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Step 4: Develop a Written Change Plan

This step is an integrative process based on all the work that has been implemented so far. Informed by the ATTOC Environmental Scan and the assessment of organizational readiness for change in Step 3, Champions and members of the leadership group are now revisiting the preliminary organizational goals established in Steps 1 and 2 in order to develop a fully articulated change plan. Each broad goal is expanded to include specific strategies and tactics to achieve the broad goals. What is learned in Step 3 about the organization’s readiness to change may lead to adjustments in timing or priority, or help to refine planners’ understanding of the most effective tactics to achieve goals. The Change Plan includes: Strategic Priorities; Implementation Plan, and Monitoring Plan.





Task 1. Refine vision of changed organization.

Capture the choices that express what the facility would like to have, to do, and to be in the near or distant future. You and others in the Tobacco Leadership Group need to revise the vision to reflect the commitments your agency is making to achieve its goals. For example, the vision may make clear that nicotine dependence will be treated the same as other types of addiction that are assessed and treated to promote the health, well being, and recovery of all patients who seek help at the facility. At this stage, the vision should be disseminated widely to clearly demonstrate the agency’s commitment to realize this vision.

Task 2. Finalize SMART Goals, Strategies, and Tactics.

Dahl’s acronym “SMART” is a useful way to remember the critical components of goals: Specific; Measurable; Attainable; Relevant; and Time Bound. Goals will be needed for each area in which the organization intends to move forward. For each goal, identify both general strategies and specific tactics to achieve it.

Task 3. Identify and charge work groups to achieve the goals.

Create work groups that consist of people at administrative and staff levels who represent all the agency departments involved in implementing the goals in question. Those who have been known as opinion leaders should be invited to join the work groups. Each work group will oversee the activities needed to achieve goals, reporting back to the Tobacco Leadership Group on their progress.

Task 4. Identify steps to achieve goals, including changes in policy.

Break tasks into smaller and attainable steps. Achieving these smaller steps will be seen by leadership and other stakeholder groups as early successes in the process, which will help the agency gain strength and momentum to move forward.

Task 5. Develop one-page strategic planner for each task.

Dahl (2003) developed the structure of one-page strategic planner that is built around “Top 10” task questions. Some of the questions are basic, obvious, and easy to answer; others are deeper and more complex, requiring more time and effort. For example, in one agency, a one-page strategic planner for task “Assessing and Documenting CO levels at Admission” was formulated. Planners like these provide at-a-glance tools for monitoring achievements on the work group level.