Change Management and Organizational Intervention
Change models
Know the major frameworks: Lewin's unfreeze–change–refreeze, Kotter's staged model (urgency, coalition, vision, communication, empowerment, short-term wins, consolidation, anchoring), the ADKAR individual-change model (awareness, desire, knowledge, ability, reinforcement), and Bridges' transition model (endings, neutral zone, new beginnings). Understand that organizational change and individual transition are different tracks-implementing a structure does not mean people have transitioned.
Resistance and readiness
Resistance is information, not defiance. Diagnose its sources: loss of competence, loss of status, unclear rationale, insufficient participation, or genuine disagreement. Readiness assessment and stakeholder analysis precede intervention. Traps include treating resistance as a communication failure only, skipping the coalition-building step, and declaring victory after early wins without anchoring.
Intervention design
Interventions should be matched to diagnosis and evaluated against intended outcomes. Consider unintended consequences, ethics of mandated change, and sustainability. Participation generally increases commitment but is not a substitute for clear decision rights.
Rule of thumb
Use the "loss, logic, and latitude" check: what are people losing, is the rationale credible, and how much influence do they have? Address all three before rollout.
Worked example
A new EHR rollout stalls. ADKAR analysis shows high awareness and knowledge but low desire. The intervention is not more training-it is addressing workflow burden and involving clinicians in configuration decisions.