Use the ADKAR Model in Healthcare for Change Success

Managing change successfully is essential for healthcare organizations. If change isn’t managed responsibly, it can impact patient health and safety. The good news is that applying the Prosci ADKAR® Model in healthcare provides structure and flexibility when implementing change. As a result, healthcare professionals can prioritize patient safety and maintain high levels of care.But how exactly does the ADKAR Model work?

This article examines how the Prosci ADKAR Model guides healthcare organizations through critical changes in policy, practice and patient care protocols.

What Is the ADKAR Model?

The Prosci ADKAR Model is a framework for managing individual change in an organization. It’s based on the premise that organizational change starts when individuals change. This model guides individuals through a particular change, addressing roadblocks along the way.

Prosci ADKAR Model

ADKAR is a core part of the Prosci Methodology, a structured, adaptable and repeatable approach for managing the people side of change. It enables organizations to continually change and evolve to succeed.

Here's how the Prosci Methodology, and some of its models and frameworks, work together:

1. Prosci ADKAR Model –  This model puts people at the center of change. ADKAR describes the five building blocks necessary for individual change: Awareness, Desire, Knowledge, Ability and Reinforcement. In healthcare, ADKAR guides individuals through the change process and helps them move past common barriers that create resistance to change, especially with autonomous individuals like nurses and physicians.  

2. Prosci Change Triangle (PCT) Model – The PCT Model highlights four critical aspects of successful organizational change efforts—leadership/sponsorship, project management, change management and success—and how they work together.

3. Prosci 3-Phase Process – This step-by-step framework enables you to deploy the entire change management process in three phases: 

• Phase 1 – Prepare Approach involves defining success and developing a change management strategy that aligns with it.
• Phase 2 – Manage Change involves creating and implementing change management plans and tasks successfully.
• Phase 3 – Sustain Outcomes involves ensuring that changes are adopted and sustained for the long term.

4. Change Management Plans – These can include specific plans such as the Sponsor Plan, People Manager Plan, Communications Plan, Training Plan, Resistance Management Plan, and others—each addressing critical aspects of the change management strategy.

5. Role Roster – This identifies the specific roles needed to successfully manage the change initiative from an employee-centric perspective.

6. Unified Value Proposition (UVP) – This visual framework illustrates how change management and project management are complementary disciplines with a common objective of achieving success. 

Now, let’s take a closer look at the components of the Prosci ADKAR Model in healthcare.

Awareness 

Here’s how to increase Awareness:

• Ensure team members understand the need for change – Answer the “why” of the change by outlining the reason it’s necessary. Consider an improvement in electronic medical records (EMR) as an example. Healthcare providers might resist this change initially, querying whether it’s necessary and how it could impact their ability to give care. When you explain how the system enables the sharing of patient records across departments (like acute care, rehabilitation, and home care providers), it immediately shows why the solution is necessary: to improve patient care.
• Explain the downsides of not implementing the change – Show employees what will happen if the change isn’t implemented. For example, not complying with federal or state regulations, or impacting patient care. 
• Use the right people to share key messages – Ensure the right people share the right messages when building awareness of the need for change. Prosci research shows that people prefer to receive personal-impact messages from supervisors but would like organizational messages to come from business leaders. 
• Provide the right training and support – Give employees the training, resources and support they need to understand the impact of change at an individual level. If we go back to the patient record example, this would involve showing healthcare workers how the new system works, how it impacts their day-to-day, and how they can use it effectively. 

Preferred Senders of Messages

Desire

Once people understand why a change is necessary, the next step is to make a compelling case for adopting the change. The aim is to increase the Desire element, enabling team members to participate in the change and move forward through their transitions.

Here are some ways to increase Desire:

• Answer WIIFM – Team members may ask, “What's in it for me (WIIFM)?” In healthcare, this often translates to, “What’s in it for the patient?” With our patient records example, team members would need to hear how the new system will save them time and allow them to provide better care.  
• Share case studies – Show team members where change has made an impact to support the concept and provide evidence to back up your claims. For example, you might show how other healthcare providers have upgraded their patient record systems and improved the patient experience. 

Knowledge

Provide training and support for team members to develop their knowledge and confidence around the change. This involves showing them what to do during the transition and how to perform effectively in the future state. 

Let’s walk through some of the ways to develop knowledge:

• Explain how individuals will make the change – Communicate with team members about what the change involves and how it will impact them individually. Change looks different for everyone, and it’s important to provide unique training and resources to suit each individual or similarly impacted group. For example, clinicians working on the patient floor might experience change differently from those working in healthcare administration.
• Identify skill gaps – Identify where employees need new skills and training to incorporate the change. Talk to employees about their current abilities, review HR documentation, and narrow down the key skill sets that you’ll need to refine before the change. Then, provide hands-on instruction and interactive training to give people the skills to enact change.
• Train in a safe environment – Be sure that any training is held in a safe environment to ensure that patient care isn’t compromised. In our patient record example, ability building should happen away from patients to keep their data safe and secure until team members are confident in using the system accurately.

Note that it's a common mistake for organizations to start the change journey with training, effectively skipping Awareness and Desire. But those arriving at training without Awareness and Desire are unlikely to have a learning mindset. Before functional training, you must ensure that team members understand why the change is happening and hve decided to engage with the change. Team members must want to learn for the change to be successful. 

Ability

Ability is the stage where the change becomes clear in behaviors, mindsets and other expected outcomes from the change. These successful outcomes are defined at the start of a change. For example, if the change involves a new shift scheduling system, success would be achieved by team members using the system effectively. 

Here are two ways to increase Ability:

• Provide hands-on practice during training – Give team members a chance to implement their training by trialing it as part of the training process. For example, if you’re rolling out a new EHR system, let everyone try it to ensure they understand how it works.
• Offer expert resources to help team members – Ensure that all team members have access to any resources or expert advice needed to perform the change successfully. For example, training documentation or mentorships from other healthcare experts. 

Reinforcement

As human beings, we tend to slip back into past, comfortable patterns without realizing it. Plus, it can be hard to keep changes in place in larger organizations, where multiple people are involved in the change process.

Reinforcement is about maintaining change over time, preventing things from reverting to the old ways.

Here’s how to increase Reinforcement:

• Monitor progress – Define success measures that clearly indicate if the change is happening. With the patient record system example, you can create patient care metrics to measure success—such as the waiting time to transfer to rehabilitation, setup time for home care, reductions in lost patient records, or even numbers of privacy breaches. Tracking these metrics ensures that the change stays on course to achieve the desired outcomes.
• Engage senior leaders – Active and visible support from leaders can significantly impact its long-term success. Leaders must endorse change as an integral part of the organization to encourage team members to follow it through. 

How Effective Is the ADKAR Model in Healthcare?

Let’s explore how the using the ADKAR change management model in healthcare guides organizations through critical changes in policy, practice, staffing models and technology.

Rolling out new policy changes

ADKAR helps healthcare facilities successfully roll out new policies, helping to ensure that team members understand the need for new policies and how the change will directly impact patient care. 

Let’s use a handwashing policy as an example:

• Awareness – Communicate the need for the handwashing update, explaining that it will improve patient care by reducing the spread of contagions and contaminants.
• Desire – Highlight case studies showcasing the reduction of infections and illnesses in facilities where this new policy was implemented.  
• Knowledge – Teach people about the new policy through demonstration, practice, and informative posters at handwashing stations.
• Ability – Provide expert support to team members, giving feedback to team members as the new habits are built.
• Reinforcement – Showcase the positive results periodically after the change has begun. 

Updating healthcare practices

ADKAR helps healthcare facilities update their practices, such as the vast changes resulting from a new bug or virus:

• Awareness: Alert employees to the urgency to change, explaining what the current situation is and how change is necessary to keep patients and staff safe. Most healthcare providers will already be aware of the need to change from news media updates and leadership tables.
• Desire: Focus on the risks of not incorporating the change (such as increased infection and limited resources) and the positive outcomes (such as better patient care and a safer work environment).
• Knowledge: Teach employees how to handle new situations, ensuring proper use of PPE, sanitation, and updated care protocols.
• Ability: Have experts on hand to support healthcare workers with patient care.
• Reinforcement: Monitor patient health and comfort levels. 

Launching new staffing models

Applying the ADKAR Model in healthcare can be a beneficial method for launching new staffing models after organizational changes, such as a merger. 

Here’s how it ensures everyone follows a structured approach to creating a cohesive and collaborative organizational culture:

• Awareness – Explain why the merger is happening, focusing on the expected benefits.
• Desire – Highlight the benefits of the new structure to team members, including complementary skills that lead to opportunities for career growth and patient outcomes.  
• Knowledge – Teach team members about the behaviors they need to demonstrate to help the new structure succeed. Cover who they’ll work with going forward, offer means for team building, and teach people leaders how to show up for their new teams. 
• Ability – Help team leaders put the change into practice by helping their teams adopt and demonstrate required behaviors. Ensure team members apply the team-building activities and behaviors to convert them into habits. 
• Reinforcement – Use team member feedback surveys to track progress and identify corrective actions where teams aren’t flourishing. Use a 360-degree feedback system to reinforce the new ways of working. 

Implementing new technologies

New technologies are becoming more prevalent in healthcare organizations. The global healthcare analytics market is expected to grow by $66.54 billion between 2023 and 2028. Plus, health and life science leaders agree that automation (79%) and artificial intelligence (69%) are important to the future of their facility.

But launching a new healthcare system can be difficult, especially in an industry where technology changes can directly impact patient care. For example, losing key patient data or being unable to access certain medical information will create operational challenges and resistance behaviors that hold successful changes back.  

Here’s how the Prosci ADKAR Model can help you overcome these challenges and implement new technology:

• Awareness – Communicate the rationale for implementing new technology, such as increased efficiency or compliance with new regulations.
• Desire – Generate enthusiasm by highlighting the benefits of new technology, including how it will make their lives easier and improve patient care. 
• Knowledge – Train and coach staff on using the new technology for a hands-on approach, increasing their understanding of the system. 
• Ability – Give team members access to virtual support and documentation to aid their learning and ensure they’re confident using the new technology.
• Reinforcement – Track usage to ensure team members use the new system. Depending on the new technology, you could track other metrics like usability, improvements to patient care, duration of appointments, and so on.

Why Is Change Management Important for Healthcare Organizations?

Take a look at why an effective change management process is vital for the healthcare industry. 

Adapting to constant change

Change is constant in healthcare. An aging population, higher patient expectations, evolving technologies, and economic pressures are just some of the changes the healthcare sector will face over the next decade. 

A structured healthcare change management model ensures healthcare leaders are prepared and able to adapt to these changes. 

For example, using the Prosci ADKAR Model in healthcare shows how change happens, putting the spotlight on the steps we go through as we adapt to new ways of working. From front-line workers to senior leaders, everyone learns how change happens and where to focus their energy during each part of the journey. 

The more we understand how to change, the more we can make it quicker and easier to adapt to these changes. Take a look at how a Chicago-based academic health system used the Prosci Methodology to retain employee engagement levels and ensure all employees’ personal motivation to participate in the change remained over 90% for the duration of the integration. 

The health system was integrating two organizational entities within just two years, and their leadership team recognized the importance of supporting the people side of change. 

Prosci provided several solutions, including outlining a strategy for a consistent and structured approach through the Prosci ECM Boot Camp, engaging and educating sponsors, and establishing a structured framework for planning and executing change management.

To maintain quality of care

Effective change management minimizes the impact on patient care when change is necessary. For example, when implementing a new EHR system, a change management process ensures that records don’t get misplaced during the upgrade and that healthcare professionals can still access essential patient data. 

You think about every aspect of the change ahead of time, making sure everything runs as smoothly as possible when the system goes live.

As a result, you can help continuously ensure that patients receive the best care possible.

Plus, it enables employees to continue doing their jobs as effectively as possible. This prevents stress and minimizes burnout, allowing healthcare professionals to do their jobs with less disruption. 

Work With Prosci To Implement Successful Change in Healthcare

Putting people at the heart of change is crucial to success, which is why ADKAR is incredibly valuable for healthcare organizations looking to implement change. When you make people your focus, you will be more successful at encourgaging employees to engage, adopt and use new processes, tools or techniques in healthcare settings. In fact, research and experience consistently shows that using the Prosci ADKAR Model to drive change improves the likelihood of success with changes of all kinds.