Change Management Methodologies

To Overcome Resistance

Navigating Change in Healthcare

Resistance to change is inevitable in healthcare organizations, where routines and protocols often provide a sense of stability. However, managing this resistance effectively is crucial for sustainable transformation.

Change management methodologies such as Lewin’s Three-Step Model, Kotter’s 8-Step Model, and systems thinking offer structured yet flexible approaches for leaders to address barriers, engage stakeholders, and ensure successful implementation.

Lewin’s Three-Step Model: Unfreeze, Change, Refreeze

Lewin’s model remains one of the foundational frameworks for understanding change in healthcare.

Unfreeze: Prepare individuals for change by communicating the rationale and creating awareness of why change is necessary. This helps break down existing mindsets and prepares staff emotionally and cognitively for transition.
Change: Introduce new processes while providing education, mentorship, and open communication.
Refreeze: Solidify the new behaviours and embed them into organizational culture.

Wilis et al,, 2014)

Example in practice:
In palliative care, this model was effectively used to implement new end-of-life communication protocols. Engaging team members early in dialogue about communication gaps reduced resistance, and reinforcing the new practices during shift handovers helped sustain consistency across care teams.

Kotter’s 8-Step Model: Driving Momentum and Engagement

Kotter’s 8-Step Model builds upon Lewin’s framework by emphasizing leadership and communication as drivers of change.

Key steps such as creating urgency and forming a guiding coalition help foster shared ownership and direction (Weber & Joshi, 2000). Communicating a compelling vision enables staff to understand the broader purpose behind the change.

Empowering action and generating short-term wins are particularly effective for addressing resistance, as they build confidence and momentum (Roberts, 2020).

Example in practice:
When introducing electronic charting in a home palliative care program, forming a small pilot group of enthusiastic staff served as a guiding coalition. Their early success stories became “short-term wins” that encouraged broader participation and reduced hesitation.

The Role of Transformational Leadership and Emotional Intelligence

Leaders play a pivotal role in mitigating resistance by applying transformational leadership behaviors, such as inspirational motivation, intellectual stimulation, and individualized consideration, to align personal and organizational goals (Roberts, 2020).

Additionally, emotional intelligence (EI) strengthens a leader’s ability to recognize and address emotions linked to change. Emotionally intelligent leaders use empathy and active listening to reduce anxiety and foster psychological safety (Heikkinen et al., 2025).

Example in practice:
During workflow changes on a palliative unit, acknowledging nurses’ concerns about reduced patient connection and creating shared reflection sessions helped the team feel supported, which in turn minimized pushback.

Systems Thinking: Understanding Resistance as a Signal

A systems thinking perspective broadens the focus from individual resistance to the organizational structures and interconnections that shape behavior (Senge, 2006).

Resistance can be reframed as feedback, revealing underlying system issues such as communication breakdowns or resource constraints (Willis et al., 2014).

Example in practice:
When staff expressed hesitancy toward a new documentation system, leaders discovered that time pressures and limited training were the true barriers. By addressing these systemic factors, the organization improved both confidence and compliance.

Integrating Leadership and Methodology

Overcoming resistance requires combining structured methodologies with relational leadership. Leaders who integrate Kotter’s and Lewin’s frameworks with emotional intelligence and systems thinking foster trust, collaboration, and adaptability (Willis et al., 2014).

Example in practice:
In palliative care, where change often involves emotional and ethical considerations, this balanced approach ensures that transformation is both compassionate and sustainable.

Sustaining Engagement After Change

Sustaining change does not end with implementation. Leaders must cultivate an environment of continuous learning and reflection.

Embed structured feedback loops such as debriefs and reflective sessions.
Encourage professional development and recognize team contributions.
Model reflective inquiry and responsiveness to reinforce a culture of trust and shared growth.

When leaders view change as an evolving process of improvement, rather than a one-time disruption, organizations become more resilient and adaptable, ultimately improving patient care and staff satisfaction.

(Senge, 2006)

Summing it Up!!

In this video you’ll learn about the models we discussed — Kurt Lewin’s Three-Step Model (Unfreeze→Change→Refreeze), John Kotter’s 8-Step Model, and the ADKAR Model framework.

Page updated

Google Sites

Report abuse