Change Management in Healthcare: Using the Principles of Transformational Leadership


Managing change in a nursing environment is a challenging task due to the lack of the values, philosophy, and guidelines that allow nurses to improve their performance. In addition, the lack of motivation is evident in the specified context. However, the introduction of the principles of Transformational Leadership (TL) is expected to alter the current situation. Because of the focus on all stakeholders involved, as well as the promotion of engagement and enthusiasm, TL is believed to produce impressive results. Particularly, a drop in workplace burnouts, a rise in the levels of staff motivation, and a general improvement of service quality is expected.

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What makes the realm of healthcare special is the necessity to upgrade the quality of provided services on a regular basis. Continuous enhancement of efficiency is crucial in a nursing environment since it increases the probability of a positive outcome. Therefore, the adoption of a leadership technique that could lead to the gradual transformation of nurses and the promotion of knowledge and skills acquisition among them is vital. It is assumed that the principles of the Transformational Leadership (TL) approach will help improve the quality of medical services and the conditions in which nurses work.

In addition, to encourage change in the nursing context, one will also have to deploy innovative technology, particularly, tools for communication and patient monitoring. The specified step will also require the use of TL since nurses will need to acquire skills for managing the specified devices. Thus, the threat of medical errors will be reduced since a range of procedures will become automated (Boamah, Laschinger, Wong, & Clarke, 2018). Moreover, TL will help manage some of the organizational issues that may emerge during the alterations in the workplace environment. For instance, some staff members may be unwilling to reconsider their workplace behavior and accept new knowledge. Since the transfer to the philosophy of the continuous improvement as the foundation for providing high-quality services will demand an impressive effort, some employees are likely to refuse to make it. Consequently, the problems associated with the promotion of a new corporate philosophy will need to be acknowledged and addressed.

Theoretical Framework

In order to introduce change to the target environment, one will need to select Rogers’ Change Theory (RCT), which is a modification of Lewin’s Change Theory (LCT). While the latter provides a seemingly sufficient platform for promoting change with its three stages of freezing, moving, and unfreezing, RCT offers a more elaborate framework. RCT incorporates five stages, which include awareness, interest, evaluation, implementation and adoption (Mohammadi, ‎ Poursaberi, & Salahshoor, 2018). The suggested tool allows exploring change and locating the methods of institutionalizing it.

Literature Review

In order to explore the effects of TL on the quality of nursing care, the number of positive patient outcomes, and the quality of nurses’ life one will need to adopt the theoretical framework that will help to consider the observed factors. To attain the required results one will have to use Neuman’s Systems Model as the foundation for promoting change. The selected framework will allow addressing patients’ unique needs and focus on the active promotion of innovative ideas.

Studies indicate that there is a strong need in introducing new tools for improving the quality of care. For example, a paper by Top, Akdere, and Tarcan (2015) explains that the use of TL strategies will allow building the levels of workplace commitment high. Consequently, nurses will treat their responsibilities with greater care and concern. Furthermore, the significance of TL for healthcare workers also needs to be explored in depth. For example, the application of TL will contribute to a rapid rise in the quality of nurses’ lives, as recent research suggests (Top et al., 2015). Therefore, the active promotion of the proposed framework for managing nursing issues is essential. Therefore, the effects of TL will need to be measured based on different aspects of nursing, including organizational issues, structural levels of a hospital’s functioning, promotion of innovations, and meeting the needs of providers and patients.

Furthermore, the use of innovative approaches and especially the adoption of the electronic Health records (EHR) system will help to keep patients’ data safe. The identified detail is particularly important in the era of IT innovations and the increase in the number and intensity of cyberattacks (Lavin, Harper, & Barr, 2015). Because of the threat to which patients’ personal data is subjected, the use of TL as a tool for enhancing their security must be studied.

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Over the past several years, numerous technologies for improving the quality of care have appeared. For instance, the opportunity for keeping health records of all patients within the confinements of a single system should be mentioned as an important achievement (Bates et al., 2014). The Electronic Health records (EHR) system has allowed reducing the number of medical errors and meting patient-specific needs without omitting crucial information. The application of the specified strategy, however, is fraught with problems due to the lack of connectivity between healthcare facilities across the state.

To conduct the study and define the efficiency of TL, one will need to use the quantitative method. A survey that will help detail the effects of Tl on the efficiency of care, recovery rates, and the improvement in nurses’ quality of life will have to be designed. The survey will include ten Likert-scale questions inviting nurses and patients to define their levels of satisfaction. The pre- and post-intervention responses will be compared using Student t-test as the platform for the analysis. The survey will be distributed among patients and nurses form several local hospitals. Its further analysis will help see the algorithm in the implementation of the TL-based approach.

Data Analysis

A sample of 225 participants (106 patients and 119 nurses) was selected for the study. The questionnaire was sent to the target demographic via e-mail. After the participants had provided their responses to the survey questions, it became evident that there was a strong tendency in the improvement of care, a rise in the levels of patients’ and nurses’ motivation, and an overall improvement in the communication techniques used within the selected healthcare settings.

Furthermore, the outcomes of the analysis have shown that the active focus on communication during TL strategy implementation leads to massive improvements as the key algorithm to deploy. It is imperative to maintain the dialogue between nurses and managers, as well as patients and nurses, to ensure the effective management of the target populations’ needs. Finally, the importance of the consistent learning has been proven for both nurses and patients. The former need the active education to maintain the quality of services high and be able to address the needs of diverse audiences. Patients, in turn, require education to be capable of locating a health threat and seeking the support of professionals.

Applicability to Nursing

The general process of managing change will be aimed at not only introducing alterations to the existing approach toward managing stakeholders’ needs but also institutionalizing them. Put differently, the phenomenon of the consistent improvement and change as the integral part of the nursing process will have to be incorporated into the current set of values and standards of performance. For this purpose, the Six Sigma tool, particularly, the DMAIC (Define, Measure, Analyze, Improve, and Control) model will have to be deployed (McFadden, Lee, Gowen, & Sharp, 2014). Resistance to change will be handled by providing staff members with a role model that they can follow and offering them incentives along with a shift in values. Furthermore, the active use of IT tools for maintaining the communication between nurses and patients consistent, controlling changes in patients’ health status, and keeping their records in order will be needed.

The research has its limitations, the sample size being the key one Because of the use of a survey with a limited number of questions and a small number of participants as the key tool for gathering data, the research results may not be representative for the entirety of the target populations. Furthermore, one must test the plan experimentally in order to prove its viability and effectiveness in the environment of a nursing facility or a hospital. Therefore, a future study is needed as the means of proving the significance of TL in nursing.


Innovative health technology provides nurses and patients with extensive opportunities for a faster transfer of relevant information and a safer management of data. As a result, the quality of care improves significantly. However, what makes the suggested change especially meaningful for both patients and nurses is the use of TL. TL strategies help nurses to focus on the continuous improvement of the quality of services, whereas patients feel encouraged to educate themselves and learn more about health concerns, available resources, and the means of contacting healthcare services. Therefore, the proposed TL-based framework of the consistent improvement and IT use in the nursing setting must be seen as a necessity.

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Bates, D. W., Saria, S., Ohno-Machado, L., Shah, A., & Escobar, G. (2014). Big data in health care: Using analytics to identify and manage high-risk and high-cost patients. Health Affairs, 33(7), 1123-1131. doi:10.1377/hlthaff.2014.0041

Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189. doi:10.1016/j.outlook.2017.10.004

Lavin, M. A., Harper, E., & Barr, N. (2015). Health information technology, patient safety, and professional nursing care documentation in acute care settings. The Online Journal of Issues in Nursing, 20(6), 1-6. doi:10.3912/OJIN.Vol20No02PPT04

McFadden, K. L., Lee, J. Y., Gowen, C. R. I., & Sharp, B. M. (2014). Linking quality improvement practices to knowledge management capabilities. Quality Management Journal, 21(1), 42-58. doi:10.1080/10686967.2014.11918375

Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2018). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: A model testing study. Health Promotion Perspectives, 8(1), 25-32. doi:10.15171/hpp.2018.03

Top, M., Akdere, M., & Tarcan, M. (2015). Examining transformational leadership, job satisfaction, organizational commitment and organizational trust in Turkish hospitals: Public servants versus private sector employees. The International Journal of Human Resource Management, 26(9), 1259-1282. doi:10.1080/09585192.2014.939987

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StudyCorgi. 2021. "Change Management in Healthcare: Using the Principles of Transformational Leadership." July 21, 2021.


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