change management

Change Management in Health and Social Care – Types, Models, Principles and Steps

Change is inevitable in any environment, including care facilities and care systems. Change management is the act of approaching transitioning to new territories. It helps institutions settle to changes that will improve the quality of care in the health and social care system.

This article highlights the key concepts in change management. It also provides an actionable plan to implement change in your organisation with as little resistance as possible.

In this article:

  • What is change management?
  • Types of change management
  • Lewins’ change model
  • Forced field analysis
  • Change management principles
  • 5 steps to effective change implementation
change management

To explore how to assess your practice and improve the quality of your services, you may want to read this article on quality improvement tools.

Types of change management

Three major types of change management happen in any system: development, transitional, and transformational change management. Understanding each type of change places you in a better position to choose the right strategies to deal with change and the new challenges it brings.


It is the type of change that requires an upgrade of the system to improve the operations, systems, customer service, and even sales. Developmental change management will assist you in implementing the changes seamlessly so that you can grow your facility.


Transitional change is associated with mergers, acquisitions, or rebranding. The new ways of operating may cause stress to employees even when the core business doesn’t change. It takes a while for people to adapt to the transition, and you need to manage the change.


Transformational change occurs when a company tries new policies and procedures. Managing transformational change is the toughest of all because of all types of change management.

Lewin’s change model

In the 1950s, Kurt Lewin, a German-American organisational psychologist, studied how people and processes work within organisations. He proposed the Lewin’s change model, which is still commonly used today in implementing organisational change.

The model is also useful in team-building to help institute the culture of change among staff and make it part of day-to-day operations. It also helps to re-orient employees about the benefits of change.

According to Lewin’s change model, change is a transition between one state to another, and happens in three stages:

  1. Unfreezing existing behaviour or processes
  2. Moving to new behaviour or process
  3. Refreezing the behaviour or process

To apply this model to your organisation, educate staff to help them unlearn (unfreeze) their existing practice. Then, introduce the new practice and show why it is better than the existing ones. Finally, make the new practice permanent (refreeze) with regular reminders as often as appropriate.

Force field analysis

Also developed by Kurt Lewin in the 1950s, the force field analysis helps to examine factors that are likely to influence the success of implementing change.

force field analysis
Force field analysis example

In this analysis, all factors influencing change are “forces” that can be categorised into two:

  • Driving forces: These are factors that are likely to initiate change or support its implementation. In other words, these are factors for change.
  • Restraining forces: There are factors likely to act against the driving forces. Thus, these are factors against change.

To use the force field analysis, conduct a quick workshop with staff and brainstorm all the factors for and against the proposed change. For each driving force, come up with ideas to increase its impact. For each restraining force, brainstorm how to eliminate or reduce its impact. Better yet, come up with ideas on how to turn some of the restraining forces into driving factors.

Note that evidence suggests that reducing the restraining forces is much more effective in implementing change than increasing the driving forces.

Principles of change management

Several principles of change management will help you to implements them in the right manner. Poor implementation of change management is more common, and it can hinder the quality of healthcare. Here are some of the principles that will help you successfully implement change management in your organization.

Identify the problem

You need to identify the problem that needs to change before you start the change management process. The easiest way to identify a problem is to choose an approach and figure out why it doesn’t produce the intended results.

Change the culture

A healthcare facility’s culture will determine how employees will take the new changes. Changing the organizational culture will help you reduce the resistance from employees that love the old way of doing things. Be patient when you are trying to change the corporate culture because change takes time.

Consider all aspects

It is essential to work with all employees to help you figure out the technicalities of implementing organizational-wide changes. You need to work with top and middle management to find out the best changes for improving quality.

Work with influencers

You need to engage the employees that influence veterans, stakeholders, and executives. Engaging people with influence will help improve the quality of health and social care go on faster.

Clear instructions

You need to provide clear instructions to the managers on how the changes need to occur. Every manager and supervisor in the health and social care facility should understand the course of action from the first day. Communication will be vital in ensuring that everyone understands what to do.


All new changes come with some new sets of skills and procedures. You need to train your staff on the recent changes that will be taking place in the facility. Managers and supervisors need training on how to follow the progress of change management. It is essential to have a Q&A session with your employees to answer any questions they may have.


Someone needs to be in charge of implementing the change management plan. It is essential to have someone to monitor the progress of the changes you are making continually. A leader with a clear strategy will be in a position to evaluate the uptake of the changes and identify what needs to be done to ensure the changes stay on track.

Five steps to effective change management

Five steps will help you to effectively implement change management to improve the quality of health and social care services. It is not easy to apply change management in any institution, let alone a healthcare facility. Here are some of the steps you need to consider:

Step 1: Planning

You cannot successfully implement change unless you have a clear plan and strategy on improving the quality of your services. You cannot afford to change everything at once. It would be best to make the changes in phases to help everyone in the organization adjust. You need to work hand-in-hand with top management and supervisors to implement the plan.

Step 2: Start from the top

All changes need to start from the top for the transition to go through as planned. Everyone in the top management should endorse the changes in improving the quality of services in healthcare facilities. Keep in mind that your juniors will be looking at the top management to see whether they are taking the changes seriously.

Change management should be a team of you want to see any quality improvements in your facility. The change needs to begin with you, and the juniors will follow suit.

Step 3: Talk to all cadres and layers of staff

Changes are hard to comply with, and some may be harder on some departments than others. Take time to evaluate how the changes affect other staff in different departments.

Healthcare providers may resist change when there is no appropriate support during the transition period. You can check-in with supervisors and see the challenges that they face from the implementation process. Health care providers are an essential part of the health and social care system, and you must make sure that everyone is taking the changes in stride.

Step 4: Evaluation

Evaluate the chain of change management to ensure everything is running smoothly. Implementation of change usually has an intended outcome. Evaluation of the real progress of the changes enables you to understand your progress towards achieving your goals. The person in charge of implementing the changes should be in a position to provide regular progress reports.

Also, an evaluation will uncover undesirable outcomes due to the transition.

Step 5: Prepare for surprises

There will always be surprises when it comes to implementing any plan. Evaluating your strategies is a good start to identifying any surprise outcomes during the early stages.

Shocks can slow down your implementation process if you don’t have a contingency plan. Make it your business to come up with corrective measures for any surprises in the system. Identifying pitfalls in advance will enable you to improve health and social care quality with several strategic changes.

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