Frameworks for Change Management: Applying the ADKAR Model and Kotter’s 8-Step Change Model in Healthcare Settings

Change management means how organizations move from how things are now to how they want them to be. In healthcare, this often means starting new systems like electronic health records (EHRs), improving billing processes, or using AI for front-office tasks. Change management focuses on helping people adjust to new ways of working with as little trouble as possible.

Many health projects fail because they don’t handle people’s resistance to change or don’t match the new change with the organization’s culture and what people want. Research shows that when projects have strong management, teamwork across different groups, and focused change efforts, they are much more likely to succeed. In fact, projects with good change management are up to seven times more successful than those without it.

Healthcare groups often find it hard to stay on the same page during change because healthcare work is complicated and involves many roles—from nurses and doctors to office staff. It is important to choose change methods that fit these special challenges.

The ADKAR Model: Focus on Individual Change

The ADKAR Model was created by Jeff Hiatt in 1996. It is a clear system that focuses on change for individuals. The name ADKAR stands for five steps:

  • Awareness of why change is needed
  • Desire to support and take part in the change
  • Knowledge about how to change
  • Ability to use new skills and behaviors
  • Reinforcement to keep the change going

This model shows that change in an organization only works when people use new tools or ways of working. It helps leaders find and fix problems by clear talks, training, and support.

In healthcare, ADKAR has helped staff get ready for new technology, like helping nurses in Iran learn nursing Kardex systems, or helping clinical teams in New York switch to new care models. In New York, patient satisfaction went up by 26.8% within a month of the change. This shows that managing both the technology and people side is important.

The model works well because it focuses on people first and offers clear steps to get workers involved. For example, during the Desire step, it helps staff see personal benefits from the change. This helps reduce resistance caused by habits or fear.

Microsoft shows how ADKAR can help by treating employees differently based on what stage they are at in the change process. Desire is often the hardest part because no one can be forced to want to change. Good leaders create open talks and involve teams early in decisions.

Kotter’s 8-Step Change Model: A Leadership-Driven Approach

John Kotter made his 8-Step Change Model in 1996 after studying many changes in organizations. His method is a top-down plan for leaders to make change happen:

  • Create a sense of urgency to show why change is needed
  • Build a guiding coalition of strong leaders and helpers
  • Form a strategic vision to explain goals and results
  • Enlist a volunteer army to support and push the change
  • Enable action by removing barriers, like bad rules or systems
  • Generate short-term wins to keep energy going
  • Sustain acceleration by pushing change continuously
  • Institute change by making new habits part of culture

Kotter’s model is good for building excitement in the group and making leaders share the same vision. It is often used for big changes with many involved people, like hospital mergers or new system launches.

Groups like United Way of Greater Kansas City say that being part of leadership teams helped workers understand their organization better and care more about the change. Bunge also said that change needs many people to take part, like Kotter’s “volunteer army.”

Some say Kotter’s model can take many resources and sometimes does not focus enough on people’s feelings or motivation. This can cause resistance if employees don’t join in or give feedback.

In healthcare, where workers are often very busy and stressed, Kotter’s method should be used carefully with good communication and cooperation between different teams.

Comparing the ADKAR and Kotter Models in Healthcare

Both ADKAR and Kotter’s models are useful in healthcare but have different strengths and challenges.

  • Employee Participation: ADKAR focuses on individual workers and their behavior, which helps with tasks like using new EHR systems or AI tools. Kotter focuses more on leadership and aligning the whole organization.
  • Type of Change: ADKAR works well for small or step-by-step changes, helping teams get ready and keep the change going. Kotter’s model fits big changes needing big shifts in culture.
  • Handling Resistance: ADKAR leads individuals gently step-by-step to accept change, while Kotter builds energy from the top down. Using both can help healthcare group manage strategy and worker involvement.

Ron Avignone, who has worked a long time in health technology, says ADKAR is best for helping people understand and accept new tools during updates. Kotter’s model helps with bigger culture changes.

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Integrating AI and Workflow Automations with Change Management

Healthcare in the U.S. is quickly adding AI and automation to improve front-office jobs like scheduling, patient questions, and billing. AI phone systems can help reduce the work for staff and make it easier for patients to get help.

For example, Simbo AI uses AI phone systems to manage many calls, direct patients well, and answer common questions without needing a person.

Introducing AI needs careful change management. Without it, staff might resist because they worry about losing jobs or find new tools hard. The ADKAR Model helps by focusing on clear talks and building desire to use AI. Leaders can reassure that AI helps clinical work and cuts down on boring tasks, giving more time for patient care.

Good project management and early input from different groups help IT managers plan AI rollouts with clear goals. Teamwork between doctors, front-office workers, and IT helps make better designs and improve how users adopt the tools.

Kotter’s steps like making urgency about problems with old phone systems can help get leaders to support AI spending. Showing quick wins, like shorter wait times on calls or better appointment confirmations, keeps people confident and motivated.

Also, keeping the new ways going is important. Regular training, listening to users, and adding AI into daily work help make changes stick. This matches ADKAR’s last step—reinforcement—to build good habits that last.

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Practical Tips for Medical Practice Administrators and IT Managers

  • Assess readiness: Check how aware and willing staff are before starting changes. This fits ADKAR’s steps and helps tailor messages.
  • Involve stakeholders early: Include people from clinical, admin, and IT teams in planning to spot problems and build support.
  • Use clear communication: Give clear reasons for changes, explain effects on roles, and share expected benefits.
  • Provide training and support: Hands-on practice builds ability while ongoing help reduces frustration with new tools like AI or EHRs.
  • Celebrate milestones: Mark short-term wins like faster call responses or better billing to motivate teams and show progress.
  • Monitor progress: Get regular feedback and check how changes are going to fix problems early.
  • Embed changes: Make new habits part of daily work by updating policies, workflows, and performance measures.

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Summary of Key Learnings

  • The ADKAR Model helps manage change one person at a time. It gets healthcare workers to learn and keep new ways.
  • Kotter’s 8-Step Model gives a wide plan for leaders. It builds urgency and teamwork for big changes.
  • Both models can work together to guide healthcare changes needing both worker involvement and leader direction.
  • Using AI and automation in healthcare needs careful planning to handle resistance and help users.
  • Successful change needs strong management, good communication, teamwork, and ongoing support.

Healthcare leaders who understand these models and use them carefully will have better results when changing technology. This will improve patient care, efficiency, and staff satisfaction.

Medical practice administrators, owners, and IT managers working in U.S. healthcare must use proven change models like ADKAR and Kotter’s 8-Step approach. This is essential to keep success going as technology and rules keep changing.

Frequently Asked Questions

What are the critical factors for successful technical system implementations?

The critical factors include strong project management, seamless cross-functional team collaboration, and effective change management.

Why is strong project management important in change management?

Strong project management ensures clear timelines, budgets, and milestones, keeping teams aligned and focused on the goals, even amidst unexpected challenges.

How does cross-functional collaboration enhance change management?

Cross-functional teams bring diverse skills and insights, helping organizations anticipate challenges, reduce silos, and make informed decisions.

What causes implementations to fail?

Resistance to change often leads to implementation failures, making effective change management essential to drive user adoption.

How can early stakeholder involvement help in change management?

Early stakeholder involvement helps identify potential risks and issues before they escalate, saving time and resources during implementation.

What frameworks can be used for effective change management?

Key frameworks include the Change Control Process, ADKAR Model, and Kotter’s 8-Step Change Model, each providing structured approaches to manage change.

What role does communication play in change management?

Clear and consistent communication fosters transparency, helps gain buy-in from stakeholders, and keeps everyone informed about the changes.

Why is user adoption critical for successful project outcomes?

User adoption ensures that individuals embrace new tools or processes, maximizing the project’s benefits and driving overall success.

How does change management minimize disruption and risks?

By anticipating changes and their impacts, change management can proactively implement strategies that mitigate risks before they become significant issues.

What strategies improve employee satisfaction during change?

Well-timed communication, adequate training, and emotional support enhance morale and increase productivity, making transitions smoother and more accepted.