care delivery model on a unit may not work well if staff have not been appropriated the necessary resources to provide care. Knowing how non-linear theories work can advance organizational functioning in health care organizations and systems in the twenty-first century.
Essential Learning Activity 9.4.1
Watch Claire Burge’s TEDx Talk titled “The Future of Work is Chaos” (13:43) for a more in-depth understanding of chaos theory.
Essential Learning Activity 9.4.2
Cindy is an RN with three years’ experience working on a busy surgical unit in a large urban hospital. Cindy enjoys her job and is keen to pursue an intensive care course after which she plans to work in the intensive care unit of the same hospital. She has received a one-year grant to establish a cardiac program for patients and caregivers. This project will be evaluated at the end of one year. Cindy, as the change agent, is tasked with implementing the change. Stephanie, the nurse manager, is highly supportive, but some of the nurses don’t have time and are not willing to help make the program a reality.
How should Cindy proceed with the change process? Could Lewin’s change theory be used to guide the change? If so, how would you envision the change occurring?
How can she persuade other nurses to buy into the change? What effective leadership and followership strategies could she implement in the change process?