Factsheet: Key Evidence: Approaches to Change

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Key Evidence: Approaches to Change




Action research
(eg Community based; Participatory Action Research).


Action research is a cyclical approach to change in which researchers and decision makers work together (in large or small contexts) to initiate change. There are many adaptations but essentially all adapt and adjust the change process based on lessons learned through a disciplined process of planning, initiating, implementing, and reflecting on the change process.



ADKAR is a goal-oriented model that allows teams to focus their activities on specific results. The model was originally used as a tool for determining if change management activities were having the desired results. The acronym stands for:

AWARENESS of the need to change;

DESIRE to participate and support the change;

KNOWLEDGE of how to change and what the change looks like;

ABILITY to implement the change on a day-to-day basis; and

REINFORCEMENT to keep the change in place.

Appreciative Inquiry.


Appreciative Inquiry is a form of action research that articulates a future vision, and then uses a disciplined process of identifying strengths, designing changes to maximize those strengths, and then implementing those designs.

Balanced Scorecard.


The Balanced Scorecard integrates measures derived from strategy so managers can guide an organisation to achieve results under a balance of related management perspectives. The perspectives focus on achieving the vision of the organization. In its classic form, a Balanced Scorecard defines performance objectives under financial, customer, internal business processes and learning and growth perspectives.

Bridges Transition Model.


Bridges approach addresses the psychological transitions of the people impacted by the change It is a three-phase process of:

(1) ending, losing, and letting go of previous processes;

(2) getting through the neutral zone; and

(3) accepting a new beginning.




Business Process Engineering.


The primary goal of Business Process Engineering (BPR) is to effect change to improve either efficiency or effectiveness of core business processes.

AS tools: dialogue conferences, communities of practice etc.


These tools attempt to bring diverse and sometimes competing individuals and groups together and takes them through disciplined processes of interaction and communication, aimed at ‘meaning making’ together; and gaining multi-individual and group support for actions required for change to happen.

Change Handbook – a Definitive Resource.

Tools, techniques.

A compendium of 61 practices and processes (eg, future search; open space) aimed at supporting individuals who are committed to changing whole systems – organizations and communities. Individuals pick and choose the particular approach germane to their context and purpose.

Change-Related Commitment Measure.


Jansen (2004) developed a Change-Related Commitment measure consisting of eight items assessing organizational members’ agreement and willingness to work toward the change goal. It can be used to assess readiness for change in a sample of organisational members.

Complex Adaptive Systems approach.

Conceptual process.

A four-stage conceptual approach, employing a Complex Adaptive Systems (CAS) perspective, is based on the premise that in large systems, CAS is more applicable than the more linear approaches that are used in clinical redesign.

Force-field analysis.


Force field analysis identifies the driving and resisting forces associated with any change, and to achieve success, ensures that driving forces outweigh resisting forces.

Instruments to measure culture


Nine instruments identified by Scott et al (2003) are available to assess organisational culture, all of which have limitations in terms of their scope, ease of use, or scientific properties. The choice of instrument should be determined by how organisational culture is conceptualized, the purpose of the investigation, intended use of the results, and availability of resources.

Instruments to measure readiness.


Five instruments are suggested. Klarner et al’s (2007) instrument measures organizational capacity for change. Jansen (2004) developed a Change-Related Commitment measure. Holt and colleagues (2007) developed a Readiness for Organizational Change Instrument. Herscovitch and Meyer (2002) developed a Commitment to Change measure. The ORCA (Helfrich et al, 2009) was designed to test readiness for change related to implementing evidence-based improvements in practice. The choice of instrument should be determined by what aspects of readiness need to be determined.

Klarner model.

Assessment tool.

Klarner et al’s (2007) instrument measures organisational capacity for change, based on a conceptual model for change that combines both the process and context determinants of change. An analysis of an organisation’s change capacity allows it to better deal with the determinants of change capacity, which increases adaptation and survival.

Kotter’s 8 stages of change.


Kotter’s model outlines eight critical components of generating transformation in organizations. These components take the manager through a disciplined process of initiating change, planning change, implementing change, and institutionalizing the change (drawn from private sector).

Kübler-Ross Model.


Commonly known as The Five Stages of Grief, is a hypothesis first introduced by Elisabeth Kübler-Ross in her book On Death and Dying. The stages, popularly known by the acronym DABDA include: Denial, Anger, Bargaining, Depression, Acceptance.

Lewin Model.


Kurt Lewin’s change model is a simple three-step change model. The first step in the process of changing behaviour is to unfreeze the existing situation. Only then can change, or movement, occur (the second step). Finally, to make the new behaviours stick, a third, refreezing step is necessary.

Lomas’ change approach.


Theoretical framework for connecting research and policy to facilitate change. This framework emphasizes the importance of not only sharing information and evidence to impact policy, but also using formal and informal networks for dialogue and exchange with stakeholders.

McKinsey’s 7-S model.


Developed by well-known business consultants Robert H. Waterman, Jr. and Tom Peters in the 1980s. The 7S are structure, strategy, systems, skills, style, staff and shared values. The model is most often used as a tool to assess and monitor changes in the internal situation of an organisation. The model is based on the theory that, for an organisation to perform well, these seven elements need to be aligned and mutually reinforcing. So, the model can be used to help identify what needs to be realigned to improve performance, or to maintain alignment (and performance) during other types of change. Whatever the type of change – restructuring, new processes, organisational merger, new systems, change of leadership, and so on – the model can be used to understand how the organisational elements are interrelated, and so ensure that the wider impact of changes made in one area is taken into consideration.

PDSA cycle.


This model tests ideas in rapid cycles for improving a component of the system. The four steps are Plan the work; Do the work; Study whether the outcome was achieved, or not; and Act on the change by adopting/adjusting as needed.

Readiness for Change Instrument.


Holt and colleagues (2007) developed a Readiness for Organisational Change Instrument.

Six Sigma.


Six Sigma seeks to improve the quality of process outputs by identifying and removing the causes of defects (errors) and minimizing variability in practices.

Swedish Change Model.


This ‘top down, bottom up’ model outlines a set of 11 criteria by which to examine the quality of the change process and how likely it will succeed. The model seems to work well for adaptability and handling contextual dependency.

Transformation Cycle.

Conceptual approach.

The transformation cycle integrates key cornerstones of transformational change; a model of transformational leadership; connecting them with strategic/business planning, execution, and performance monitoring.

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