Why Is Successful Change So Hard to Create?

Change is an important part of improvement. While new solutions can go a long way toward revolutionizing a health system’s processes, at Pulsara, we believe that change is 5% technology, 15% process and 80% about people.

People have a profound impact on their organization. While making changes on an individual level may not seem significant enough to make an impact, the global leaders in change management at Prosci make it clear that individuals are the true drivers of change: “Organizations don’t change, people do. It is the cumulative impact of successful individual change that brings about successful organizational change. If individuals don’t make changes to their day-to-day work, an organizational transformation effort will not deliver.”[1]

Change is hard for most people, and there are many reasons why. Cultural and process changes can affect people neurologically, socially, psychologically or even physiologically.[2] However, resistance to change doesn’t necessarily equal opposition. Taking the time to understand how change affects people is important, and working to overcome obstacles people face when navigating change has a direct impact on productivity. Organizations that have a well-oiled change management process see less financial impact than those that don’t prioritize it when initiating change.

Resistance to change is normal, and it should be something that change leaders anticipate. The Kübler-Ross Change Curve nicely illustrates that emotions like shock, denial and frustration do not mean that those in your organization are opposed to change; these are normal stages of the change management process that need to be accounted for.[3] By recognizing and understanding the human response to change, healthcare leaders can implement change management strategies that minimize the financial impact on their organization.

What does this look like in practice? There are many existing frameworks, courses, and certifications, but Gleicher’s Formula for Change (later refined by Kathie Dannemiller) is a good place to start.[4] The formula is:

D x V x F > R

Dissatisfaction x Vision x First Concrete Steps > Resistance

The combined impact of dissatisfaction, vision and concrete steps forward is greater than the resistance to change. Leveraged together, they can help overcome it.

  1. Dissatisfaction: What’s not working? What conditions are dissatisfactory? Understand and discuss why the change is necessary. Make sure to clearly communicate the issues to all stakeholders, so that they understand why change is needed.
  2. Vision: Create a positive vision for the future. Help stakeholders understand the type of positive changes that will happen if everyone undertakes the change together. Create a positive picture of how it will change everyone’s work for the better.
  3. First Concrete Steps: In order to get started, everyone needs a clear idea of how to begin. Make sure to clearly define the first concrete steps toward making the vision a reality.

For change management to be successful, it’s essential for everyone to understand both why change is needed and what the path forward looks like. Getting on the same page with all team members can help reduce the friction caused by introducing something new. When everyone has a chance to be involved in the process and feels heard in their concerns, buy-in is much more likely.

Painting a clear picture of the end goal will also help team members adjust to the idea of change. When everyone understands the “why” behind the change and sees the positive impacts it’s meant to bring about, they’ll be more willing to participate.

And finally, helping everyone understand the vision for the future is just as important as outlining the first steps toward making the change happen. By defining a clear expectation of the steps that need to be taken, you’ll set team members up for success in knowing what their role in the process will look like.

For more ideas on successful change management, check out these resources:

4 Keys for Managing Change Amid Chaos

Regional Change Management: How Healthcare Leaders Are Connecting Teams and Organizations for Better Outcomes (Webinar)

Pulsara is the leading mobile telehealth, communication and logistics platform that unites healthcare teams and technologies across organizations during dynamic events. Studies report an average decreased treatment time of approximately 30% when using Pulsara. For more information, visit www.pulsara.com.


[1] Prosci, “What Is Change Management?,” online, accessed June 2022

[2] Be the Change, “Why Do We Resist Change? Improvement Is All About People,” online, accessed June 2022

[3] Elizabeth Kübler-Ross Foundation, “Kübler-Ross Change Curve,” online, accessed June 2022

[4] Chris Pennington, “We Are Hardwired to Resist Change,” blog post, April 3, 2018

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