Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2022
Editorial ReviewUsing Kotter's 8 Steps of Change to Tackle Over-fasting of children attending day surgery.
Over-fasting before surgery can lead to dehydration, irritability, lethargy, nausea, hypoglycemia, tricky intravenous cannulation, and decreased patient satisfaction (Newton et al., Pediatr Anesth, 2017, 27, 793). We used "Kotter's 8 steps for change" as an approach to tackling the problem of over-fasting in our day surgery unit (Kotter, Leading Change, Harvard Business School Press, 1996). Using a video of a patient's experience with overfasting, we created a sense of urgency and need for change (Step1: create urgency). ⋯ Our change ideas were divided into "short-term wins," "intermediate term goals," and "longer term goals." We focussed on creating short-term wins (Step6: create quick wins) and celebrated successes along the way to create initial momentum. We did this in parallel with working on longer term changes. We continued to work on cementing these new ideas (Step7: build on the changes), so that transformation in the day surgery would persist before using the same system to spread the change to the rest of the hospital (Step8: making it stick).