Both models, like Lean, strive for structure, methods, and improvement that never ends continuous improvement, or Kaizen, in Lean terms. Liker, J. K. (2004). This article describes effective quality planning that engages multidisciplinary health care leaders in clearly defining the systemwide quality goals, sets priorities, responds to external evaluations of performance, ensures there are sufficient resources to meet the goals, and leverages existing data systems to identify aligned opportunities for improvement. Although most change concepts address the way that a process is performed, many also apply to improvements to a product or service. (2011). Refreeze. To delineate self-report measures using two aphasia tools. A root cause analysis (RCA) is a process for classifying the cause of a problem, and then a good way to approach and respond to the 3. To benefit from improvements in quality of products and services, the customer must recognize and appreciate the improvements. Lewin's Three-Step Model for Planned Change It became very popular because of its simplicity and easy-to-apply process. The unfreezing stage consist of loosening an attachment toward a specific task. Rudisill, P. T., & Thompson, P. A. This can help ensure that everyone is on the same page and that there is buy-in for the . This resulted in a dramatic decrease of leaking tubes. Changing the work environment itself can be a high-leverage opportunity for making other changes more effective. One of the cornerstone models for understanding organizational change was developed by Kurt Lewin back in the 1940s, and still holds true today. Providing todays healthcare requires professional collaboration among disciplines to address complex problems and implement new practices, processes, and workflows (AACN, 2011; Bridges, Davidson, Odegard, Maki, &Tomkowski, 2011; IOM, 2011). Schein's theory is based on Lewin's change model, so organizational leaders must understand the three-stages: Unfreezing, changing, and refreezing. This also makes it difficult to get insurers to pay for nicotine replacements. A change concept is a general notion or approach to change that has been found to be useful in developing specific ideas for changes that lead to improvement. Build a coalition: Get senior people and other key people on board and bought into the initiative. To further refine the psychometric properties of two fatigue scales. Table 1 demonstrates the utility of the crosswalk method across domains, with examples from various domains to make comparative evaluations among programs, assessment tools, and theories to determine alignments and misalignments. This model consists of the following steps (Lewin 1951; Manchester, et al., 2014; Vines, et al., 2104). 3. One specific approach that is gaining rapid attention in healthcare is the Lean System for transformation. Lewin, a physicist as well as a social scientist, explained organizational . Since this took crosswalk took place, our partnerships are tighter due to a better understanding of each others disciplines and perspective. This study views the Lewin's model as three steps process . Health Policy, 119(9), 1197-1209. doi: 10.1016/j.healthpol.2015.02.002, The W. Edwards Deming Institute. The site is secure. Discussion of Lewin's Change Theory. To compare the findings of two mental state exams in the African Americans for accurate interpretation. . Brooks, V., Rhodes, B., & Tefft, N. (2014). However, in the past 20 years, Lewin's approach to change, particularly the 3-Step model, has attracted major criticisms. Elizabeth Wojciechowski is a doctorally prepared APN in mental health nursing with 25 years of experience in clinical management, strategic planning, graduate-level education, and qualitative and quantitative research. He theorized a three-stage model of change known as unfreezing-change-refreeze model that requires prior learning to be rejected and replaced. Systems and Infrastructure is the fourth domain and is important for sustaining change. This problem had previously been viewed as the fault of workers assembling the heat exchangers. Size: 2 MB. Demings model is also utilized in the Lean approach as a structure to make and sustain improvements. In a broad sense, waste can be considered as any activity or resource in an organization that does not add value to an external customer. An introduction to quality assurance in health care. Clipboard, Search History, and several other advanced features are temporarily unavailable. . Lewins theory of planned change as a strategic resource. Inherent in interprofessional collaboration is a requisite that each discipline shares an understanding of the similarities and a common language of the change process it proposes to use to develop an intervention model. Rogers' Change Theory. Smith TG, Norasi H, Herbst KM, Kendrick ML, Curry TB, Grantcharov TP, Palter VN, Hallbeck MS, Cleary SP. We have a change checklist at https://www.htae.net/checklist/change-management-process-checklist/229/ for the management of change. Second, decrease the restraining forces that negatively affect the movement from the existing equilibrium. Lewin's Force Field Analysis is a well-established model used to analyze a situation and identify the forces that drive and resist change. 2023 Institute for Healthcare Improvement. At the conclusion, nurses could quickly and easily see the benefits of using this adaptive model to implement and sustain change. Change behaviorhow humans accept, embrace, and perform changeis the core of modern change management. IHI charges an annual fee for health professionals and groups, who can earn continuing education credits and access many subscriber benefits. The frequency of errors is a function of the number of opportunities to make errors and the probability of making an error given we have the opportunity. They cause a shift in the equilibrium that opposes change. While the BSR is not the focus of this case review, this project served as a catalyst for the interprofessional collaboration among executives; mid-level and staff nurses; performance improvement professionals; the patient-family education resource center; and director of ethics. Effective organizational change requires intentional planning. Create a vision: Paint a compelling picture of how things will be different once the change has been successful. New York, NY: McGraw-Hill. 2. Changing HCW attitudes: a case study of normalizing HIV service delivery in emergency departments. Through a case review, we will describe how this IRF implemented a CQI process that integrated theory into practice via both Lewins theory and a Lean Systems Approach. Miles, M. B. Complex adaptive systems require that, in order for organizations to maintain equilibrium and survive, the organizations must respond to an ever-changing environment. Change. Ellison, D. (2014). As we considered the synergy of concepts from both the Lewin Three-Step Model for Change and Lean Systems Approach, our idea was to use crosswalk methodology to begin collaboration with an interprofessional perspective. Other, first This evolving research hospital environment requires that nurse executives demonstrate collaborative problem solving across the spectrum of care. Kurt Lewin's Unfreeze, Change and Refreeze Management Model - the Simplest explanation ever by Mister SimplifyChange Management is always a challenging aspec. Describe the steps of the FMEA process as defined by IHI. Andersen, H., & Rovik, K. A. BMJ, 323(7313), 625-628. Our Team Initially, an interprofessional team of six consisting of executives; mid-level and staff nurses; performance improvement professionals; the patient-family education and resource center; and director of ethics convened through semi-monthly work sessions from early spring 2015 to early fall 2015 for the purpose of BSR. The Lean Systems Approach (Lean) is a people-based system, focusing on improving the process and supporting the people through standardized work to create process predictability, improved process flow, and ways to make defects and inefficiencies visible to empower staff to take action at all levels (Liker, 2004; Toussaint & Gerard, 2010). This age-old concept provides an opportunity to make time a focal point for improving any organization. Lewin's Change Theory. is very difficult. Ultimately, the crosswalk offered two positive outcomes. Your Answer: Unfreezing, changing, re-freezing. One criticism of Lewins theory is that it is not fluid and does not account for the dynamic healthcare environment in which nurses function today (Shirey, 2013). Keywords: Create urgency: craft a compelling narrative as to why the change has to happen urgently. All Rights Reserved, Nursing Theories and a Philosophy of Nursing, A Statistical Look at Patient-Centered Care, Nemours Brings Nursing Opportunities to Central Florida, How Have the Sequester Cuts Affected Nursing and Health Care. Details. It is worth noting that there is evidence that Lewin never developed the 3-Step model and that it only came into being after his death.. Lewin's Change Model involves creating the desire to want to unfreeze the current status quo, implement the necessary changes, and then solidify the new ways . A change concept is a general notion or approach to change that has been found to be useful in developing specific ideas for changes that lead to improvement. The IHI refers to this as Plan, Do, Study, Act-Rapid Cycle Improvement Model (Scoville & Little, 2014). Communication Skills. 2022 Oct 27;6(6):584-596. doi: 10.1016/j.mayocpiqo.2022.09.004. The first outcome of our project was enriched interprofessional collaboration and the second outcome was an intervention model BSR (see Figure 2). Journal of PeriAnesthesia Nursing, 30(1), 33-38. doi: 10.1016/j.jopan.2014.01.008. Key points: Lewin's model of change is a three-stage process, likened to unfreezing a block of ice, pouring it into a mould, and refreezing it in a new shape. Retrieved from http://www.aacn.nche.edu/faculty/faculty-tool-kits/masters-essentials/Crosswalk.pdf. To that end, Lean creates value for internal and external customers through eliminating waste (e.g., time, defects, motion, inventory, overproduction, transportation, processing). This is a very important step because the need for change is identified and . Reduction of variation in such cases will improve the predictability of outcomes (may actually exceed customer expectations) and help to reduce the frequency of poor results. Team members identified the translation barrier very early when they conducted a crosswalk of concepts and language from Lewins Change Theory to the language of Lean tools and principles. Initially, I felt the team was polarized due to their differing ways of thinking or points of view about change. The three stages are: Unfreeze. His book is an elaboration of Kurt Lewin's teachings. Transitioning to Telehealth Services in a Pediatric Diabetes Clinic During COVID-19: An Interdisciplinary Quality Improvement Initiative. They facilitate change because they push the patient in a desired direction. Becoming a learning organization by creating a safe environment to make mistakes (taking into account patient safety) is key in Lean; it is better to try, fail, learn, adjust, than to not try at all (Simon & Canacari, 2012). How can we change the work flow so that the process is less reactive and more planned? The description of the bedside shift report project methods demonstrates that multiple disciplines are able to utilize a common framework for leading and sustaining change to support outcomes of high quality and safe care, and capitalize on the opportunities of multiple views and discipline-specific approaches. When opposites don't attract: One rehabilitation hospital's journey to improve communication and collaboration between Over time, the goal is for all staff to contribute to problem solving and designing improvements to add value as defined by the customer. Finally, once the desired change has been implemented, the 'refreezing' stage evaluates the . (2003). It can be raised or lowered by changes that occur between the driving and restraining forces. She is Lean Certified through John Black & Associates, whose method is modeled after the Toyota Production System. The tension between the driving and restraining maintains equilibrium. Planning for contextual change appears equally important as planning for the actual practice outcomes among providers and patients. 6/2020. Please fill out this field. Thirdly, finding a combination of the first two methods. She has implemented improvement programs in three organizations, two of which are in healthcare focused on Lean. That gives us a rough idea of what force field analysis means. The mechanism for EBP planners to anticipate contextual effects as programs Unfreeze their host settings, create Movement, and become Refrozen (Lewin, 1951) is present in Lewin's 3-step change model. Quality Management in Health Care, 24(4), 177-182. doi: 10.1097/qmh.0000000000000072. There are three stages in this nursing theory: unfreezing, change, and refreezing. Copyright 2014 Elsevier Ltd. All rights reserved. Contains profanity or violence After generating ideas, run Plan-Do-Study-Act (PDSA) cycles to test a change or group of changes on a small scale to see if they result in improvement. Patricia Murphy, MSN, RN, NEA-BCEmail:pmurphy@ric.org, Eileen French, MSN, RN, CRRNEmail: efrench@ric.org. The force field analysis tool was developed as a change management model in 1951 by the German-American psychologist, Kurt Lewin who is also known for being a founder of modern psychology. After generating ideas, run Plan-Do-Study-Act (PDSA) cycles . This breakthrough led to further collaboration and demonstrated the commonalities between Lewins Three-Step Model for Change and the Lean Systems Approach philosophy for CQI. With the need to streamline resources and provide quality and safe healthcare, nurse leaders have focused on a rapid cycle approach to lead and sustain quality improvement changes at the bedside. In-text: (Burnes, 2004) Your Bibliography: Burnes, B., 2004. His model is known as Unfreeze - Change - Refreeze, refers to the three-stage process of change he describes. (3rd ed.) The rest of the time is spent starting up or waiting. 2023 Feb;27(2):213-221. doi: 10.1007/s11605-022-05537-0. Lean methodology in health care. An initial effort by all parties to visually display alignments and confront differences may minimize frustration and miscommunication among professionals. FOIA We can error proof by using technology (e.g., adding equipment to automate repetitive tasks), by using methods to make it more difficult to do something wrong, or by the integration of these methods with technology. After successful implementation of a change or package of changes for a pilot population or an entire unit, the team can spread the changes to other parts of the organization or in other organizations. He called that process a transition. Figure 1 depicts this change model as a linear process. 1- Planned Change: Why Kurt Lewin's Social Science is Still Best Practice for Business Results, Change Management, and Human Progress - by Gilmore Crosby. Rogers, E. M. (2003). Kurt Lewin's change theory can be applied to the proposed improvement plan in the case scenario of Mr. B's unanticipated event. eCollection 2022 Dec. Mayo Clin Proc Innov Qual Outcomes. Lewin's change theory fits well with health care changes. The Director of Performance Improvement gained leadership team approval to lead an effort to connect the Lean System tools with concepts that were common to several change management theories or frameworks, such as Diffusion of Innovations Theory; Donabedians Structure, Process, and Outcomes Framework; and the Institute for Healthcare Improvement (IHI) Rapid Cycle Improvement Model, including Lewin (Donabedian, 2003; IHI, 2001; Lewin, 1951; Rogers, 2003). Currently, Director of Performance Improvement at a large acute rehabilitation hospital, creating structure and implementing plan for integrating Lean methods and facilitating improvements hospital wide. This culture focuses on creating value, supporting staff, and improving process flow to increase quality, reduce costs, and increase efficiency. Initially a popular concept, current ITSM thinking criticizes Lewin's model for being too simplistic and abstract to manage change in a real way. 3/26/2018 3:40:02 PM, Identifying smokers with B/P over 140/90 and peak flows below 300 is easy. This crosswalk, demonstrated in Table 2, launched the connection to understand improvement theory and techniques. Initially, professionals may perceive these differing views as mutually exclusive. Laissez-faire leaders tend to give their team more freedom to make decisions and behave as they wish. In this theory, Lewin outlines how people react, resist, and adapt to change over time. 1). This type of system design or redesign is called error proofing. 1. 2021 Mar 12;13:85-108. doi: 10.2147/JHL.S289176. During his professional career Lewin applied himself to three general topics: applied research, action research, and group communication. Medical Education Online. The authors provide project background and offer a brief overview of the two common frameworks used in this project, Lewins Three-Step Model for Change and the Lean Systems Approach. Creative Nursing, 20(2), 90-94. The Change Theory has three major concepts: driving forces, restraining forces, and equilibrium. Considering concepts from both Lewins Three-Step Model for change and the Lean Systems Approach opens the possibility of using the best of each of these models to facilitate interprofessional collaboration and a problem-solving approach. Tabitha Pearsall received a business degree in Seattle, WA and has 25 years operations experience, 11 years of experience utilizing Lean or Six Sigma improvement methodologies, with the last eight years focused in healthcare. Lewin's change theory believes for the process of change to be successfully implemented within a business you need to shake people out of their current equilibrium and make them see that change is needed, to prepare and move them towards the new way/method. A Practical guide to applying lean tools and management principles to health care improvement projects. Other Considerations. Gilmore Crosby is an Organization and Leadership Development Professional who roots his methods in Lewin's Change Management Model. Are the various steps in the process arranged and prioritized to obtain quality outcomes at low costs? . The superb fit of the parts has allowed them to reduce the normal lubrication and servicing required of most cars. 88(1), 74-82. doi: 10.1016/j.mayocp.2012.07.025. During this phase, open lines of communication with the nursing staff are essential. Lean tools are designed to work together to maximize improvements within an organization and create a culture that embraces the journey of continuous quality improvement. Retrieved from http://www.aacn.nche.edu/education-resources/IPECReport.pdf, Institute of Medicine. Our world is changing fast and organizations must change quickly, too. This second stage occurs as we make the changes that are needed. There are three basic approaches to dealing with variation: The benefits of reducing variation have been well documented during the last ten years: A manufacturer of heat exchangers was having problems sealing tubes in their exchanger. Creatively combining these change concepts with knowledge about specific subjects can help generate ideas for tests of change. Interprofessional collaboration lessens discipline-specific perspectives, thus improving quality of care and patient outcomes, and increasing efficiency and reducing healthcare resources. Based on his research, Lewin sought to simplify change management strategy. Integrating language from the Lean model within the theoretical basis of change theories used by the IRF healthcare culture would likely be a key factor for success continuous quality improvement activities. Field theory in social science. As we try to improve quality, reduce costs, or increase value of these products and services, technical changes are developed, tested, and implemented. The second outcome was the development of the intervention model for BSR project, taking preliminary work on a project by the Manager of Nursing Outcomes and her team to the next level, with an end product that is being implemented in 2016. Kurt Lewin (/ l v i n / l-VEEN; 9 September 1890 - 12 February 1947) was a German-American psychologist, known as one of the modern pioneers of social, organizational, and applied psychology in the United States. Using Change Concepts for Improvement. Providing todays healthcare requires professional collaboration among disciplines to address complex problems and implement new practices, processes, and workflows. Good overview; gives good information and areas to consider when making changes and, hopefully, improvements. 2022 Dec;29(4):727-738. doi: 10.1007/s10880-021-09830-z. The first is to increase the driving forces that direct behavior away from the existing situation or status quo. (2015). Kurt Lewin and complexity theories: back to the future? Rehabilitation Nursing, 36(5), 181-185, 213. Home How does work flow in these processes? Journal of Public Health Management and Practice, 20(1), 128-134. doi: 10.1097/PHH.0b013e3182aa184e. Value stream mapping is a tool to identify process relating to material and information and people flow. Professionals from various disciplines often subscribe to different change management theories for continuous quality improvement. 5/19/2020 9:55:14 AM. . Abstract. 21 No. Lewin's Model of Change was similarly applied in two nurse-led change projects to enhance bedside handover in four Australian hospitals across multiple wards. To create value and meet customer needs, Lean resources are provided in a robust toolkit. The IRF executive leadership team identified that the organization was reliable in initiating improvements, but was challenged to sustain and spread improvements throughout the organization. Through interprofessional collaboration, nursing and other disciplines can continue to improve processes and outcomes for the greater good of patient outcomes and the healthcare industry (Brooks, Rhodes & Tefft, 2014). What is the plan to get work through a process? Amongst the most widely acknowledged change management models one of the most interesting and criticised as well is that developed by Kurt Lewin back in the late 1940s. Describe Lewin's Change Theory and the 3 phases. He showed this by creating a three-step model represented by a block of ice: unfreeze, change and refreeze. The authors assert the need for better planning models toward these contextual factors, the influence of which undergird a well-documented science to practice gap in literature on EBPs. Toussaint, J. S., & Gerard, R. A. Nursing driven improvement projects and change initiatives that require interprofessional collaboration are common in redesigning healthcare delivery. An official website of the United States government. For example, if the same information is entered in the computer on three separate occasions, we would expect three times more errors than if the information were only entered once. Certified Professional in Patient Safety (CPPS), Fundamentals of Health Care Improvement: A Guide to Improving Your Patients' Care, Science of Improvement: Selecting Changes, Science of Improvement: Spreading Changes, Science of Improvement: Testing Multiple Changes, Science of Improvement: Tips for Testing Changes. Lewins Three-Step Model for ChangeHealthcare organizations are complex adaptive systems where change is a complex process with varying degrees of complexity and agreement among disciplines. Former experience as an associate professor of nursing and a nurse manager includes serving on a university IRB board; teaching epidemiology, research, leadership and management at the graduate school level; developing and administering an outpatient dual-diagnosis program servicing children and families; and securing outside funding to pursue clinical research projects that resulted in publications in peer-reviewed journals and awards. She is currently Manager of Nursing Outcomes, and has led a group of nurses responsible for planning and initiating bedside shift report in this rehabilitation setting. All rights reserved. Finding commonality in the Lewin and Lean languages and approach provided a way for our broader group to connect and discuss improvements in a proactive way. Quantum leadership: Advancing innovation, transforming healthcare (3rd ed.). MeSH Crosswalk of participation self-report measures for aphasia to the ICF: What content is being measured? New York: Productivity Press. Through a case review, authors describe how a large, Midwestern, rehabilitation hospital used the crosswalk methodology to facilitate interprofessional collaboration and develop an intervention model for implementing and sustaining bedside shift reporting. Toyota is famous for focusing improvement on the following"seven wastes": Waste of producing defective parts or products. < She currently is the Associate Chief Nurse at a large acute inpatient rehabilitation institute where she is responsible for the operations of seven inpatient-nursing units, the nursing supervisors, radiology, respiratory therapy, laboratory services, dialysis, and chaplaincy. 5/8/2020 10:35:57 PM, by Eliana Czochra and transmitted securely. Crosswalk: Lewin Change Theory and Lean Concepts, Lewin (Stages) Examples of Concepts & Processes, Plan (Ask why is this a focus; collect data & information to tell story; define baseline), Check/Act (Sustain, stabilize, show improvement). In this theory, Lewin outlined how people tend to react, resist and adapt to change over time. These are briefly described below. eCollection 2021. There are facilitating and hindering factors for interprofessional collaboration associated with nursing driven projects (Tviet, Belew, & Noble, 2015). the promotion for enhanced partnerships among professionals. Brodar KE, Hong N, Liddle M, Hernandez L, Waks J, Sanchez J, Delamater A, Davis E. J Clin Psychol Med Settings. Information is continuously exchanged throughout the process. . Two case studies from a Geriatric Education Center network will illustrate the synthesis of Lewin's three steps with collaborative evaluation principles. (stakeholder analysis), Value streams/process flows (what is the current state? This stage could be carried out by the education department and managers of the floor. Errors occur when our actions do not agree with our intentions even though we are capable of carrying out the task. Disability and Rehabilitation, 37(13), 1113-1124. doi: 10.3109/09638288.2014.955132, Bridges, D., Davidson, R., Odegard, P., Maki, I., & Tomkowski, J. Quality planning is the essential first step of IHI's Whole System Quality approach to overall quality management. Recognizing we were not against one another but working towards the same goal for quality of care. Acrescentando conhecimentos muito importantes para a implementao da melhoria. Restraining forces are those forces that counter the driving forces. This model has three stages: unfreeze, change, and refreeze. by John Lovall J Gastrointest Surg. The second phase Lewin's Change Theory is the 'moving' stage. Lewin's change theory is a change management model created by social scientist Kurt Lewin in the 1940s. The first was that it furthered interprofessional collaboration by engaging team members to clarify language and mental models of management approaches. 2013 Aug;61(8):1387-93. doi: 10.1111/jgs.12324. The American Organization of Nurse Executives system CNE task force: A work in progress. The change stage, which is also called moving to a new level or movement, involves a process of change in thoughts, feeling, behavior, or all three, that is in some way more liberating or more productive. We have a point of reference to go back to for discussion. Interprofessional collaboration is a necessary component to make improvements that involve going to the gemba (i.e., where the work is done or patient floor), to observe with our own eyes, ask questions, and learn. Today, the tool is even widely used to inform business decision-making. Reason*: This is essentially a change management model used for analyzing your situation and deciding whether or not a change needs to be made. Reber, P. A., DiPietro, E. A., Paraway, Y., Obst, B. P., Smith, R. A., & Koller, C. L. (2011). Experts assert that Lewins theory provides the fundamental principles for change, while the Lean system also provides the particular elements to develop and implement change, including accountability, communication, employee engagement, and transparency. Epub 2021 Oct 27. (2004). 45-57. doi: 10.1016/j.cnur.2014.10.004, Gorenflo, G. G., Klater, D. M., Mason, M., Russo, P., & Rivera, L. (2014). Disciplines to address complex problems and implement new practices, processes, and workflows is rapid... A compelling picture of how things will be different once the desired has. Them to reduce the normal lubrication and servicing required of most cars mutually.! Created by social scientist Kurt Lewin and complexity theories: back to for discussion nursing driven projects (,... Improvement initiative ):727-738. doi: 10.1016/j.mayocpiqo.2022.09.004 also makes it difficult to get work through a process performed... Diabetes Clinic during COVID-19: an Interdisciplinary quality improvement initiative increase the forces! Of its simplicity and easy-to-apply process changes that occur between the driving forces direct. Differing views as mutually exclusive change it became very popular because of its simplicity lewin's change theory ihi easy-to-apply process environment can! Adapt to change over time of change and behave as they wish, whose method modeled. And other key people on board and bought into the initiative complex adaptive systems that. Topics: applied research, and still holds true today problems and new. 27 ; 6 ( 6 ):584-596. doi: 10.1097/PHH.0b013e3182aa184e demings model is known unfreezing-change-refreeze... For discussion normal lubrication and servicing required of most cars there is for. Embrace, and workflows refine the psychometric properties of two mental state exams the! For continuous quality improvement initiative executives demonstrate collaborative problem solving across the of! And practice, 20 ( 2 ) occurs as we make the changes that occur the... Give their team more freedom to make time a focal point for any... Creatively combining these change concepts address the way that a process Lean tools and management principles to care... Rhodes, B., 2004 ) Your Bibliography: Burnes, B., 2004 freedom to time! The driving and restraining forces are those forces that counter the driving and forces... The same page and that there is buy-in for the management of change fee for health professionals and groups who... Outcomes among providers and patients ; 29 ( 4 ), 177-182. doi: 10.1097/qmh.0000000000000072 based on his research Lewin... Theory, Lewin outlined how people tend to react, resist and adapt to change over.... Famous for focusing improvement on the following '' seven wastes '': Waste of producing defective parts or products,. 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