Tag: Model Answer

  • [Solved] Famint

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    – Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment. – Summarize the overall health behaviors of the family. Describe the current health of the family. – Based on your findings, …

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    Assignment Prompt & Instructions

    – Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.
    – Summarize the overall health behaviors of the family. Describe the current health of the family.
    – Based on your findings, describe at least two of the functional health pattern strengths noted in the findings.
    – Discuss three areas in which health problems or barriers to health were identified?
    – Your assignment must include an eco-map and a genogram – as shown in the required textbook.

  • [Solved] problem focused soap note 682 wk4

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    – ## TemplateFNPSOAPNote-1-1.docx **## TemplateFNPSOAPNote-1-1.docx** **FNP SOAP Note Template** Use this template for Comprehensive Notes (H&Ps) and Problem-Focused Notes (Episodic/progress notes). For the Problem-Focused Notes, _only_ include pertinent problem-focused information related to the ch…

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    – ## TemplateFNPSOAPNote-1-1.docx

    **## TemplateFNPSOAPNote-1-1.docx**

    **FNP SOAP Note Template**

    Use this template for Comprehensive Notes (H&Ps) and Problem-Focused Notes (Episodic/progress notes). For the Problem-Focused Notes,
    _only_ include pertinent problem-focused information related to the chief concern (CC).

    **Demographic Data**

    · Patient age and gender identity

    · MUST BE HIPAA compliant

    **Subjective**

    **Chief Complaint (CC)**

    · Place the complaint in Quotes

    · Brief description -only a few words and in the patient’s words … “My chest hurts,” “I cannot breath,” or “I passed out,” etc.

    **History of Present Illness (HPI)**– the
    **reason for the appointment today**

    · Use the OLD CARTS acronym to document the eight elements of a chief concern (CC): Onset, Location/radiation, Duration, Character, Aggravating factors, Relieving factors, Timing, and Severity)

    · Briefly describe the general state of health prior to the problem.

    · Are Activities of Daily Living (ADL) impacted by the current problem?

    **Past Medical History**:

    · List current and past medical diagnoses

    **Past Surgical History**:

    · List all past surgeries

    **FAMILY HISTORY:**

    · Include medical/psychiatric problems to include 3 generations (parents, grandparents, siblings, or
    direct relatives.

    **Current Medications:**

    · Include current prescription(s), over-the-counter medications, herbal/alternative medications as well as vitamin/supplement use.

    **ALLERGIES**: Include medications, foods, and chemicals such as latex.

    **Immunizations History:** list current immunization status and address deficiency

    **Preventative health History: (** See Table below – Appendix A)

    **SOCIAL HISTORY:**

    ·
    **Include** nutrition, exercise, substance use (details of use: caffeine, EtOH, illicit drug use), sexual history/preference, financial problems, legal issues, kids, and history of abuse, including sexual, emotional, or physical.

    ·
    **Employment/Education:** occupation (type), exposure to harmful agents, highest school achievement

    **REVIEW OF SYSTEMS:**

    · A ROS is a question-seeking inventory by body systems to identify signs and/or symptoms that the patient may be experiencing or has experienced that may or may not correlate with the CC.

    *If a + finding is found not related to the cc this may represent an additional problem that will need to be detailed in the HPI.

    · Must include any physical complaint(s) by the body system that is relevant to the treatment and management of the current concern(s).
    **List only the pertinent body systems specific to the CC.**

    ·
    Remember to include pertinent positive and negative findings when detailing the ROS related to a chief concern (cc).

    ·
    Do not repeat the information provided in HPI

    · Use the format below when detailing the ROS

    **ROS:**

    General:

    Eyes:

    Ears, nose, mouth & throat:

    Cardiovascular:

    Respiratory:

    Gastrointestinal:

    Skin & Breasts:

    Musculoskeletal:

    Allergic:

    Immunologic:

    Endocrine:

    Hematopoietic/Lymphatic:

    Genitourinary:

    Neurological:

    Psychiatric/Mental Status:

    **Objective**

    PHYSICAL EXAMINATION:

    VITAL SIGNS: Blood pressure. Heart rate (regular or irregular). Respirations. SaO2 (on room air or O2). Temperature. Weight. Height.

    *Document the presence of any internal/external devices (IV, Central lines, NGTs, G-tubes, Ostomies, urinary catheters) and dates of placement.

    General:

    Eyes:

    Ears, nose, mouth & throat:

    Cardiovascular:

    Respiratory:

    Gastrointestinal:

    Skin & Breasts:

    Musculoskeletal:

    Allergic:

    Immunologic:

    Endocrine:

    Hematopoietic/Lymphatic:

    Genitourinary:

    Neurological:

    Psychiatric/Mental Status:

    **Pertinent Diagnostic Test Results:**

    **Assessment (Diagnosis)**

    Differential Diagnosis (DDx)

    · Include two (2) differential diagnoses you considered but did not select as the final diagnosis. Why were these 2 diagnoses not selected? Support with pertinent positive and negative findings for each differential with an evidence-based guideline(s) (required).

    Working or Final Diagnosis:

    · Final or working diagnosis (1) (including ICD-10 code)

    · Provide a rational explanation supported by evidenced-based guidelines (required). List the pertinent positive and negative symptoms/signs that support your final diagnosis.

    **Plan**

    Treatment (Tx) Plan: pharmacologic and/or nonpharmacologic

    · Pharmacologic -include full prescribing information for each medication(s) ordered

    · Refill Provided: Include full prescribing information for each medication(s) refilled and the correlating diagnosis related to the refill.

    Patient Education:

    · Include specific education related to each medication prescribed.

    · Was risk versus benefit of current treatment plan addressed for medication(s) and interventions? Was the patient included in the medical decision making and in agreement with the final plan

    · NPs should not be prescribing non-FDA approved medications or medications related to off-label use. If a physician prescribed a non-FDA-approved medication for working diagnosis or recommended off-label use was education provided and was the risk to benefit of the medication(s) addressed in the patient’s education?

    Prognosis Good, Fair, or Poor?

    · Indicate the patient’s prognosis: Good, Fair, Poor

    · Provide support for your selected prognosis

    Referral/Follow-up

    · Did you recommend follow-up with PCP, or other healthcare professionals?

    · When is the subsequent follow-up?

    Disposition:

    · Indicate the disposition of the patient.

    · Was the patient sent home, Emergency room via EMS, etc.

    · Include rationale for the follow-up recommendation or referral

    Reference(s)

    · Include APA formatted references for written assignments.

    · Minimum 2 references are required from evidence-based resources.

    · Oral assignments should include verbally articulated evidence-based guideline(s) used to prepare the oral presentation.

    APPENDIX A

    **PREVENTATIVE CARE SCHEDULE (Example – not all-inclusive)**

    | | | | |
    | — | — | — | — |
    | Preventive Care | Date | Result | Referrals Made |
    | Pap | | | |
    | Mammogram | | | |
    | A1C | | | |
    | Eye Exam | | | |
    | Monofilament Test | | | |
    | Urine<br>Microalbumin | | | |
    | Diet/Lifestyle Modifications | | | |
    | Digital Rectal Exam (DRE) | | | |
    | PSA | | | |
    | Colonoscopy or FOBT | | | |
    | Dexa Scan | | | |
    | CXR | | | |
    | BNP | | | |
    | ECG | | | |
    | Echo | | | |
    | Stress <br>Test | | | |
    | | | | |
    | Vaccines | | | |
    | | | | |
    | | | | |
    | | | | |
    | | | | |
    | | | | |

    **## TemplateFNPSOAPNote-1-1.docx**

    **FNP SOAP Note Template**

    Use this template for Comprehensive Notes (H&Ps) and Problem-Focused Notes (Episodic/progress notes). For the Problem-Focused Notes,
    _only_ include pertinent problem-focused information related to the chief concern (CC).

    **Demographic Data**

    · Patient age and gender identity

    · MUST BE HIPAA compliant

    **Subjective**

    **Chief Complaint (CC)**

    · Place the complaint in Quotes

    · Brief description -only a few words and in the patient’s words … “My chest hurts,” “I cannot breath,” or “I passed out,” etc.

    **History of Present Illness (HPI)**– the
    **reason for the appointment today**

    · Use the OLD CARTS acronym to document the eight elements of a chief concern (CC): Onset, Location/radiation, Duration, Character, Aggravating factors, Relieving factors, Timing, and Severity)

    · Briefly describe the general state of health prior to the problem.

    · Are Activities of Daily Living (ADL) impacted by the current problem?

    **Past Medical History**:

    · List current and past medical diagnoses

    **Past Surgical History**:

    · List all past surgeries

    **FAMILY HISTORY:**

    · Include medical/psychiatric problems to include 3 generations (parents, grandparents, siblings, or
    direct relatives.

    **Current Medications:**

    · Include current prescription(s), over-the-counter medications, herbal/alternative medications as well as vitamin/supplement use.

    **ALLERGIES**: Include medications, foods, and chemicals such as latex.

    **Immunizations History:** list current immunization status and address deficiency

    **Preventative health History: (** See Table below – Appendix A)

    **SOCIAL HISTORY:**

    ·
    **Include** nutrition, exercise, substance use (details of use: caffeine, EtOH, illicit drug use), sexual history/preference, financial problems, legal issues, kids, and history of abuse, including sexual, emotional, or physical.

    ·
    **Employment/Education:** occupation (type), exposure to harmful agents, highest school achievement

    **REVIEW OF SYSTEMS:**

    · A ROS is a question-seeking inventory by body systems to identify signs and/or symptoms that the patient may be experiencing or has experienced that may or may not correlate with the CC.

    *If a + finding is found not related to the cc this may represent an additional problem that will need to be detailed in the HPI.

    · Must include any physical complaint(s) by the body system that is relevant to the treatment and management of the current concern(s).
    **List only the pertinent body systems specific to the CC.**

    ·
    Remember to include pertinent positive and negative findings when detailing the ROS related to a chief concern (cc).

    ·
    Do not repeat the information provided in HPI

    · Use the format below when detailing the ROS

    **ROS:**

    General:

    Eyes:

    Ears, nose, mouth & throat:

    Cardiovascular:

    Respiratory:

    Gastrointestinal:

    Skin & Breasts:

    Musculoskeletal:

    Allergic:

    Immunologic:

    Endocrine:

    Hematopoietic/Lymphatic:

    Genitourinary:

    Neurological:

    Psychiatric/Mental Status:

    **Objective**

    PHYSICAL EXAMINATION:

    VITAL SIGNS: Blood pressure. Heart rate (regular or irregular). Respirations. SaO2 (on room air or O2). Temperature. Weight. Height.

    *Document the presence of any internal/external devices (IV, Central lines, NGTs, G-tubes, Ostomies, urinary catheters) and dates of placement.

    General:

    Eyes:

    Ears, nose, mouth & throat:

    Cardiovascular:

    Respiratory:

    Gastrointestinal:

    Skin & Breasts:

    Musculoskeletal:

    Allergic:

    Immunologic:

    Endocrine:

    Hematopoietic/Lymphatic:

    Genitourinary:

    Neurological:

    Psychiatric/Mental Status:

    **Pertinent Diagnostic Test Results:**

    **Assessment (Diagnosis)**

    Differential Diagnosis (DDx)

    · Include two (2) differential diagnoses you considered but did not select as the final diagnosis. Why were these 2 diagnoses not selected? Support with pertinent positive and negative findings for each differential with an evidence-based guideline(s) (required).

    Working or Final Diagnosis:

    · Final or working diagnosis (1) (including ICD-10 code)

    · Provide a rational explanation supported by evidenced-based guidelines (required). List the pertinent positive and negative symptoms/signs that support your final diagnosis.

    **Plan**

    Treatment (Tx) Plan: pharmacologic and/or nonpharmacologic

    · Pharmacologic -include full prescribing information for each medication(s) ordered

    · Refill Provided: Include full prescribing information for each medication(s) refilled and the correlating diagnosis related to the refill.

    Patient Education:

    · Include specific education related to each medication prescribed.

    · Was risk versus benefit of current treatment plan addressed for medication(s) and interventions? Was the patient included in the medical decision making and in agreement with the final plan

    · NPs should not be prescribing non-FDA approved medications or medications related to off-label use. If a physician prescribed a non-FDA-approved medication for working diagnosis or recommended off-label use was education provided and was the risk to benefit of the medication(s) addressed in the patient’s education?

    Prognosis Good, Fair, or Poor?

    · Indicate the patient’s prognosis: Good, Fair, Poor

    · Provide support for your selected prognosis

    Referral/Follow-up

    · Did you recommend follow-up with PCP, or other healthcare professionals?

    · When is the subsequent follow-up?

    Disposition:

    · Indicate the disposition of the patient.

    · Was the patient sent home, Emergency room via EMS, etc.

    · Include rationale for the follow-up recommendation or referral

    Reference(s)

    · Include APA formatted references for written assignments.

    · Minimum 2 references are required from evidence-based resources.

    · Oral assignments should include verbally articulated evidence-based guideline(s) used to prepare the oral presentation.

    APPENDIX A

    **PREVENTATIVE CARE SCHEDULE (Example – not all-inclusive)**

    | | | | |
    | — | — | — | — |
    | Preventive Care | Date | Result | Referrals Made |
    | Pap | | | |
    | Mammogram | | | |
    | A1C | | | |
    | Eye Exam | | | |
    | Monofilament Test | | | |
    | Urine<br>Microalbumin | | | |
    | Diet/Lifestyle Modifications | | | |
    | Digital Rectal Exam (DRE) | | | |
    | PSA | | | |
    | Colonoscopy or FOBT | | | |
    | Dexa Scan | | | |
    | CXR | | | |
    | BNP | | | |
    | ECG | | | |
    | Echo | | | |
    | Stress <br>Test | | | |
    | | | | |
    | Vaccines | | | |
    | | | | |
    | | | | |
    | | | | |
    | | | | |
    | | | | |

  • [Solved] Clinical Reflection Journal #5- Nursing Hw

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    Based on your knowledge of the population you serve (Miami, FL); a community health nurse teaching health promotion must include the social determinants of health into the caring for clients, planning any activity or health interventions. [Social Determinants of Health – Healthy People 2030 | healt…

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    Assignment Prompt & Instructions

    Based on your knowledge of the population you serve (Miami, FL); a community health nurse teaching health promotion must include the social determinants of health into the caring for clients, planning any activity or health interventions. [Social Determinants of Health – Healthy People 2030 | health.govLinks to an external site.](https://health.gov/healthypeople/priority-areas/social-determinants-health)
    https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health
    1. Please provide at least one intervention that is most likely to positively influence the client's adoption of a new healthy behavior.
    2. Relate the intervention you chose to one of the Social Determinants of Health, why you chose this topic?

  • [Solved] Week 9 Discussion Response- Managing People and Promoting Collab

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    **Colleague 1** Angela Eaker While coordinating an adult education program, I assumed that implementing a new digital learning platform would automatically enhance student engagement and performance. I believed that because the platform offered interactive features and flexible access, learners woul…

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    Assignment Prompt & Instructions

    **Colleague 1**
    Angela Eaker
    While coordinating an adult education program, I assumed that implementing a new digital learning platform would automatically enhance student engagement and performance. I believed that because the platform offered interactive features and flexible access, learners would readily adopt it and instructors would seamlessly integrate it into their teaching. However, this assumption proved to be only partially accurate. While some students adapted quickly, others struggled with digital literacy, and several instructors were hesitant due to a lack of training and support. This assumption impacted my behavior—I focused more on the technical rollout than on preparing stakeholders for the change. As a result, initial usage rates were low, and some learners felt frustrated or excluded. According to Fullan (2007), successful educational change requires attention to both the innovation and the human factors involved in implementation. If I were to face a similar situation again, I would invest more time in professional development, stakeholder feedback, and gradual integration. However, I would not abandon the use of technology altogether, as it ultimately expanded access and improved learning outcomes once properly supported. The experience taught me that assumptions about readiness must be validated through inclusive planning and ongoing communication.
    **References**
    Fullan, M. (2007). _The new meaning of educational change_ (4th ed.). Teachers College Press.
    **Colleague 2**
    Leslie Allen
    One experience in my professional life was working alongside a small team of engineers during the commissioning stage of an industrial project. I was the youngest on the team and quickly learned that the window of opportunity to capture defects during the warranty period, which fed into a report to the awarded supplier, was paramount for rectification. Although I primarily worked along with two engineers to populate the corrective maintenance management software, there was the assumption that I didn’t need to backcheck their work because they are experts in the field. I considered tech savvy, and in researching how the software works, I contributed to restructuring mismatched locations and identifying equipment with the agreed tree structure.
    Leaders tend to place restrictions on those that they lead (Finkelstein, 2017). This fundamental procedure could have led to poor data retrieval, which could have cost thousands of dollars in defects and buried historical data. If placed in a similar situation, I would not assume that senior staff cannot make errors. I should ask clarifying questions when given a task that requires collaboration, even if I am the least experienced person.
    **Resources:**
    Finkelstein, S. (2017, July 13). 4 ways managers can be more inclusive. Harvard Business Review Digital Articles, 2–5. http://hbr.org

  • [Solved] Team case analysis – strategic management

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    I am only needing certain parts completed for this team case analysis- needed as a shell as well. needed by Thursday 10 pm CST(US). Please see attachments for reference there is an outline of the team case analysis (the outline is how we are completing the assignment), the sample case analysis (same…

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    Assignment Prompt & Instructions

    I am only needing certain parts completed for this team case analysis-   needed as a shell as well. needed by Thursday 10 pm CST(US).
    Please see attachments for reference there is an outline of the team case analysis (the outline is how we are completing the assignment), the sample case analysis (same write up as a reference) and also the honeysuckle document – the honeysuckle is the actual case analysis we have to focus on – the team case analysis,
    I am needing the Introduction, Part 1- Major problems/issues, and the conclusion (those parts only)
    \
    samplewriteupCaseAnalysis_Geaux-1-1.docx](https://www.sweetstudy.com/files/samplewriteupcaseanalysis-geaux-1-1-docx "samplewriteupCaseAnalysis_Geaux-1-1.docx")
    \
    HoneysuckleAcresCaseStudy.docx](https://www.sweetstudy.com/files/honeysuckleacrescasestudy-docx "HoneysuckleAcresCaseStudy.docx")
    \
    CASEANALYSISOUTLINERevised-11.docx](https://www.sweetstudy.com/files/caseanalysisoutlinerevised-11-docx "CASEANALYSISOUTLINERevised-11.docx")

  • [Solved] Nursing ASSIGNMENT

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    – ## WEEK9ASSIGNMENTPRACTFocusedSOAPNoteandPatientCasePresetation.docx **## WEEK9ASSIGNMENTPRACTFocusedSOAPNoteandPatientCasePresetation.docx** Focused SOAP Note and Patient Case Presetation, Part 1 FOCSED SOAP NOTES AND PATIENT CASE PRESENTATION: Prepared: Review the **Kaltura button** from the **C…

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    Assignment Prompt & Instructions

    – ## WEEK9ASSIGNMENTPRACTFocusedSOAPNoteandPatientCasePresetation.docx

    **## WEEK9ASSIGNMENTPRACTFocusedSOAPNoteandPatientCasePresetation.docx**

    Focused SOAP Note and Patient Case Presetation, Part 1

    FOCSED SOAP NOTES AND PATIENT CASE PRESENTATION:

    Prepared: Review the
    **Kaltura button** from the
    **Classroom Support Center** (accessed via the
    **Help** button) for help creating your self-recorded Kaltura video.

    · Select an
    adult patient that you examined during the last 4 weeks who presented with a disorder
    other than the disorder present in your Week 3 Case Presentation.

    · Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations.

    **Please Note:**

    · All SOAP notes must be signed, by your Preceptor.

    **Note:** Electronic signatures are not accepted.

    · When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of the completed assignment signed by your Preceptor.

    · You must submit your SOAP note using Turnitin.

    **Note:** If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy.

    · Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record.

    · Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning.

    · Ensure that you have the appropriate lighting and equipment to record the presentation.

    SED SOAP NOTES AND PATIENT CASE PRESENTATION

    **## WEEK9ASSIGNMENTPRACTFocusedSOAPNoteandPatientCasePresetation.docx**

    Focused SOAP Note and Patient Case Presetation, Part 1

    FOCSED SOAP NOTES AND PATIENT CASE PRESENTATION:

    Prepared: Review the
    **Kaltura button** from the
    **Classroom Support Center** (accessed via the
    **Help** button) for help creating your self-recorded Kaltura video.

    · Select an
    adult patient that you examined during the last 4 weeks who presented with a disorder
    other than the disorder present in your Week 3 Case Presentation.

    · Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations.

    **Please Note:**

    · All SOAP notes must be signed, by your Preceptor.

    **Note:** Electronic signatures are not accepted.

    · When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of the completed assignment signed by your Preceptor.

    · You must submit your SOAP note using Turnitin.

    **Note:** If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy.

    · Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record.

    · Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning.

    · Ensure that you have the appropriate lighting and equipment to record the presentation.

    SED SOAP NOTES AND PATIENT CASE PRESENTATION

  • [Solved] Teaching Project Presentation- Nursing HW

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    Create a Power Point **Teaching Project Presentation- My topic has been about stroke (community is Miami, FL)** **1.** Title of the project. 2. Introduction (what is essential to learn about this issue). You may present statistics such as mortality, morbidity, incidence, and prevalence). 3. Findi…

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    Assignment Prompt & Instructions

    Create a Power Point
    **Teaching Project Presentation- My topic has been about stroke (community is Miami, FL)**
    **1.** Title of the project.
    2. Introduction (what is essential to learn about this issue). You may present statistics such as mortality, morbidity, incidence, and prevalence).
    3. Findings of your assessment: why do you believe the topic is essential for the audience? Please indicate the learning objectives. After the presentation, the participant will:
    4. Include barriers and assets for your specific population. What can you teach to empower the population to take a proactive stand for wellness?
    5. The presentation should be age, cultural, and health literacy-appropriate.
    6. The health teaching presentation should provide accurate, evidence-based information to the participant.
    7. The teaching presentation should have examples of outcomes, what happens if I change…., if I don't.
    8. The presentation should have examples of how to do the intended behavior.
    8. The presentation should have time for participants to ask questions and make comments.
    9. The presentation should have a section that evaluates the audience's attainment of the education objectives.
    \
    TeachingProjectPresentation.pdf](https://www.sweetstudy.com/files/teachingprojectpresentation-pdf "TeachingProjectPresentation.pdf")

  • [Solved] DU

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    In-depth study guidance and analytical solution covering DU.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] focused note

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    – ## GIfocusednote.docx **## GIfocusednote.docx** Episodic Visit: Gastrointestinal or Genitourinary Condition Focused Note Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as…

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    Assignment Prompt & Instructions

    – ## GIfocusednote.docx

    **## GIfocusednote.docx**

    Episodic Visit: Gastrointestinal or Genitourinary Condition Focused Note

    Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

    For this Assignment, you will work with a pediatric patient with gastrointestinal or genitourinary condition that you examined during the last 3 weeks, and complete a Focused SOAP Note Template in which you will gather patient information, relevant diagnostic and treatment information, and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc. In this week’s Learning Resources as well as prior week’s resources, please refer to the Focused Note resources for guidance on writing Focused Notes.

    **Note**: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using Turnitin.

    **Note**: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/172095/modules/items/6936939)

    **To prepare:**

    · Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment.

    · Use the Focused SOAP Note Template found in the Learning Resources for this week to complete this Assignment.

    · Select a patient with gastrointestinal or genitourinary condition that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note.

    **Assignment**

    · Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies.

    · Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.

    · Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 codes for the diagnosis. What was your primary diagnosis and why?

    · Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.

    · Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

    **Note**: Your Focused Note Assignment must be signed by Day 7 of Week 9.

    By Day 7

    **Submit** your Gastrointestinal or Genitourinary Condition Focused Note Assignment. (
    **Note**: You will submit two files, your Focused Note Assignment, and a Word document of pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 9.)

    submission information

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the
    **Turnitin Drafts** from the
    **Start Here** area.

    1. To submit your completed assignment, save your Assignment as
    **WK9Assgn2+last name+first initial.**

    2. Then, click on
    **Start Assignment** near the top of the page.

    3. Next, click on
    **Upload File** and select
    **Submit Assignment** for review.

    Rubric

    **PRAC_6541_Week9_Assignment2_Rubric**

    | | | |
    | — | — | — |
    | PRAC_6541_Week9_Assignment2_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeOrganization of Write-up | **10 to >6.0 ptsExcellent** All information organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**6 to >3.0 ptsGood** Information generally organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**3 to >0.0 ptsFair** Errors in format; information intermittently organized. Headings are used some of the time.<br> <br>**0 ptsPoor** Errors in format; information disorganized. Headings are not used appropriately. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of History | **20 to >15.0 ptsExcellent** Thoroughly documents all pertinent history components for type of note; includes critical as well as supportive information.<br> <br>**15 to >11.0 ptsGood** Documents most pertinent examination components.<br> <br>**11 to >7.0 ptsFair** Documents some pertinent examination components.<br> <br>**7 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 20 pts |
    | This criterion is linked to a Learning OutcomeHistory of Present Illness | **10 to >6.0 ptsExcellent** Thoroughly documents all 8 aspects of HPI and pertinent other data relevant to chief complaint. Includes critical as well as supportive information.<br> <br>**6 to >4.0 ptsGood** Documents at least 6 aspects of the HPI and pertinent other data relevant to chief complaint. Includes critical information.<br> <br>**4 to >2.0 ptsFair** Documents at least 4 aspects of HPI and some data pertinent to chief complaint. Lacks some critical information or rambling in history.<br> <br>**2 to >0 ptsPoor** Missing many aspects of HPI and pertinent data. Critical information missing. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of Physical Exam | **10 to >7.0 ptsExcellent** Thoroughly documents all pertinent examination components for type of note.<br> <br>**7 to >4.0 ptsGood** Documents most pertinent examination components.<br> <br>**4 to >2.0 ptsFair** Documents some pertinent examination components.<br> <br>**2 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 10 pts |
    | This criterion is linked to a Learning OutcomeDiagnostic Reasoning | **10 to >7.0 ptsExcellent** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes all secondary problems. Cost effective when ordering diagnostic tests.<br> <br>**7 to >4.0 ptsGood** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes most secondary problems.<br> <br>**4 to >2.0 ptsFair** Assessment mostly consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests.<br> <br>**2 to >0 ptsPoor** Assessment not consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests. | 10 pts |
    | This criterion is linked to a Learning OutcomeTreatment Plan/Patient Education | **20 to >15.0 ptsExcellent** Treatment plan addresses all issues raised by diagnoses, excellent insight into patient’s needs. Medications prescribed are appropriate and full prescription is included. Evidence based decisions. Cost effective treatment.<br> <br>**15 to >10.0 ptsGood** Treatment plan addresses most issues raised by diagnoses. Medications prescribed are appropriate but include 1 or 2 error in writing prescription.<br> <br>**10 to >5.0 ptsFair** Treatment plan fails to address most issues raised by diagnoses. Medications are inappropriate or include 3 or more errors in writing prescription.<br> <br>**5 to >0 ptsPoor** Minimal treatment plan addressed. Medications are inappropriate or poorly written prescription. | 20 pts |
    | This criterion is linked to a Learning OutcomePatient Education / Follow Up / Reflection | **10 to >8.0 ptsExcellent** Patient education addresses all issues raised by diagnoses, excellent insight into patient’s needs. Follow up plan in appropriate and reflects acuity of illness. Reflection is thoughtful and in depth.<br> <br>**8 to >5.0 ptsGood** Patient education addresses most issues raised by diagnoses. Follow up plan is appropriate but lacks specifics Reflection is thoughtful and in depth.<br> <br>**5 to >3.0 ptsFair** Patient education fails to address most issues raised by diagnoses. Follow up plan is lacking specifics or is inappropriate for patient acuity. Reflection is brief, vague. and does not discuss anything that would have been done in addition to or differently.<br> <br>**3 to >0 ptsPoor** Minimal patient education addressed. Follow up plan is inappropriate Reflection is absent. | 10 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation. Professional language utilized | **5 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors. Professional language utilized.<br> <br>**4 ptsGood** Contains a few (1-2) grammar, spelling, and punctuation errors. Contains a few errors (1 or 2) in professional language use.<br> <br>**2 ptsFair** Contains several (3-4) grammar, spelling, and punctuation errors. Contains several errors (3 -4) in professional language use.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Contains many errors in professional language use. | 5 pts |
    | This criterion is linked to a Learning OutcomeScholarly References and Clinical Practice Guidelines. The assignment includes a minimum of 3 scholarly references that are not older than 5 years. Clinical practice guidelines are included if applicable. | **5 ptsExcellent** Contains parenthetical/in-text citations and at least 3 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**4 ptsGood** Contains parenthetical/in-text citations and at least 2 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**2 ptsFair** Contains parenthetical/in-text citations and at least 1 evidenced based reference less than 5 years old is listed. Clinical practice guidelines are not cited if applicable.<br> <br>**0 ptsPoor** Contains no parenthetical/in-text citations and 0 evidenced based references listed. Clinical practice guidelines are not cited if applicable. | 5 pts |

    **## GIfocusednote.docx**

    Episodic Visit: Gastrointestinal or Genitourinary Condition Focused Note

    Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

    For this Assignment, you will work with a pediatric patient with gastrointestinal or genitourinary condition that you examined during the last 3 weeks, and complete a Focused SOAP Note Template in which you will gather patient information, relevant diagnostic and treatment information, and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc. In this week’s Learning Resources as well as prior week’s resources, please refer to the Focused Note resources for guidance on writing Focused Notes.

    **Note**: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using Turnitin.

    **Note**: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/172095/modules/items/6936939)

    **To prepare:**

    · Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment.

    · Use the Focused SOAP Note Template found in the Learning Resources for this week to complete this Assignment.

    · Select a patient with gastrointestinal or genitourinary condition that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note.

    **Assignment**

    · Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies.

    · Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.

    · Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 codes for the diagnosis. What was your primary diagnosis and why?

    · Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.

    · Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

    **Note**: Your Focused Note Assignment must be signed by Day 7 of Week 9.

    By Day 7

    **Submit** your Gastrointestinal or Genitourinary Condition Focused Note Assignment. (
    **Note**: You will submit two files, your Focused Note Assignment, and a Word document of pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 9.)

    submission information

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the
    **Turnitin Drafts** from the
    **Start Here** area.

    1. To submit your completed assignment, save your Assignment as
    **WK9Assgn2+last name+first initial.**

    2. Then, click on
    **Start Assignment** near the top of the page.

    3. Next, click on
    **Upload File** and select
    **Submit Assignment** for review.

    Rubric

    **PRAC_6541_Week9_Assignment2_Rubric**

    | | | |
    | — | — | — |
    | PRAC_6541_Week9_Assignment2_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeOrganization of Write-up | **10 to >6.0 ptsExcellent** All information organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**6 to >3.0 ptsGood** Information generally organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**3 to >0.0 ptsFair** Errors in format; information intermittently organized. Headings are used some of the time.<br> <br>**0 ptsPoor** Errors in format; information disorganized. Headings are not used appropriately. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of History | **20 to >15.0 ptsExcellent** Thoroughly documents all pertinent history components for type of note; includes critical as well as supportive information.<br> <br>**15 to >11.0 ptsGood** Documents most pertinent examination components.<br> <br>**11 to >7.0 ptsFair** Documents some pertinent examination components.<br> <br>**7 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 20 pts |
    | This criterion is linked to a Learning OutcomeHistory of Present Illness | **10 to >6.0 ptsExcellent** Thoroughly documents all 8 aspects of HPI and pertinent other data relevant to chief complaint. Includes critical as well as supportive information.<br> <br>**6 to >4.0 ptsGood** Documents at least 6 aspects of the HPI and pertinent other data relevant to chief complaint. Includes critical information.<br> <br>**4 to >2.0 ptsFair** Documents at least 4 aspects of HPI and some data pertinent to chief complaint. Lacks some critical information or rambling in history.<br> <br>**2 to >0 ptsPoor** Missing many aspects of HPI and pertinent data. Critical information missing. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of Physical Exam | **10 to >7.0 ptsExcellent** Thoroughly documents all pertinent examination components for type of note.<br> <br>**7 to >4.0 ptsGood** Documents most pertinent examination components.<br> <br>**4 to >2.0 ptsFair** Documents some pertinent examination components.<br> <br>**2 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 10 pts |
    | This criterion is linked to a Learning OutcomeDiagnostic Reasoning | **10 to >7.0 ptsExcellent** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes all secondary problems. Cost effective when ordering diagnostic tests.<br> <br>**7 to >4.0 ptsGood** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes most secondary problems.<br> <br>**4 to >2.0 ptsFair** Assessment mostly consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests.<br> <br>**2 to >0 ptsPoor** Assessment not consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests. | 10 pts |
    | This criterion is linked to a Learning OutcomeTreatment Plan/Patient Education | **20 to >15.0 ptsExcellent** Treatment plan addresses all issues raised by diagnoses, excellent insight into patient’s needs. Medications prescribed are appropriate and full prescription is included. Evidence based decisions. Cost effective treatment.<br> <br>**15 to >10.0 ptsGood** Treatment plan addresses most issues raised by diagnoses. Medications prescribed are appropriate but include 1 or 2 error in writing prescription.<br> <br>**10 to >5.0 ptsFair** Treatment plan fails to address most issues raised by diagnoses. Medications are inappropriate or include 3 or more errors in writing prescription.<br> <br>**5 to >0 ptsPoor** Minimal treatment plan addressed. Medications are inappropriate or poorly written prescription. | 20 pts |
    | This criterion is linked to a Learning OutcomePatient Education / Follow Up / Reflection | **10 to >8.0 ptsExcellent** Patient education addresses all issues raised by diagnoses, excellent insight into patient’s needs. Follow up plan in appropriate and reflects acuity of illness. Reflection is thoughtful and in depth.<br> <br>**8 to >5.0 ptsGood** Patient education addresses most issues raised by diagnoses. Follow up plan is appropriate but lacks specifics Reflection is thoughtful and in depth.<br> <br>**5 to >3.0 ptsFair** Patient education fails to address most issues raised by diagnoses. Follow up plan is lacking specifics or is inappropriate for patient acuity. Reflection is brief, vague. and does not discuss anything that would have been done in addition to or differently.<br> <br>**3 to >0 ptsPoor** Minimal patient education addressed. Follow up plan is inappropriate Reflection is absent. | 10 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation. Professional language utilized | **5 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors. Professional language utilized.<br> <br>**4 ptsGood** Contains a few (1-2) grammar, spelling, and punctuation errors. Contains a few errors (1 or 2) in professional language use.<br> <br>**2 ptsFair** Contains several (3-4) grammar, spelling, and punctuation errors. Contains several errors (3 -4) in professional language use.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Contains many errors in professional language use. | 5 pts |
    | This criterion is linked to a Learning OutcomeScholarly References and Clinical Practice Guidelines. The assignment includes a minimum of 3 scholarly references that are not older than 5 years. Clinical practice guidelines are included if applicable. | **5 ptsExcellent** Contains parenthetical/in-text citations and at least 3 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**4 ptsGood** Contains parenthetical/in-text citations and at least 2 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**2 ptsFair** Contains parenthetical/in-text citations and at least 1 evidenced based reference less than 5 years old is listed. Clinical practice guidelines are not cited if applicable.<br> <br>**0 ptsPoor** Contains no parenthetical/in-text citations and 0 evidenced based references listed. Clinical practice guidelines are not cited if applicable. | 5 pts |

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    JWI 556 (1196) Page 1 of 9

    JWI 556
    Leading Change by Putting People First

    Week Three Lecture Notes

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 2 of 9

    SETTING THE STAGE FOR CHANGE

    What It Means

    Proper planning is critical in leading change initiatives, especially large-scale ones. No matter
    how tempting it may be to just get on with it, you have to prepare both the plan and the people
    who will be change agents along with you in order to succeed. Without a solid foundation in
    place, your enthusiasm for the initiative will not be enough to get the change done.

    Why It Matters

    • Successful change begins with urgency. You have to get people excited or frightened
    enough to break them out of their complacency and comfort zones. Without this, you just
    won’t have the rocket fuel to get off the ground.

    • Change is not a solo activity. You need a group of engaged teammates whom others
    respect and look to for leadership. This is your guiding coalition, your inner circle, your
    frontline army in the battle against the status quo. These people will be both a support
    network and a means to spread the change message beyond what you can do alone.

    • You must create a vision of the Promised Land. Without this clear and compelling picture
    of the future state, people won’t really understand why the change will be good for them,
    and with the first signs of resistance, they will give up.

    “Good leaders create a vision and relentlessly drive it to completion.”

    Jack Welch

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 3 of 9

    THE ROLE OF LEADERSHIP IN CREATING A SENSE OF URGENCY
    AND COMBATING COMPLACENCY

    “To get ahead of the competition, a change leader must create urgency and a need that
    isn’t obvious to the general population.”

    Jack Welch

    Kotter argues that complacency arises from a fundamental disconnect between what is happening
    outside an organization and what people are seeing, feeling, and believing inside it.

    “Much of the problem here is related to historical victories – for the firm as a whole, for
    departments, and for individuals. Past success provides too many resources, reduces our
    sense of urgency, and encourages us to turn inward. For individuals, it creates an ego
    problem; for firms, a cultural problem.”

    Leading Change, p. 44

    The starting point for building a case for change is the systematic collection of data to illuminate risks and
    opportunities. Building a business case can be a shared or a distributed activity. Deliberately increasing
    people’s contact with external constituencies – such as through customer meetings, conferences,
    consultants, or participation in external projects – and making sure that new questions or insights are
    identified and shared can help build urgency.

    Business case development is frequently a top-down activity. But it is important to remember that people
    on the “frontlines” of an organization often have the best insights into what is happening on the outside.
    This includes sales people and customer service reps. It can also include people who are new to the
    organization, especially those who come from a competitor, supplier, or customer.

    Of course, the business case will be different in each situation, but here are some signs you should pay
    attention to that can form the cornerstone of a case for change:

    • A crisis of any kind
    • Negative trends in key performance indicators (e.g., sales, profits, membership, market share,

    new customers)
    • Emergence of a new competitor or game-changing technology in your industry
    • Emergence of a new competitor or game-changing technology in an adjacent industry (think

    about the impact the iPod had on the music industry)
    • Restructuring or consolidation in your industry or among your customers or suppliers
    • Big social or demographic shifts
    • Changes in popular culture or values
    • Emerging needs, markets, or skills in other countries
    • Trends toward significant shortages or availability of key inputs or outputs

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 4 of 9

    If you see any of these happening, major changes are probably coming. Build a case around these
    trends, and then communicate the way forward with everything you’ve got.

    “Establishing a sense of urgency is crucial to gaining needed cooperation. With
    complacency high, transformations usually go nowhere because few people are even
    interested in working on the change problem. With urgency low, it’s difficult to put
    together a group with enough power and credibility to guide the effort or to convince key
    individuals to spend the time necessary to create and communicate a change vision.”

    Leading Change, pp. 37-38

    What is it about crises that releases hidden potential and allows change to happen so quickly?

    • Everyone involved sees the clear consequences of failure and the unambiguous measures of
    success; waiting to act is not an option – results must be achieved quickly

    • People jump in to do whatever they can, regardless of formal position or job title
    • There’s lots of experimentation and a willingness to take good ideas from anyone on the team
    • Participants feel a great sense of teamwork; competing agendas and priorities are suspended in

    service to a clear, common goal

    Kotter posits that “creating a strong sense of urgency usually demands bold or even risky actions that we
    normally associate with good leadership.” He suggests nine ways to raise the urgency level:

    1. Create a crisis by allowing a financial loss or even allowing errors to go unchecked

    2. Eliminate obvious examples of excess

    3. Set performance targets so high that they can’t be reached without change

    4. Establish broader performance metrics that hold everyone accountable

    5. Send out more data on substandard performance relative to the competition

    6. Make people talk to unsatisfied customers

    7. Bring in consultants to force discussion of unfavorable data

    8. Stop the “happy talk” from senior management and focus on the problems

    9. Bombard people with information about opportunities for a better future

    Leading Change, p. 46

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 5 of 9

    THE IMPORTANCE OF AN EFFECTIVE COALITION,
    AND HOW TO BUILD ONE

    “Pick your change partners wisely…Don’t make the mistake of thinking you can,

    or even have to convince every last person to support change, and don’t let
    the negative polluters poison the well.”

    Jack Welch

    In a world as complex and fast-moving as the one we live in today, no leader can drive change alone.
    Regardless of intelligence, power, or charisma, one person cannot foresee the thousands of changes that
    need to be made to transform an organization or affect all the people who are part of it. The success of a
    major change initiative hinges on leaders who can mobilize the necessary commitment from key people
    throughout the organization – a guiding coalition.

    “No one individual, even a monarch-like CEO, is ever able to develop the right vision,
    communicate it to large numbers of people, eliminate all the key obstacles, generate
    short-term wins, lead and manage dozens of change projects, and anchor new
    approaches deep in the organization’s culture.”

    Leading Change, p. 53

    Beyond the guiding coalition, you can think more broadly about who else’s commitment you need to
    mobilize in order to win hearts and minds and spread the word about the change initiative. You want to
    think about key functions or locations that are so central to the organization’s identity or competitive
    advantage that they have their own center of gravity. If people in these areas do not get with the change
    program, they will hold others back. Conversely, if they do get with it, their momentum pulls others
    forward. Consider including respected thought leaders in the organization as well. They may be
    experienced people with unique and valued functional expertise, or rising stars who have captured
    attention for their competence or brilliance. They may be behind-the-scenes types who have quietly built
    the organization’s intellectual capital.

    Kotter advises that a guiding coalition needs to have four key characteristics:

    1. Position Power: Are enough key players on board, especially the main line managers, so that
    those left out cannot easily block progress?

    2. Expertise: Are the various points of view – in terms of discipline, work experience, nationality,
    etc. – relevant to the task at hand adequately represented so that informed, intelligent decisions
    will be made?

    3. Credibility: Does the group have enough people with good reputations in the firm so that its
    pronouncements will be taken seriously by other employees?

    4. Leadership: Does the group include enough proven leaders to be able to drive the change
    process?

    Leading Change, p. 59

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 6 of 9

    Who should we avoid bringing into our guiding coalitions?

    Kotter and Jack both caution us to avoid egos and snakes. The former will grab all the attention for
    themselves and leave no room for anyone else. The latter may support the effort, but their real love in life
    is sowing the seeds of doubt and spreading gossip. They also advise us to avoid reluctant participants
    who will join because they feel they have to, but who either: (a) really don’t want to lead the change, even
    if they agree with it, or (b) are just too busy to contribute what you need them to do.

    There is one additional piece of advice from Kotter that draws us back to the “leader-versus-manager”
    distinction presented in Week 1:

    “A guiding coalition with good managers but poor leaders will not succeed. A managerial
    mindset will develop plans, not vision; it will vastly undercommunicate the need for and
    direction of change; and it will control rather than empower people…A guiding coalition
    made up of only managers – even superb managers who are wonderful people – will
    cause major change efforts to fail.”

    Leading Change, p. 61

    Given everything we have learned about the importance of guiding coalitions, we might ask why all
    change initiatives don’t begin with them.

    Kotter suggests the following:

    “Most senior-level executives were raised managerially in an era when teamwork was not
    essential. They may have talked ‘team’ and used sports metaphors, but the reality was
    hierarchical – typically, a boss and his eight direct reports. Having seen many examples
    of poorly functioning committees, where everything moves slower instead of faster, they
    are often much more comfortable in sticking with the old format, even if it is working less
    and less well over time.

    The net result: In a lot of reengineering and restrategizing efforts, people simply skip this
    step or give it minimum attention. They then race ahead to try to create the vision, or
    downsize the organization, or whatever. But sooner or later, the lack of a strong team to
    guide the effort proves fatal.”

    Leading Change, pp. 58-59

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 7 of 9

    CREATING AND SHARING THE VISION FOR A CHANGE

    “Good leaders create a vision, articulate the vision, passionately own the vision,

    and relentlessly drive it to completion.”

    Jack Welch

    Kotter argues that an effective, well-communicated vision for change accomplishes three tasks:

    I. “[A] good vision can help clear the decks of expensive and time-consuming clutter. With
    clarity of direction, inappropriate projects can be identified and terminated, even if they
    have political support. The resources thus freed can be put toward the transformation
    process.”

    II. “A good vision helps to overcome…natural reluctance to do what is (often painfully)
    necessary by being hopeful and therefore motivating. A good vision acknowledges that
    sacrifices will be necessary but makes clear that these sacrifices will yield particular
    benefits and personal satisfactions that are far superior to those available today – or
    tomorrow – without attempting to change.”

    III. “[V]ision helps align individuals, thus coordinating the actions of motivated people in a
    remarkably efficient way.”

    Leading Change, pp. 71-72

    Since the term “vision” can come with a lot of different interpretations or baggage, let’s remind ourselves
    that Kotter defines vision as “a picture of the future with some implicit or explicit commentary on why
    people should strive to create that future.” He lays out six characteristics of an effective vision.

    1. Imaginable: Conveys a picture of what the future will look like

    2. Desirable: Appeals to the long-term interests of employees, customers, stockholders, and others
    who have a stake in the enterprise

    3. Feasible: Comprises realistic, attainable goals

    4. Focused: Is clear enough to provide guidance in decision making

    5. Flexible: Is general enough to allow individual initiative and alternative responses in light of
    changing conditions

    6. Communicable: Is easy to communicate; can be successfully explained within five minutes

    Leading Change, p. 74

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 8 of 9

    Although it is the leader’s job to make sure a compelling vision is created and communicated, vision-
    setting needs to be a group effort.

    The final simplicity of good visions can be deceptive. In fact, they are the result of long and hard
    discussions among the leadership team. They are hard because they must work through the implications
    of what stays and what goes, where trade-offs will be made, where resources will be focused and where
    they will be withdrawn, and which projects are consistent with the vision and which are not. The
    leadership team needs to be able to predict the implications of the vision for a range of future
    contingencies, most of them unknown.

    Ideally, the essence of a vision can be captured in a compelling couple of sentences. But this statement
    cannot stand alone. People need to translate it into what we specifically need to do and what success will
    look like. Taking the time to work through these elements helps ensure that the pieces fit together.

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 9 of 9

    GETTING THE MOST OUT OF THIS WEEK’S CLASS

    As you read the materials and participate in class activities, stay focused on the key learning outcomes
    for the week:

    • Explore the role of leadership in creating a sense of urgency and combating complacency

    Thinking about a specific change initiative you are passionate about, what sense of urgency
    exists among your colleagues that this change is critical to the success of the organization and
    should be pursued sooner rather than later? What sources can you leverage to combat
    complacency? What are your customers saying about the current state? What are competitors
    doing in this space to change the game? What is the likely outcome if the change is not made?
    What, if anything, has already been done to address the issue, and what was the outcome?
    Conduct a focus group with a small number of colleagues who will be impacted by this change.
    Identify three positive results that would come from the change and three negatives if the change
    is not made.

    • Understand the importance of an effective guiding coalition, and how to build one

    As Jack says, “pick your change partners wisely.” Ask around. How can you assess the people
    who might be the ones you want to partner with? Choose carefully, because a bad decision here
    could spell the end of the change before it gets off the ground. What roles will you want to have
    represented? You will need people with the right technical skills, influence, and energy to drive
    the change forward. Talk to recruits for your guiding coalition to feel them out. Start to build a list
    of potential change agents you can leverage.

    • Leverage strategies to create and share the vision for a change

    Refine your change vision. What should definitely be in scope and out of scope of the initiative?
    Craft a vison of the change that can be shared with others. Your vision should be a bit like an
    “elevator pitch” with:

    o A clear and succinct presentation of the problem to be addressed (ideally with data to
    validate the statement)

    o An action statement of what the team proposes to do, including clear parameters of the
    scope of the project

    o An outcome statement of what will be accomplished through the change that clearly
    articulates what success will look like

    Ask others to validate the vision. Do they get excited? Does it make sense? Can they see it
    actually happening? Have your change leadership group present it back to you, and continue to
    refine and tighten it until it is precise, easily understood, and compelling.

    **JWI556SharellResponseWeek3.jpeg**

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    **JWI556JavondaResponseWeek3.jpeg**

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    **Week3Discussion556.jpeg**

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    **Week3Discussion556.jpeg**

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    **## JWI556Week3LectureNotes.pdf**

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 1 of 9

    JWI 556
    Leading Change by Putting People First

    Week Three Lecture Notes

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 2 of 9

    SETTING THE STAGE FOR CHANGE

    What It Means

    Proper planning is critical in leading change initiatives, especially large-scale ones. No matter
    how tempting it may be to just get on with it, you have to prepare both the plan and the people
    who will be change agents along with you in order to succeed. Without a solid foundation in
    place, your enthusiasm for the initiative will not be enough to get the change done.

    Why It Matters

    • Successful change begins with urgency. You have to get people excited or frightened
    enough to break them out of their complacency and comfort zones. Without this, you just
    won’t have the rocket fuel to get off the ground.

    • Change is not a solo activity. You need a group of engaged teammates whom others
    respect and look to for leadership. This is your guiding coalition, your inner circle, your
    frontline army in the battle against the status quo. These people will be both a support
    network and a means to spread the change message beyond what you can do alone.

    • You must create a vision of the Promised Land. Without this clear and compelling picture
    of the future state, people won’t really understand why the change will be good for them,
    and with the first signs of resistance, they will give up.

    “Good leaders create a vision and relentlessly drive it to completion.”

    Jack Welch

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 3 of 9

    THE ROLE OF LEADERSHIP IN CREATING A SENSE OF URGENCY
    AND COMBATING COMPLACENCY

    “To get ahead of the competition, a change leader must create urgency and a need that
    isn’t obvious to the general population.”

    Jack Welch

    Kotter argues that complacency arises from a fundamental disconnect between what is happening
    outside an organization and what people are seeing, feeling, and believing inside it.

    “Much of the problem here is related to historical victories – for the firm as a whole, for
    departments, and for individuals. Past success provides too many resources, reduces our
    sense of urgency, and encourages us to turn inward. For individuals, it creates an ego
    problem; for firms, a cultural problem.”

    Leading Change, p. 44

    The starting point for building a case for change is the systematic collection of data to illuminate risks and
    opportunities. Building a business case can be a shared or a distributed activity. Deliberately increasing
    people’s contact with external constituencies – such as through customer meetings, conferences,
    consultants, or participation in external projects – and making sure that new questions or insights are
    identified and shared can help build urgency.

    Business case development is frequently a top-down activity. But it is important to remember that people
    on the “frontlines” of an organization often have the best insights into what is happening on the outside.
    This includes sales people and customer service reps. It can also include people who are new to the
    organization, especially those who come from a competitor, supplier, or customer.

    Of course, the business case will be different in each situation, but here are some signs you should pay
    attention to that can form the cornerstone of a case for change:

    • A crisis of any kind
    • Negative trends in key performance indicators (e.g., sales, profits, membership, market share,

    new customers)
    • Emergence of a new competitor or game-changing technology in your industry
    • Emergence of a new competitor or game-changing technology in an adjacent industry (think

    about the impact the iPod had on the music industry)
    • Restructuring or consolidation in your industry or among your customers or suppliers
    • Big social or demographic shifts
    • Changes in popular culture or values
    • Emerging needs, markets, or skills in other countries
    • Trends toward significant shortages or availability of key inputs or outputs

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 4 of 9

    If you see any of these happening, major changes are probably coming. Build a case around these
    trends, and then communicate the way forward with everything you’ve got.

    “Establishing a sense of urgency is crucial to gaining needed cooperation. With
    complacency high, transformations usually go nowhere because few people are even
    interested in working on the change problem. With urgency low, it’s difficult to put
    together a group with enough power and credibility to guide the effort or to convince key
    individuals to spend the time necessary to create and communicate a change vision.”

    Leading Change, pp. 37-38

    What is it about crises that releases hidden potential and allows change to happen so quickly?

    • Everyone involved sees the clear consequences of failure and the unambiguous measures of
    success; waiting to act is not an option – results must be achieved quickly

    • People jump in to do whatever they can, regardless of formal position or job title
    • There’s lots of experimentation and a willingness to take good ideas from anyone on the team
    • Participants feel a great sense of teamwork; competing agendas and priorities are suspended in

    service to a clear, common goal

    Kotter posits that “creating a strong sense of urgency usually demands bold or even risky actions that we
    normally associate with good leadership.” He suggests nine ways to raise the urgency level:

    1. Create a crisis by allowing a financial loss or even allowing errors to go unchecked

    2. Eliminate obvious examples of excess

    3. Set performance targets so high that they can’t be reached without change

    4. Establish broader performance metrics that hold everyone accountable

    5. Send out more data on substandard performance relative to the competition

    6. Make people talk to unsatisfied customers

    7. Bring in consultants to force discussion of unfavorable data

    8. Stop the “happy talk” from senior management and focus on the problems

    9. Bombard people with information about opportunities for a better future

    Leading Change, p. 46

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 5 of 9

    THE IMPORTANCE OF AN EFFECTIVE COALITION,
    AND HOW TO BUILD ONE

    “Pick your change partners wisely…Don’t make the mistake of thinking you can,

    or even have to convince every last person to support change, and don’t let
    the negative polluters poison the well.”

    Jack Welch

    In a world as complex and fast-moving as the one we live in today, no leader can drive change alone.
    Regardless of intelligence, power, or charisma, one person cannot foresee the thousands of changes that
    need to be made to transform an organization or affect all the people who are part of it. The success of a
    major change initiative hinges on leaders who can mobilize the necessary commitment from key people
    throughout the organization – a guiding coalition.

    “No one individual, even a monarch-like CEO, is ever able to develop the right vision,
    communicate it to large numbers of people, eliminate all the key obstacles, generate
    short-term wins, lead and manage dozens of change projects, and anchor new
    approaches deep in the organization’s culture.”

    Leading Change, p. 53

    Beyond the guiding coalition, you can think more broadly about who else’s commitment you need to
    mobilize in order to win hearts and minds and spread the word about the change initiative. You want to
    think about key functions or locations that are so central to the organization’s identity or competitive
    advantage that they have their own center of gravity. If people in these areas do not get with the change
    program, they will hold others back. Conversely, if they do get with it, their momentum pulls others
    forward. Consider including respected thought leaders in the organization as well. They may be
    experienced people with unique and valued functional expertise, or rising stars who have captured
    attention for their competence or brilliance. They may be behind-the-scenes types who have quietly built
    the organization’s intellectual capital.

    Kotter advises that a guiding coalition needs to have four key characteristics:

    1. Position Power: Are enough key players on board, especially the main line managers, so that
    those left out cannot easily block progress?

    2. Expertise: Are the various points of view – in terms of discipline, work experience, nationality,
    etc. – relevant to the task at hand adequately represented so that informed, intelligent decisions
    will be made?

    3. Credibility: Does the group have enough people with good reputations in the firm so that its
    pronouncements will be taken seriously by other employees?

    4. Leadership: Does the group include enough proven leaders to be able to drive the change
    process?

    Leading Change, p. 59

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 6 of 9

    Who should we avoid bringing into our guiding coalitions?

    Kotter and Jack both caution us to avoid egos and snakes. The former will grab all the attention for
    themselves and leave no room for anyone else. The latter may support the effort, but their real love in life
    is sowing the seeds of doubt and spreading gossip. They also advise us to avoid reluctant participants
    who will join because they feel they have to, but who either: (a) really don’t want to lead the change, even
    if they agree with it, or (b) are just too busy to contribute what you need them to do.

    There is one additional piece of advice from Kotter that draws us back to the “leader-versus-manager”
    distinction presented in Week 1:

    “A guiding coalition with good managers but poor leaders will not succeed. A managerial
    mindset will develop plans, not vision; it will vastly undercommunicate the need for and
    direction of change; and it will control rather than empower people…A guiding coalition
    made up of only managers – even superb managers who are wonderful people – will
    cause major change efforts to fail.”

    Leading Change, p. 61

    Given everything we have learned about the importance of guiding coalitions, we might ask why all
    change initiatives don’t begin with them.

    Kotter suggests the following:

    “Most senior-level executives were raised managerially in an era when teamwork was not
    essential. They may have talked ‘team’ and used sports metaphors, but the reality was
    hierarchical – typically, a boss and his eight direct reports. Having seen many examples
    of poorly functioning committees, where everything moves slower instead of faster, they
    are often much more comfortable in sticking with the old format, even if it is working less
    and less well over time.

    The net result: In a lot of reengineering and restrategizing efforts, people simply skip this
    step or give it minimum attention. They then race ahead to try to create the vision, or
    downsize the organization, or whatever. But sooner or later, the lack of a strong team to
    guide the effort proves fatal.”

    Leading Change, pp. 58-59

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 7 of 9

    CREATING AND SHARING THE VISION FOR A CHANGE

    “Good leaders create a vision, articulate the vision, passionately own the vision,

    and relentlessly drive it to completion.”

    Jack Welch

    Kotter argues that an effective, well-communicated vision for change accomplishes three tasks:

    I. “[A] good vision can help clear the decks of expensive and time-consuming clutter. With
    clarity of direction, inappropriate projects can be identified and terminated, even if they
    have political support. The resources thus freed can be put toward the transformation
    process.”

    II. “A good vision helps to overcome…natural reluctance to do what is (often painfully)
    necessary by being hopeful and therefore motivating. A good vision acknowledges that
    sacrifices will be necessary but makes clear that these sacrifices will yield particular
    benefits and personal satisfactions that are far superior to those available today – or
    tomorrow – without attempting to change.”

    III. “[V]ision helps align individuals, thus coordinating the actions of motivated people in a
    remarkably efficient way.”

    Leading Change, pp. 71-72

    Since the term “vision” can come with a lot of different interpretations or baggage, let’s remind ourselves
    that Kotter defines vision as “a picture of the future with some implicit or explicit commentary on why
    people should strive to create that future.” He lays out six characteristics of an effective vision.

    1. Imaginable: Conveys a picture of what the future will look like

    2. Desirable: Appeals to the long-term interests of employees, customers, stockholders, and others
    who have a stake in the enterprise

    3. Feasible: Comprises realistic, attainable goals

    4. Focused: Is clear enough to provide guidance in decision making

    5. Flexible: Is general enough to allow individual initiative and alternative responses in light of
    changing conditions

    6. Communicable: Is easy to communicate; can be successfully explained within five minutes

    Leading Change, p. 74

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 8 of 9

    Although it is the leader’s job to make sure a compelling vision is created and communicated, vision-
    setting needs to be a group effort.

    The final simplicity of good visions can be deceptive. In fact, they are the result of long and hard
    discussions among the leadership team. They are hard because they must work through the implications
    of what stays and what goes, where trade-offs will be made, where resources will be focused and where
    they will be withdrawn, and which projects are consistent with the vision and which are not. The
    leadership team needs to be able to predict the implications of the vision for a range of future
    contingencies, most of them unknown.

    Ideally, the essence of a vision can be captured in a compelling couple of sentences. But this statement
    cannot stand alone. People need to translate it into what we specifically need to do and what success will
    look like. Taking the time to work through these elements helps ensure that the pieces fit together.

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 9 of 9

    GETTING THE MOST OUT OF THIS WEEK’S CLASS

    As you read the materials and participate in class activities, stay focused on the key learning outcomes
    for the week:

    • Explore the role of leadership in creating a sense of urgency and combating complacency

    Thinking about a specific change initiative you are passionate about, what sense of urgency
    exists among your colleagues that this change is critical to the success of the organization and
    should be pursued sooner rather than later? What sources can you leverage to combat
    complacency? What are your customers saying about the current state? What are competitors
    doing in this space to change the game? What is the likely outcome if the change is not made?
    What, if anything, has already been done to address the issue, and what was the outcome?
    Conduct a focus group with a small number of colleagues who will be impacted by this change.
    Identify three positive results that would come from the change and three negatives if the change
    is not made.

    • Understand the importance of an effective guiding coalition, and how to build one

    As Jack says, “pick your change partners wisely.” Ask around. How can you assess the people
    who might be the ones you want to partner with? Choose carefully, because a bad decision here
    could spell the end of the change before it gets off the ground. What roles will you want to have
    represented? You will need people with the right technical skills, influence, and energy to drive
    the change forward. Talk to recruits for your guiding coalition to feel them out. Start to build a list
    of potential change agents you can leverage.

    • Leverage strategies to create and share the vision for a change

    Refine your change vision. What should definitely be in scope and out of scope of the initiative?
    Craft a vison of the change that can be shared with others. Your vision should be a bit like an
    “elevator pitch” with:

    o A clear and succinct presentation of the problem to be addressed (ideally with data to
    validate the statement)

    o An action statement of what the team proposes to do, including clear parameters of the
    scope of the project

    o An outcome statement of what will be accomplished through the change that clearly
    articulates what success will look like

    Ask others to validate the vision. Do they get excited? Does it make sense? Can they see it
    actually happening? Have your change leadership group present it back to you, and continue to
    refine and tighten it until it is precise, easily understood, and compelling.

    **JWI556SharellResponseWeek3.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/jwi556sharellresponseweek3-jpeg)

    **JWI556JavondaResponseWeek3.jpeg**

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    **Week3Discussion556.jpeg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/week3discussion556-jpeg)

    **## JWI556Week3LectureNotes.pdf**

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 1 of 9

    JWI 556
    Leading Change by Putting People First

    Week Three Lecture Notes

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 2 of 9

    SETTING THE STAGE FOR CHANGE

    What It Means

    Proper planning is critical in leading change initiatives, especially large-scale ones. No matter
    how tempting it may be to just get on with it, you have to prepare both the plan and the people
    who will be change agents along with you in order to succeed. Without a solid foundation in
    place, your enthusiasm for the initiative will not be enough to get the change done.

    Why It Matters

    • Successful change begins with urgency. You have to get people excited or frightened
    enough to break them out of their complacency and comfort zones. Without this, you just
    won’t have the rocket fuel to get off the ground.

    • Change is not a solo activity. You need a group of engaged teammates whom others
    respect and look to for leadership. This is your guiding coalition, your inner circle, your
    frontline army in the battle against the status quo. These people will be both a support
    network and a means to spread the change message beyond what you can do alone.

    • You must create a vision of the Promised Land. Without this clear and compelling picture
    of the future state, people won’t really understand why the change will be good for them,
    and with the first signs of resistance, they will give up.

    “Good leaders create a vision and relentlessly drive it to completion.”

    Jack Welch

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 3 of 9

    THE ROLE OF LEADERSHIP IN CREATING A SENSE OF URGENCY
    AND COMBATING COMPLACENCY

    “To get ahead of the competition, a change leader must create urgency and a need that
    isn’t obvious to the general population.”

    Jack Welch

    Kotter argues that complacency arises from a fundamental disconnect between what is happening
    outside an organization and what people are seeing, feeling, and believing inside it.

    “Much of the problem here is related to historical victories – for the firm as a whole, for
    departments, and for individuals. Past success provides too many resources, reduces our
    sense of urgency, and encourages us to turn inward. For individuals, it creates an ego
    problem; for firms, a cultural problem.”

    Leading Change, p. 44

    The starting point for building a case for change is the systematic collection of data to illuminate risks and
    opportunities. Building a business case can be a shared or a distributed activity. Deliberately increasing
    people’s contact with external constituencies – such as through customer meetings, conferences,
    consultants, or participation in external projects – and making sure that new questions or insights are
    identified and shared can help build urgency.

    Business case development is frequently a top-down activity. But it is important to remember that people
    on the “frontlines” of an organization often have the best insights into what is happening on the outside.
    This includes sales people and customer service reps. It can also include people who are new to the
    organization, especially those who come from a competitor, supplier, or customer.

    Of course, the business case will be different in each situation, but here are some signs you should pay
    attention to that can form the cornerstone of a case for change:

    • A crisis of any kind
    • Negative trends in key performance indicators (e.g., sales, profits, membership, market share,

    new customers)
    • Emergence of a new competitor or game-changing technology in your industry
    • Emergence of a new competitor or game-changing technology in an adjacent industry (think

    about the impact the iPod had on the music industry)
    • Restructuring or consolidation in your industry or among your customers or suppliers
    • Big social or demographic shifts
    • Changes in popular culture or values
    • Emerging needs, markets, or skills in other countries
    • Trends toward significant shortages or availability of key inputs or outputs

    © Strayer University. All Rights Reserved. This document contains Strayer University Confidential and Proprietary information and may not
    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 4 of 9

    If you see any of these happening, major changes are probably coming. Build a case around these
    trends, and then communicate the way forward with everything you’ve got.

    “Establishing a sense of urgency is crucial to gaining needed cooperation. With
    complacency high, transformations usually go nowhere because few people are even
    interested in working on the change problem. With urgency low, it’s difficult to put
    together a group with enough power and credibility to guide the effort or to convince key
    individuals to spend the time necessary to create and communicate a change vision.”

    Leading Change, pp. 37-38

    What is it about crises that releases hidden potential and allows change to happen so quickly?

    • Everyone involved sees the clear consequences of failure and the unambiguous measures of
    success; waiting to act is not an option – results must be achieved quickly

    • People jump in to do whatever they can, regardless of formal position or job title
    • There’s lots of experimentation and a willingness to take good ideas from anyone on the team
    • Participants feel a great sense of teamwork; competing agendas and priorities are suspended in

    service to a clear, common goal

    Kotter posits that “creating a strong sense of urgency usually demands bold or even risky actions that we
    normally associate with good leadership.” He suggests nine ways to raise the urgency level:

    1. Create a crisis by allowing a financial loss or even allowing errors to go unchecked

    2. Eliminate obvious examples of excess

    3. Set performance targets so high that they can’t be reached without change

    4. Establish broader performance metrics that hold everyone accountable

    5. Send out more data on substandard performance relative to the competition

    6. Make people talk to unsatisfied customers

    7. Bring in consultants to force discussion of unfavorable data

    8. Stop the “happy talk” from senior management and focus on the problems

    9. Bombard people with information about opportunities for a better future

    Leading Change, p. 46

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    JWI 556 (1196) Page 5 of 9

    THE IMPORTANCE OF AN EFFECTIVE COALITION,
    AND HOW TO BUILD ONE

    “Pick your change partners wisely…Don’t make the mistake of thinking you can,

    or even have to convince every last person to support change, and don’t let
    the negative polluters poison the well.”

    Jack Welch

    In a world as complex and fast-moving as the one we live in today, no leader can drive change alone.
    Regardless of intelligence, power, or charisma, one person cannot foresee the thousands of changes that
    need to be made to transform an organization or affect all the people who are part of it. The success of a
    major change initiative hinges on leaders who can mobilize the necessary commitment from key people
    throughout the organization – a guiding coalition.

    “No one individual, even a monarch-like CEO, is ever able to develop the right vision,
    communicate it to large numbers of people, eliminate all the key obstacles, generate
    short-term wins, lead and manage dozens of change projects, and anchor new
    approaches deep in the organization’s culture.”

    Leading Change, p. 53

    Beyond the guiding coalition, you can think more broadly about who else’s commitment you need to
    mobilize in order to win hearts and minds and spread the word about the change initiative. You want to
    think about key functions or locations that are so central to the organization’s identity or competitive
    advantage that they have their own center of gravity. If people in these areas do not get with the change
    program, they will hold others back. Conversely, if they do get with it, their momentum pulls others
    forward. Consider including respected thought leaders in the organization as well. They may be
    experienced people with unique and valued functional expertise, or rising stars who have captured
    attention for their competence or brilliance. They may be behind-the-scenes types who have quietly built
    the organization’s intellectual capital.

    Kotter advises that a guiding coalition needs to have four key characteristics:

    1. Position Power: Are enough key players on board, especially the main line managers, so that
    those left out cannot easily block progress?

    2. Expertise: Are the various points of view – in terms of discipline, work experience, nationality,
    etc. – relevant to the task at hand adequately represented so that informed, intelligent decisions
    will be made?

    3. Credibility: Does the group have enough people with good reputations in the firm so that its
    pronouncements will be taken seriously by other employees?

    4. Leadership: Does the group include enough proven leaders to be able to drive the change
    process?

    Leading Change, p. 59

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    JWI 556 (1196) Page 6 of 9

    Who should we avoid bringing into our guiding coalitions?

    Kotter and Jack both caution us to avoid egos and snakes. The former will grab all the attention for
    themselves and leave no room for anyone else. The latter may support the effort, but their real love in life
    is sowing the seeds of doubt and spreading gossip. They also advise us to avoid reluctant participants
    who will join because they feel they have to, but who either: (a) really don’t want to lead the change, even
    if they agree with it, or (b) are just too busy to contribute what you need them to do.

    There is one additional piece of advice from Kotter that draws us back to the “leader-versus-manager”
    distinction presented in Week 1:

    “A guiding coalition with good managers but poor leaders will not succeed. A managerial
    mindset will develop plans, not vision; it will vastly undercommunicate the need for and
    direction of change; and it will control rather than empower people…A guiding coalition
    made up of only managers – even superb managers who are wonderful people – will
    cause major change efforts to fail.”

    Leading Change, p. 61

    Given everything we have learned about the importance of guiding coalitions, we might ask why all
    change initiatives don’t begin with them.

    Kotter suggests the following:

    “Most senior-level executives were raised managerially in an era when teamwork was not
    essential. They may have talked ‘team’ and used sports metaphors, but the reality was
    hierarchical – typically, a boss and his eight direct reports. Having seen many examples
    of poorly functioning committees, where everything moves slower instead of faster, they
    are often much more comfortable in sticking with the old format, even if it is working less
    and less well over time.

    The net result: In a lot of reengineering and restrategizing efforts, people simply skip this
    step or give it minimum attention. They then race ahead to try to create the vision, or
    downsize the organization, or whatever. But sooner or later, the lack of a strong team to
    guide the effort proves fatal.”

    Leading Change, pp. 58-59

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    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 7 of 9

    CREATING AND SHARING THE VISION FOR A CHANGE

    “Good leaders create a vision, articulate the vision, passionately own the vision,

    and relentlessly drive it to completion.”

    Jack Welch

    Kotter argues that an effective, well-communicated vision for change accomplishes three tasks:

    I. “[A] good vision can help clear the decks of expensive and time-consuming clutter. With
    clarity of direction, inappropriate projects can be identified and terminated, even if they
    have political support. The resources thus freed can be put toward the transformation
    process.”

    II. “A good vision helps to overcome…natural reluctance to do what is (often painfully)
    necessary by being hopeful and therefore motivating. A good vision acknowledges that
    sacrifices will be necessary but makes clear that these sacrifices will yield particular
    benefits and personal satisfactions that are far superior to those available today – or
    tomorrow – without attempting to change.”

    III. “[V]ision helps align individuals, thus coordinating the actions of motivated people in a
    remarkably efficient way.”

    Leading Change, pp. 71-72

    Since the term “vision” can come with a lot of different interpretations or baggage, let’s remind ourselves
    that Kotter defines vision as “a picture of the future with some implicit or explicit commentary on why
    people should strive to create that future.” He lays out six characteristics of an effective vision.

    1. Imaginable: Conveys a picture of what the future will look like

    2. Desirable: Appeals to the long-term interests of employees, customers, stockholders, and others
    who have a stake in the enterprise

    3. Feasible: Comprises realistic, attainable goals

    4. Focused: Is clear enough to provide guidance in decision making

    5. Flexible: Is general enough to allow individual initiative and alternative responses in light of
    changing conditions

    6. Communicable: Is easy to communicate; can be successfully explained within five minutes

    Leading Change, p. 74

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    JWI 556 (1196) Page 8 of 9

    Although it is the leader’s job to make sure a compelling vision is created and communicated, vision-
    setting needs to be a group effort.

    The final simplicity of good visions can be deceptive. In fact, they are the result of long and hard
    discussions among the leadership team. They are hard because they must work through the implications
    of what stays and what goes, where trade-offs will be made, where resources will be focused and where
    they will be withdrawn, and which projects are consistent with the vision and which are not. The
    leadership team needs to be able to predict the implications of the vision for a range of future
    contingencies, most of them unknown.

    Ideally, the essence of a vision can be captured in a compelling couple of sentences. But this statement
    cannot stand alone. People need to translate it into what we specifically need to do and what success will
    look like. Taking the time to work through these elements helps ensure that the pieces fit together.

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    be copied, further distributed, or otherwise disclosed in whole or in part, without the expressed written permission of Strayer University.

    JWI 556 (1196) Page 9 of 9

    GETTING THE MOST OUT OF THIS WEEK’S CLASS

    As you read the materials and participate in class activities, stay focused on the key learning outcomes
    for the week:

    • Explore the role of leadership in creating a sense of urgency and combating complacency

    Thinking about a specific change initiative you are passionate about, what sense of urgency
    exists among your colleagues that this change is critical to the success of the organization and
    should be pursued sooner rather than later? What sources can you leverage to combat
    complacency? What are your customers saying about the current state? What are competitors
    doing in this space to change the game? What is the likely outcome if the change is not made?
    What, if anything, has already been done to address the issue, and what was the outcome?
    Conduct a focus group with a small number of colleagues who will be impacted by this change.
    Identify three positive results that would come from the change and three negatives if the change
    is not made.

    • Understand the importance of an effective guiding coalition, and how to build one

    As Jack says, “pick your change partners wisely.” Ask around. How can you assess the people
    who might be the ones you want to partner with? Choose carefully, because a bad decision here
    could spell the end of the change before it gets off the ground. What roles will you want to have
    represented? You will need people with the right technical skills, influence, and energy to drive
    the change forward. Talk to recruits for your guiding coalition to feel them out. Start to build a list
    of potential change agents you can leverage.

    • Leverage strategies to create and share the vision for a change

    Refine your change vision. What should definitely be in scope and out of scope of the initiative?
    Craft a vison of the change that can be shared with others. Your vision should be a bit like an
    “elevator pitch” with:

    o A clear and succinct presentation of the problem to be addressed (ideally with data to
    validate the statement)

    o An action statement of what the team proposes to do, including clear parameters of the
    scope of the project

    o An outcome statement of what will be accomplished through the change that clearly
    articulates what success will look like

    Ask others to validate the vision. Do they get excited? Does it make sense? Can they see it
    actually happening? Have your change leadership group present it back to you, and continue to
    refine and tighten it until it is precise, easily understood, and compelling.

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