Change Management in ICU

Background: Change management is called any strategic action or activity that aims to exploit efficient and ancillary methods that contribute to a smooth and efficient transition of an ICU Department from an existing to a new desired state. Objective: Continuous change is part of ICU life, but people tend to resist what is new and largely unknown. Thus, reactions and a climate of resistance within businesses are often created. A key role in managing change is played by the Director who are called upon to normalize the work environment and ensure the proper functioning of ICU Department. At the same time, the Director has the responsibility to communicate these changes to his respective teams with ICU leadership / management and to act as positive actor. Conclusion: Any change requires the involvement of the People. ICUs need to realize that change can reach as far as the average worker can apply it at work. Employees in ICU need to take into account every individual, not just the structures and systems.


Introduction
Change is called any conversion of an existing state. (e.g. converting the work mode, converting processes, changing strategic goals and objectives of an ICU, etc.) Change management is called any strategic action or activity that aims to exploit efficient and ancillary methods that contribute to a smooth and efficient  involved. Change management is essentially the implementation of a structured process and corresponding tools designed to enable individuals or groups to move from an existing situation to a future one in order to achieve the desired outcome [3].
«Unfreeze, Change, Refreeze» At the same time, as illustrated by the theory of Kurt Lewis, recognized as the founder of social psychology, in a business there is a dynamic of internal tendencies that affects its functioning. In the field of dynamic field analysis, as it is called, in an ICU there are some forces that lead to change or resistance. In particular, any ICU that plans to change has those forces that are in favor of change and those that are against it. In practice, this means that those who have a strategic role in planning and implementing any change must strengthen the forces for change and weaken the forces that resist it. In the first case, creating a positive climate and the leader's own vision (either of the whole ICU or the team) can make a positive contribution to the change. On the contrary, complex processes, unclear message and introversion combined with lack of structure can enhance resistance forces rather than bend it ( Figure 2).

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Copy@ Evangelia Michail Michailidou Then comes the "change" which is essentially that transitional period until the change comes. Many times, at this stage, everything that has happened so far is called into question. Stakeholders are invited to adopt new codes of conduct and codes of conduct.
At the same time, new structures, systems and processes can be established. As can be seen, all of the above "shake" executives out of their position and the so-called "comfort zone" and can create tensions and a disturbing climate. In the end, there is the "freeze" (refreeze), that is, re-engagement into a new order of things. Here, it has taken shape and the change -small or large -has begun to take shape, with the result that the calm and smooth flow of business returns. This is achieved through ways such as communication, the whole or part of the ICU. The focus center shifts to perform these changes in a clearly defined way. For example, if a large-scale tech ICU incorporates specialized engineers into its regional sales teams, then there will be changes in roles, in client coverage, in sales targeting and in teamwork. Inevitably, a whole bunch of people are affected.
Here, if the principles of change management and corresponding tools are applied, such as: the new framework of work, the creation of good relationships between Managers, the involvement of all stakeholders and the value of discipline, then the ICU's new sales approach is going to be successful and is mainly going to produce improved financial results [5].
On the other hand, as noted in the same article, the transformation is quite different. Unlike managing change, transformation does not focus on some specific, clearly defined changes, but on a portfolio of initiatives that are either interdependent or intersecting. The most important (alert) difference is that the ultimate goal of a transformation is not to make a change, but to rediscover the ICU itself and to revise the existing operating model based on the vision for the future. Beyond any doubt, it implies a much greater risk as a condition than anything else as it is unpredictable what will happen or even experimental. Indeed, as emphasized, even if a change is deemed successful in the context of total transformation, the process itself can fail.
Analysis in… internal terms However, in order for ICU change and/or transformation to be designed, implemented and ultimately implemented successfully, businesses must clearly define the goals they want to achieve through the implementation of change and set out in detail the areas in which these goals are focused.
As "companies" analyze their external environment in order to determine their strategic path and set goals, it is equally important to carry out an internal analysis to reveal their strengths and weaknesses within the ICU. In the case of ICU change, it is even more necessary to clarify the points that will help to achieve the goals of

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Ultimately, change is a common thread found throughout the business of whatever size, location and age. The world, after all, is changing so fast, and so must ICUs. Undoubtedly, the ICUs that manage change will prosper and grow while the rest will struggle to survive.

Tips for Successful Change! -For a successful change employees in ICU can apply the following Set the expectation of Change as inevitable
Many times a change ends up inexorably because employees themselves have their own tacit expectations. If employees of the ICU have fallen into the trap of assuming that their working environment will always be stable and comfortable and in which they will have a stable location, next to their colleagues, referring to the same Manager, then they are more likely to feel " blind "and out

Understand "How will I be affected?"
A change can be as positive and negative as the results it brings. For example, it may relocate to new building sites due to overall growth (positive change) or it may relate to staff reductions to meet its financial requirements (negative change) Whenever there is a significant evolution in the work environment, a decline in productivity of executives at the individual and team level can be observed in response to a new paradigm, environment, ICU structure or even team leadership. The point that will make the difference is the communication message from the ICU. The 'What is happening here is' this' and employees in ICU can do' that 'approach will create resistance or enhance the existing one. In contrast, the ICU must "wear the shoes" of its executives and give them the space and time for any adjustment. One universally sound approach is to put the message: "There is a change and we know employees in ICU are going to have questions. We are here to discuss them and talk about what concerns them."

Identify the Key players
As people respond differently to changes in the workplace, the Manager/Leader is responsible for identifying those executives who will play the role of ambassador as well as those who can sabotage any effort. Key players, then, are the executives who will lead and be called upon to manage the process of change within a wider system of people and dynamic relationships. It is crucial for Key players to "embark" from the beginning of the journey of change and to be prepared to "travel" and "reach their final destination" under any condition, with the rest of the members being involved. Each member of an ICU, from any hierarchical rank can be a Key Player to one degree.

Embrace the Challenge/Overtake the status quo
Then, and based on the culture of change, it is essential that the In order for change management techniques to achieve the desired effect, we first need to understand that a change in mindset is needed, not just actions. Change Management is a way of thinking and attitude. It defines the business function and is the methodology and logic through which we are driven to adapt to new data rapidly and flexibly.
While designing and implementing any change requires "courage" from the Management side, adopting the change requires employee confidence. Leadership groups that do not regard the human factor as important -as it is the people who will be called upon to work and perform in the new emerging environment -are, in mathematical precision, always at the forefront of failing to make any change. It is important to understand that precisely because change management is identified with the culture of the ICU, there is no common methodology for all ICUs. However, there are a number of practices and tools that can help create that environment that will make it easier for people to adapt quickly, depending on the circumstances. Change Management culture is shaped in every ICU by the leadership team whose commitment and flexibility are the most critical factor in the success of the Critical Success Factor. The leaders of ICUs in this new era must be agents of Change (Agents) and carry the agility philosophy throughout the ICU. Managing change is a big bet for companies that most often start off with buzz and drumming from management and end up with less time for a real change that brings tangible results and growth. It is well known that 70% of change initiatives fail, mainly due to employee resistance and lack of support from management [4][5][6][7].

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The vision, strategy, values, ICU structure, goals, policies and processes may be there, fully implemented and skillfully communicated, but that is not enough. It goes without saying that the above should already have been set up to begin the main task of managing change. Unfortunately, when a ICU has reached this stage, it believes that much of the work that needs to be done to implement a change has been achieved. The essence, however, is continuity. What are its actions on employees' beliefs on the values that govern their day-to-day operations, on traditions that hold captive behaviors and functions, on unwritten laws that are often more powerful than any ICU value. And even more profoundly, how the Director copes with the many feelings that emerge while managing change for each employee.
Helping to manage change can be our digital age. Although companies are increasingly using digital tools to attract customers, deal with complaints, promote products, and so on, their use of change management still seems to be quite limited.
But if we envision a ICU using digital tools to make the change management experience more personal by individually showing what the employee's contribution is to achieving it, using gamification tools, creating online forums and contests to enhance empathy and meaning. community, if it implements digital tools that will show the overall progress of the change so that employees can see what is happening in real time rather than on a quarterly basis reporting, then maybe managing change can be more painlessly done and employees turning from mere observers to ambassadors of change. Now operating in an ever-changing business environment, driven by unstoppable socio-economic and political change, the business world is called upon to change its mindset and attitude towards change. The digital world can become a competitive advantage in managing change.
We live in times of high liquidity. Everything is constantly changing, with ever increasing rates. Change is here to stay. But is this necessarily bad? Isn't change an integral part of our lives? There is nothing static in this world. Change = life. From the moment we are created to the moment we die, we are constantly transformed.
When stagnation occurs, death occurs. So ICU Departments, a system of people, relationships, and interactions, are alive. As such they are therefore changing. Time to time. That in itself is a huge challenge. Because change creates (or offers, depending on how one sees it) "problems". Problems that a "smart ICU" must see as opportunities for improvement. Even the conscious decision not to take any action is a decision. That too will create a new treaty.
In this perpetual life cycle of any ICU, the principles that govern The three truths about ICU Change are: Truth # 1: ICUs cannot change faster than the people who make them change.
Truth # 2: It succeeds or fails depending on the conditions in the ICU.
Truth # 3: To achieve change in the ICU, one needs to change its culture first.
But how is the culture of an ICU affected by a small and / or major change?
Every ICU has and definitely has certain characteristics that make it stand out and compose its culture. Changing an ICU means changing its culture, and conversely, changing its culture also results in changing the system itself. ICU culture is difficult to change but not impossible. When we talk about change in ICU or culture we mean real changes in people's behavior throughout the ICU. Peter Senge argues that in order to create and maintain a profound change it is vital to temporarily suspend our mental models and patterns and possibly change them. But how should an ICU really handle the change effort? It takes a lot of time, effort, resources and continuous effort to change a situation in an ICU. So there are no recipes and secrets. Any change requires the involvement of the People. ICUs need to realize that change can reach as far as the average worker can apply it at work. Employees in ICU need to take into account every individual, not just the structures and systems.