Navigate Change Leadership with Proven Frameworks for Healthcare Transformation

In healthcare, effective leadership during change is critical for success. Whether you're introducing new technologies, updating clinical protocols, or navigating regulatory shifts, having a structured approach to guide your organization through these transitions can mean the difference between success and failure.

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In the first installment of our Change Leadership in Healthcare series, we’ll introduce you to four essential change management frameworks: Kotter’s 8-Step Model, ADKAR, Lewin’s Change Theory, and the Kubler-Ross Change Curve. Each of these frameworks provides practical, structured approaches that healthcare leaders can apply to navigate change, engage teams, and ensure that new initiatives are successfully implemented and sustained.

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Kotter’s 8-Step Model: Building Ownership for Change

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Overview: Developed by leadership expert John Kotter, this model provides a comprehensive, step-by-step guide for leading large-scale organizational change. Kotter emphasizes the importance of building urgency, creating ownership, and embedding changes into an organization’s culture for long-term success.

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Key Steps:

1. Create a sense of urgency.
2. Build a guiding coalition.
3. Form a strategic vision and initiatives.
4. Communicate the vision to foster ownership.
5. Empower broad-based action.
6. Generate short-term wins.
7. Sustain acceleration.
8. Institute change in the culture.

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Application in Healthcare: Kotter’s model is particularly effective for large healthcare transformations, such as rolling out new electronic health record (EHR) systems, merging healthcare organizations, or implementing new care delivery models. A key element of success here is fostering ownership, rather than simply seeking "buy-in." When staff are involved in shaping the change and empowered to contribute to its success, they feel personally invested and motivated to drive the change forward. This is especially true in healthcare, where collaborative teamwork and vested interest in patient care are critical to operational success. Ownership creates a deeper, long-lasting commitment that surpasses passive acceptance and generates energy around the change.

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ADKAR Model: Focusing on the Individual’s Journey Through Change

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Overview: The ADKAR model, developed by Prosci, breaks change down into five stages that focus on the individual’s experience. It highlights how people move through the process of change and what leaders must do to support them at each stage.

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ADKAR Stages:

1. Awareness: Understanding why the change is necessary.
2. Desire: Wanting to participate in and support the change.
3. Knowledge: Knowing how to change.
4. Ability: Having the skills and behaviors to implement the change.
5. Reinforcement: Ensuring the change sticks and is sustained.

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Application in Healthcare: In healthcare, the ADKAR model is ideal for smaller-scale changes that require staff to adopt new practices or technologies. For example, during the adoption of new infection control protocols, the ADKAR model ensures that healthcare professionals move smoothly through each stage—developing awareness of the importance of change, learning the new practices, and reinforcing the change to maintain compliance. By focusing on individual behaviors, ADKAR ensures that every team member feels ownership over their role in the change process.

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Lewin’s Change Theory: A Simple, Three-Step Approach

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Overview: Kurt Lewin’s Change Theory simplifies the change process into three phases: Unfreezing, Changing, and Refreezing. This model is particularly useful when organizations need to change established behaviors or cultural norms.

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The Three Phases:

1. Unfreezing: Preparing the organization for change by breaking down old habits or mindsets.
2. Changing: Implementing the new systems, processes, or behaviors.
3. Refreezing: Solidifying the new behaviors to make them part of the organization’s standard practices.

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Application in Healthcare: Lewin’s model works well when shifting ingrained habits or practices, such as transitioning to patient-centered care models or implementing new clinical workflows. The Unfreezing stage might involve showing healthcare professionals how old practices are no longer effective, while the Changing stage introduces new procedures. The Refreezing stage ensures that these new procedures are reinforced and become part of the daily routine.

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Kubler-Ross Change Curve: Understanding the Emotional Response to Change

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Overview: Originally developed to describe the stages of grief, the Kubler-Ross Change Curve has been adapted to explain how people emotionally respond to change. The stages include Denial, Anger, Bargaining, Depression, and Acceptance.

Application in Healthcare: Healthcare changes, especially those that affect staff roles, patient care delivery, or organizational structure, can evoke strong emotional responses. The Kubler-Ross Change Curve helps leaders understand and anticipate these reactions, providing guidance on how to support their teams through each stage. For instance, during a major staffing restructure or a new regulatory mandate, healthcare professionals may initially resist the change (Denial), express frustration (Anger), and negotiate alternatives (Bargaining). With ongoing communication and support, leaders can guide their teams toward acceptance, ensuring smoother transitions and reducing resistance.

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The Difference Between "Buy-In" and "Ownership" in Healthcare Change

Many leaders approach change by seeking "buy-in" from their teams. Buy-in means gaining agreement or compliance from employees, but it can often result in a passive acceptance of the change rather than an active, vested commitment. People may go along with the change but lack the deep engagement needed to drive its success.

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On the other hand, ownership involves making team members part of the process—empowering them to contribute to the change wherever feasible and encouraging them to take responsibility for its success. This generates energy and motivation, as staff feel their input and involvement are valued. Ownership goes beyond mere compliance, inspiring employees to champion the change and work collaboratively to ensure its sustainability.

In healthcare, where every team member plays a critical role in delivering patient care, fostering ownership is key to driving successful change. Whether you’re rolling out a new initiative or reshaping clinical protocols, involving staff at every level creates a sense of shared responsibility, making the change more meaningful and enduring.

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How to Choose the Right Framework for Your Organization

Choosing the right change management framework depends on the nature and scale of the change you're leading. Here’s a quick guide:

1. For large, organization-wide changes such as technology overhauls or mergers, Kotter’s 8-Step Model provides a detailed roadmap for creating ownership, maintaining momentum, and embedding change in the culture.
2. For changes that focus on individual behaviors, such as adopting new clinical practices or improving team communication, ADKAR helps ensure each team member is equipped to navigate the change process.
3. For cultural shifts or long-standing behaviors, Lewin’s Change Theory provides a straightforward, step-by-step method to unfreeze old practices and ensure new ones are reinforced.
4. For emotionally charged or disruptive changes, such as restructuring, Kubler-Ross offers valuable insights into the psychological journey staff may experience, allowing leaders to manage emotions and foster acceptance.

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Laying the Foundation for Successful Change

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Understanding and applying structured change frameworks is the first step toward leading successful healthcare transformations. Whether you’re rolling out a new technology, implementing new patient care models, or navigating organizational restructuring, these frameworks will guide you in developing a clear strategy, creating ownership, and ensuring lasting success.

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In our next installment, we’ll explore how to develop a compelling vision for change and align it with your healthcare organization’s broader strategy. Stay tuned!

If you're ready to take your leadership to the next level and guide your healthcare organization through successful change, now is the time to act. Whether you're navigating a large-scale transformation or fine-tuning everyday processes, we can help you implement the right strategies and frameworks for success.

Book a call with us today to discuss how we can tailor a change management approach to your organization’s unique needs, ensuring that your team feels empowered, engaged, and ready for what’s ahead. Calendly - Laurie L. Smith