PMID- 36794606
OWN - NLM
STAT- MEDLINE
DCOM- 20230221
LR  - 20230227
IS  - 2398-631X (Electronic)
IS  - 2398-631X (Linking)
VI  - 6
IP  - 4
DP  - 2022 Dec
TI  - Kotter's 8 stages of change: implementation of clinical screening protocols for 
      assessing patients for COVID-19 - a review of an academic medical centre's 
      preparedness.
PG  - 319-322
LID - 10.1136/leader-2020-000379 [doi]
AB  - BACKGROUND: COVID-19 screening protocols rapidly evolved as a result of changing 
      Centers for Disease Control and Prevention (CDC) and California Department of 
      Public Health (CDPH) recommendations. These protocols led to operational 
      improvements at one large academic medical centre using change management methods 
      explained in Kotter's 8-stage change model. METHODS: We reviewed all iterations 
      of clinical process maps for identifying, isolating and assessing COVID-19 
      infections in paediatric and adult populations within one emergency department 
      (ED) from 28 February 2020 to 5 April 2020. We incorporated CDC and CDPH criteria 
      for the various roles of healthcare workers in ED patient assessment. RESULTS: 
      Using Kotter's 8-stage change model, we outlined the chronological evolution of 
      basic screening criteria, as well as how these were reviewed, modified and 
      implemented during the onset and through the time of greatest uncertainty of 
      COVID-19 in the USA. Our results demonstrate a successful creation, and 
      subsequent execution, of rapidly changing protocols across a large workforce. 
      CONCLUSION: We effectively applied a business change management framework to the 
      hospital management response during a pandemic; we share these experiences and 
      challenges to inform and guide future operational decision making during times of 
      rapid change.
CI  - (c) Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Ravi, Shashank
AU  - Ravi S
AUID- ORCID: 0000-0001-6688-1849
AD  - Department of Emergency Medicine, Stanford University School of Medicine, 
      Stanford, California, USA sravi1@stanford.edu.
FAU - Patel, Sunny R
AU  - Patel SR
AD  - Department of Emergency Medicine, Stanford University School of Medicine, 
      Stanford, California, USA.
FAU - Laurence, Shenee K
AU  - Laurence SK
AD  - Emergency Services, Stanford Health Care, Stanford, California, USA.
FAU - Sebok-Syer, Stefanie S
AU  - Sebok-Syer SS
AD  - Department of Emergency Medicine, Stanford University School of Medicine, 
      Stanford, California, USA.
FAU - Gharahbaghian, Laleh
AU  - Gharahbaghian L
AD  - Department of Emergency Medicine, Stanford University School of Medicine, 
      Stanford, California, USA.
LA  - eng
PT  - Journal Article
DEP - 20220420
PL  - England
TA  - BMJ Lead
JT  - BMJ leader
JID - 101757339
SB  - IM
MH  - Child
MH  - Humans
MH  - Change Management
MH  - *COVID-19/diagnosis
MH  - *Hospital Administration
MH  - Public Health
MH  - Transtheoretical Model
MH  - United States/epidemiology
OTO - NOTNLM
OT  - communication
OT  - continuous improvement
OT  - management
COIS- Competing interests: None declared.
EDAT- 2023/02/17 06:00
MHDA- 2023/02/18 06:00
CRDT- 2023/02/16 05:13
PHST- 2020/09/14 00:00 [received]
PHST- 2022/04/08 00:00 [accepted]
PHST- 2023/02/16 05:13 [entrez]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/18 06:00 [medline]
AID - leader-2020-000379 [pii]
AID - 10.1136/leader-2020-000379 [doi]
PST - ppublish
SO  - BMJ Lead. 2022 Dec;6(4):319-322. doi: 10.1136/leader-2020-000379. Epub 2022 Apr 
      20.