Your agenda for change is underway. While some things are going well, others seem to have made no progress, and everything is taking longer than you thought. Your CEO, who has an MBA, suggests you need to learn about Change Management. Can the business world provide you any guidance as you struggle to accomplish your goals?

Effecting change is tough because it requires multiple strategies and relentless effort. During a change effort, it is easy to get distracted or discouraged. The need for change may come from an external mandate or an internal mandate, in response to an event, or from a change identified by a transformational leader.

Change management, a large topic, describes the general approaches to effecting change that have been described through innumerable frameworks or processes. The purpose of this post is only to introduce the topic as I understand it. In my efforts to effect change, one framework I have found to be simple and particularly helpful was ADKAR. Not only was it useful for managing the change but, more importantly, in diagnosing blocks to progress. The use of ADKAR is used to develop the change agenda and is used by the guiding coalition or leadership team as they manage the change process.

The first step is (A)wareness of need for change. This step requires explanation and communication of the rationale for change and details of the proposed change. This relies on communication in multiple manners and forums (see my previous blog post on Communication by clicking here).

The second step is (D)esire. Desire is perhaps the most essential step, most nebulous, and usually the step that receives too little time and attention. Most change comes with resistance on all fronts, including hesitation to change with comfortable practise. Other issues that interfere with change include the financial cost, the change not being perceived to be important, staff feeling too busy, the change not being perceived by the individual or group to be their responsibility, and belief of the group or individual that they are “the best” already. Individuals may also refuse to change and/or state that the change will pose risk to patients. The role of a leader is to build consensus on the need to change. Multiple strategies for building desire include extensive input, listening to and, if possible, addressing concerns, and adjusting the change strategy. Communication strategies need to articulate the disadvantages of the current state (the so-called ‘burning platform’) and the advantages of the future state. Data that describes the problem can be quite powerful. Town halls can be a powerful mechanism to address concerns (see Communication). The leader must reinforce how the changes align with the mission, vision and values of the organisation. The outcome of (D)esire is that staff need to be inspired towards the changed state.

The next step is (K)nowledge. Do individuals know what they need to do to effect change? This step requires careful planning and education with staged roll out. Start usually in a few areas as a pilot and adjust the plan based on early results and feedback. Develop a mechanism to evaluate knowledge transfer and uptake.

The next step is (A)bility. Do people have the skills to implement the change? Again, this requires training sessions with mechanisms to ensure competency in effecting change.

The final step is, (R)einforcement. Inevitably after initial success and enthusiasm, performance against targets begin to slip. From the very initiation of change, plan a strategy for sustainability.

In summary, change management refers to an explicit set of stages summarized as ADKAR, that not only help create a strategy for change but also a mechanism to diagnose blocks in failure to achieve change.