How can I help my team adapt to regulatory, payment-related and other changes?

We’ve all heard that the only constant in life is change, and yet we’re often still surprised when it happens. In 2019, long-term care faces more tidal waves of change, with the Patient-Driven Payment Model set to replace RUG-IV for Medicare A payments, and the federal regulations for Phase 3 requirements coming due. Nurse leaders are tasked with leading their teams through these and many other changes every day.

Change management is both an art and a science. The science is selecting a method or process and committing to following it. Any change involves both technical and systems components, including the change concept and design, new system development, testing, training, implementation, monitoring and quality assurance. Each step must be well planned.

The art of change management is understanding where each team member is in the change process — unaware, in denial, refusing, committed or accepting. Change theories and models abound, but one of the most used is the ADKAR model. It includes the following helpful steps:

A – Awareness and recognition of the need for change

D – Desire and motivation to participate in and support the change

K – Knowledge of how to change and how to identify what the change will look like in terms of skills and behaviors

A – Ability to implement the change on a daily basis

R – Reinforcement to sustain the change over the long term

Implementing needed change with a methodical approach helps teams gain a sense of urgency and commitment. As we model steps in the change process, we inspire our staff to engage and bring their best to the process!

Please send your nursing-related questions to Judi Kulus at