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Three-Step Change Theory and Its Phases in Healthcare

To provide better health care, it is necessary to ensure that the process of improvement in it is ongoing and promoted. In this regard, the notion of positive change (i.e., the improvement of current practices and policies) is a key component of designing a better approach to the delivery of care. Various theories on how change can be implemented have been created; two major ones were developed by Lewin in his Three-Step Change Theory and by Lippitt in his Phases of Change Theory. The two theories can be compared and contrasted in order to identify the one that is the most suitable for the proposed project.

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The theory proposed by Lewin is based on three stages of change: unfreezing, movement, and refreezing (“Change theory,” 2011). It suggests that, before any changes are implemented in a facility or a field of care, established practices should be confronted and questioned (unfreezing), then fixed (movement), and then the new practices introduced according to the desired change should be established as standards (refreezing). A major benefit of the theory is that it stresses the importance of not only modifying existing processes and procedures that health care providers follow but also sustaining the change and ensuring that the providers will not eventually go back to ineffective, inefficient, or inappropriate practices in their work.

Further, Lippitt proposes a different theory that focused on the phases of change, and the number of steps was extended to seven (Kritsonis, 2005). Importantly, this theory focuses on the role of the change agent as opposed to focusing on the implementation of change as an institutional process. Also, Lippitt’s theory on phases of change suggests that, in order to ensure that positive change is sustained, it is crucial to promote it and make other people and groups interested in it. If convinced by the evidence of the effectiveness of new practices, practitioners are likely to adopt them in their own work. It helps change agents distribute the changed practices and obtain evidence of its advantages.

Although Lippitt’s theory is largely based on that developed by Lewin, the two have significant differences. First of all, Lewin’s theory addresses the way facilities and health care administrators should approach change from the organizational perspective and in the context of regulations. Unlike this theory, Lippitt’s theory suggests that providers themselves should not only advocate for the promotion of their innovative practices but also think of themselves and act as active participants of the process of delivering care. .

I believe that the latter theory is more appropriate for my evidence-based practice project. Although the proposed research pursues systematic change (which is rather common for the use of the three-stage model), the role of implementers acting as agents of change is crucial. Therefore, the evaluation of the proposed intervention will be based on how successful the change agents are in their efforts to promote positive change as opposed to evaluating how successful the administrators are in terms of managing the change process.

Although Lewin’s theory can be helpful for explaining and implementing the organizational aspects of positive change, the theory by Lippitt is considered to be more appropriate for the presented research. The reason is that the author focused on the role of change agents. Without understanding their role in the proposed intervention properly, it will be impossible to assess the effectiveness of the health care provision process.


Change theory: Kurt Lewin. (2011). Web.

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Kritsonis, A. (2005). Comparison of change theories. International Journal of Scholarly Academic Intellectual Diversity, 8(1), 1-7.

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