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Overview of Change Management (CM) Approaches - Coggle Diagram
Overview of Change Management (CM) Approaches
Need for Change
(Harrison et al., 2021;) Improvement Cymru, 2022)
Due to:
Complex Health Conditions
Coronavirus pandemic (Zenger & Bunch, 2021)
Demands of increased life expectancy
Changing population needs
Evolving treatment, technology & evidence (Connor et al., 2023)
Healthcare
Complex, adaptive, intelligent system (Harrison et al., 2021)
Allow learning & improvement opportunities
Evidence based successful practice
Efficient, safe, equitable care (Abuzied et al., 2022)
Limitations of change
CHANGE BARRIERS
Process often fails
(Chowthi-Williams & Davis,2022)
Systems
Culture
Engrained processes / behaviours (Crilly et al., 2024)
Complex systems
Resources
Lack of finance
Poor Training & Development
Competing demands
Lack of attention
Understanding
Poor measurement / feedback
Support Systems
Inadequate coaching / mentoring
Lack of stakeholder involvement
Lack of support
Behaviours
Staff - Employee Resistance (Hayes,2022)
Critic
Opposes change
Loss of control
Lack of collaboration
Victim
Panics about change
Fear
Stay in comfort zone
Bystander
Ignores Change
Lack of undestanding
Change fatigue
Leaders
Poor leadership
Lack of vision
Poor communication
Poor commitment
Lack of Engagement
Vision & Strategy
Unclear
Too complex
Goals not aligned with organisation
Wrong Model
Poor Evaluation / Lack of Adaptation
Benefits of change
Effective Resource Management
Quality (McDermott et al., 2018)
Ensures efficiency
Improves safety
Patient Centredness
Preferences
Experiences
Outcome
Effectiveness
Timelines
Widen Accessibility
Enablers of CM
(Errida & Lofti, 2021)
Policy (Stewart et al., 2020)
NHS England Change Model (2018)
Adaptable Framework
Improvement Cymru Strategy (2021-26)
Local CM Policy
Government Policy (Gopee & Galloway, 2017)
Systems
Culture
Open Communication
Feedback
Employee Engagement
"Buy in"
Readiness
Flexibility
Resources
Training & Development
Equip staff to succeed
Finances
Technology & Tools
Understanding
Current State
Desired State
The Shift (steps identified)
Support Systems
Mentors / Coaching
Strategic Planning
Minimise Risk
Behaviours
Staff
Supportive
Adaptive
Communicative (Doyle & Brody, 2018)
Influential
Change Champions
Visionary
Collaborative
Transformational Leaders (Bakker et al., 2023)
Visible
Champion Change
Motivate employees
Build Trust
Psychological Safety (Garvey-Berger, 2025)
Vision & Strategy
"WHY"
Guide decision making
Align goals with organisation
Recognise & Reward
Sustainability
MODELS
(Hayes., 2022)
No Gold Standard (Errida & Lofti, 2021)
Depends on situation (Phillips & Klein, 2023)
Allow planning, visualisation, evaluation, implementation
Lewin (Lewin, 1947)
Enabler
Simple (Cummings et al., 2016)
Barrier
Unworkable for complex change (Thompson, 2016)
3 Stages
Unfreeze
Prepare
Address resistance
Create awareness & understanding
Change
Implement
Employee engagement
Refreeze
Solidify
Sustainable
Celebrate success
PDSA
(Demming, 1986)
Enabler
Small scale
Rapid assessment
Evidence based practice informs change
Best for healthcare (NHS Improvement, 2018; Manandi et al., 2023)
Barrier
Limited research on effectiveness
Lack of clear end points (Zann et al., 2021)
Iterative approach (Abuzied et al., 2023)
PLAN
Identify problem
What will be tested (Manandi et al., 2023)
Collect data
Plan of action
Teamwork (Kiepek & Stengstack, 2019)
DO
Implement plan
Attempt & Observe change
Record data
STUDY (Reding, 2025)
Collect data
Analyse
Evaluation
Next actions
ACT (Chowthi, Williams & Davis, 2024)
Adopt
Implement on larger scale
Readiness for another change
Adapt
Retest
Discard
Other commonly used models
KOTTER
(Kotter, 1996)
8 Steps
Collaborative Coalition
Cialdinis principle of persuasion (Cialdini, 1984)
Celebrate success / Wins (Wendling,2018)
McKinsey 7 S Model
-Waterman, Peters, Phillips, 1980s (Avignone, 2021)
7 Interconnected areas
Technical aspects Hard 'S'
Social aspects Soft 'S'
Kubler Ross Change Curve
(1969)
Support through major change
7 Stages (Abebe et al., 2023)
ADKAR
Hiatt, 1996 (Olmstead, 2019)
Clear Goals
5 Stages