| Course | DNP 709 Individual and Innovation Leadership in Healthcare Practice |
|---|---|
| Module | Module 8 |
| Paper type | Change theory comparison |
| Length | About 486 words, 4 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for DNP 709 Module 8
Eight Steps or a Living System? Comparing Two Change Frameworks for Launching Hospital at Home
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 709: Individual and Innovation Leadership in Healthcare Practice
Instructor Name
Month Day, Year
Eight Steps or a Living System? Comparing Two Change Frameworks for Launching Hospital at Home
The Practice Change
Our learning community's challenge is launching a hospital-at-home program, in which selected patients who need inpatient care receive it at home with nurse visits, remote monitoring and physician oversight. A randomized trial found that home hospitalization reduced cost and readmissions compared with usual hospital care (Levine et al., 2020). The change requires new nursing roles, new workflows across emergency, inpatient and home services, and patients' trust.
Framework 1: Kotter's Eight Steps
Kotter (2012) sets out eight steps in order: make the need for change urgent, assemble a coalition with enough power to lead it, form a vision with a strategy, repeat the vision widely, clear barriers so many people can act, plan visible early wins, use those wins to push further, and root the new ways in the culture. Applied to hospital at home, urgency comes from bed shortages and emergency boarding; the coalition includes the chief nursing officer, a hospitalist lead and home health leaders; short-term wins are the first ten patients safely treated at home.
Strength: clear sequence that leaders and staff understand. Limitation: it assumes leaders can plan the change from the top, and it says little about how the innovation's features or the adopting units shape uptake.
Framework 2: Diffusion of Innovations in Service Organizations
Greenhalgh et al. (2004) reviewed hundreds of studies and built a model in which adoption depends on the innovation's attributes (relative advantage, compatibility, low complexity, trialability, observability), the adopters, communication and influence, the system's readiness and antecedents for innovation, the outer context, and the process of implementation, with linkage between these elements. Applied to hospital at home, the model asks whether emergency physicians see an advantage, whether the program fits existing nursing scope, whether it can be trialed with a small group of diagnoses, and whether results are visible to skeptics.
Strength: explains why an innovation spreads in one setting and stalls in another, and fits a complex system. Limitation: it is a map of factors, not a step-by-step plan.
Comparison
| Feature | Kotter | Greenhalgh diffusion model |
|---|---|---|
| Origin | Business transformation | Systematic review of health and service organizations |
| View of change | Planned sequence led from the top | Adaptive process shaped by many interacting factors |
| Attention to the innovation itself | Little | Central |
| Practical steps | Clear | Must be derived |
| Fit with a complex system | Limited | Strong |
Recommendation
I recommend the diffusion model as our main framework, because hospital at home will succeed or fail on its attributes, its fit with clinicians and the system's readiness, all of which the model addresses. Kotter's steps can supply the action plan: urgency, coalition and short-term wins. Seeing a hospital as a complex adaptive system supports this pairing, since structure and adaptation both matter (Plsek & Greenhalgh, 2001).
Questions for Our Discussion
Which attribute is our weakest point? Who belongs in the guiding coalition from outside nursing?
References
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581-629. https://doi.org/10.1111/j.0887-378X.2004.00325.x
Kotter, J. P. (2012). Leading change. Harvard Business Review Press.
Levine, D. M., Ouchi, K., Blanchfield, B., Saenz, A., Burke, K., Paz, M., Diamond, K., Pu, C. T., & Schnipper, J. L. (2020). Hospital-level care at home for acutely ill adults: A randomized controlled trial. Annals of Internal Medicine, 172(2), 77-85. https://doi.org/10.7326/M19-0600
Plsek, P. E., & Greenhalgh, T. (2001). The challenge of complexity in health care. BMJ, 323(7313), 625-628. https://doi.org/10.1136/bmj.323.7313.625
Reading the DNP 709 Module 8 assignment instructions
The posted syllabus grades the Change Theory Comparison at 80 points as a team assignment with two parts, a prep document and a discussion, in Weeks 12 to 13. Each student compares two contemporary change theories or frameworks and applies them to a current clinical practice change; the learning community then uses the comparisons in a collaborative discussion to choose one theory to guide implementation of the team's healthcare challenge innovation. Expect to describe each framework accurately, apply it to the change, compare strengths and limitations, and recommend one. Coordinate with teammates so the team brings a range of frameworks to the discussion. Your comparison feeds the team's choice, so share it with teammates a day or two before the learning community meets.
How this DNP 709 Module 8 example is built
The paper first describes the team's practice change with evidence, so both frameworks are applied to the same real problem. Each framework is summarized from its source, applied with specific examples and given a strength and a limitation. A comparison table lines up the two on the features that matter for the decision. The recommendation chooses one framework, explains why, and shows how the other can still contribute. Closing questions prepare the writer for the team discussion that follows. The structure lets teammates compare papers quickly when they meet to choose. Using one practice change for both frameworks keeps the comparison fair, because the reader sees each model tested against the same problem.
Where the marks sit in the DNP 709 Module 8 rubric
The rubric for a change theory comparison typically weighs a correct account of each framework, thoughtful application to a real practice change, balanced analysis of strengths and limitations, a clear comparison, a justified recommendation, and scholarly writing with current sources. Faculty look for application that goes beyond naming steps. Frameworks drawn from health care research, or justified for health care use, are well received. A recommendation that fits the team's innovation and setting shows judgment. Contributions to the team discussion are also part of the grade. A comparison table helps reviewers see differences at a glance. Recommendations that show how a second framework can still help, rather than discarding it, reflect mature judgment about theory.
DNP 709 Module 8 help with common mistakes
Comparisons often describe two theories in separate halves and never compare them. Build a table of features and write a recommendation. Another problem is choosing old, general theories when the syllabus asks for contemporary ones; check that your choices fit. Apply each framework to the same practice change. Cite the original source for each framework. If you would like help comparing change theories for your team's innovation, send the prompt and your team's project idea to the desk. Agree with teammates which frameworks each person covers so that the team can compare several. Name the source edition you used for each framework, since models are often revised and summaries online can be inaccurate.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DNP 709 Module 8 questions, answered
Where can I find a free DNP 709 Module 8 sample paper?
The change theory comparison above is complete: Kotter's eight steps and Greenhalgh's diffusion model applied to hospital at home, compared in a table with a recommendation.
How many points is the DNP 709 Change Theory Comparison?
It is an 80-point team assignment with a prep document and a discussion.
What change theories can I compare in DNP 709?
The syllabus asks for two contemporary change theories or frameworks applied to a current clinical practice change.
What are Kotter's eight steps?
Build urgency, form a coalition, set a vision, spread it, remove barriers so people can act, secure short-term wins, consolidate them and anchor the change in the culture.
What affects adoption of an innovation in health care?
The innovation's attributes, the adopters, communication, system readiness, outer context and the implementation process.