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States of Change

This February, Genesis Health Consulting is blogging about why the practice of change management is a critical enabler of large and small efforts to generate new behaviors, processes, partnerships and outcomes. Read our first blog here.

Understanding readiness for change is a key factor in managing change within a team, department or organization. Completing a readiness assessment helps leaders understand how colleagues are currently thinking about change, and allows leaders to utilize stage-specific strategies to help people progress along their change journey. There are multiple validated tools that can be used for this purpose. The PROSCI ADKAR model is one such tool.

In our last blog post, we briefly described the ADKAR methodology. Essentially, ADKAR supposes that people experience change along a continuum; from Awareness to Desire, to Knowledge and Ability, and finally, to Reinforcement. These five experiences generally track to three stages of change, as outlined in the figure below.

Current State

In order to move out of current state and start making a change, the ADKAR model posits that people need to know that there is a need for change and they have to want to change.

Awareness of the Need for Change

Developing awareness for the need for change begins with testing new perspectives on what might be possible. Our habits and routine are quiet and powerful forces that encourage maintaining the status quo. The following strategies seek to build this awareness:

  • Some colleagues will respond to facts and logic as core arguments for change. Discussing data which supports the change can be a successful strategy to build awareness of the need for change.

  • Utilizing colleagues or a champion to have peer-to-peer conversations may further legitimatize data.

  • Other colleagues will respond more strongly to an emotional appeal for change, in which case stories, pictures, and atypical messengers (e.g., children, families) may be a more effective way to communicate a change opportunity.

Desire to Support the Change

Being stuck in this step of the ADKAR model often sounds like, “But this is the way we have always done things.” People may accept that a change should to occur, as long as someone else is doing it. The following strategies help to build support for change:

  • Think of what motivates each of the person in this stage and build motivators into the process.

  • Ask leaders to deliver messages promoting culture of change (e.g., safe to try new things, even if they do not succeed).

  • Avoid giving people at this stage a large number of tasks affiliated with the change.

  • Work with the team to identify if it is possible to incorporate the change into existing processes to minimize disruption.

  • Hold listening and discussion sessions to hear firsthand the concerns people have and allow them to express the emotions they are feeling through questions such as, “What would happen if the change succeeds?”, or, “What would happen if the change fails?”

Transition State

People may be fully supportive of a change that they know needs to occur, and yet, still feel stuck in moving forward. Strategies for a transition phase seek to provide people with knowledge, skills and behaviors to enable change.

Knowledge of How to Change

People may be aware that a change needs to occur and they may wholeheartedly support that change, but may not have understand how to move from where they currently are to where they need to be. Strategies affiliated with this step work to break down these knowledge barriers:

  • Provide education in any new skills that may be required as a result of the change.

  • Create roadmaps that break the change down into small steps and outline exactly who needs to do what in each step.

  • Utilize peer-to-peer coaching and mentoring to share knowledge within and across teams.

Ability to Demonstrate the Skills and Behaviors

The step from knowledge to ability is not unlike the step from awareness to desire in that simply equipping people with knowledge is not going to immediately transform their skills and behaviors. Strategies here build on knowledge gained:

  • Incorporate practice sessions including role-modeling scenarios, and testing. equipment, processes for people to test out the new skills and/or behaviors

  • Provide technical support to teams making change through the first several cases incorporating the change.

  • Pair team members with differing skill sets to facilitate learning and provide peer coaching and support throughout the change.

Future State

Future state is where the work moves away from being “the change” and towards the new “way we do things”. The final step of the ADKAR model seeks to reinforce all of the learnings from the process.

Reinforcement to Make the Change Stick

Even with all of the above, change efforts can stall out if attention is not paid to reinforce all of the above using the following strategies:

  • Celebrate wins, no matter how large or small.

  • Set up regular feedback loops to discuss progress, barriers and data related to the change.

  • Seek out opportunities to share the process and outcomes with other audiences within the organization.


Genesis Health Consulting has deep experience in change management principles and in co-creating smart, effective and sustainable systems change in support of child health and well-being. Please email us at to learn more about our work in this area.

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