As a Change Optimisation Consultant, it is my role to ensure that new ideas, systems, or improvements are successfully adopted so that members see real benefits and experience no disruption. I see and help to manage change in lots of ways.

Healthcare is a constantly evolving environment. Advances in technology, new clinical guidelines, regulatory changes, workforce pressures and shifting patient expectations mean medical professionals are repeatedly asked to adapt often quickly and under high stakes.

The ADKAR model (Awareness, Desire, Knowledge, Ability, Reinforcement), developed by Prosci, provides a practical, human‑centred framework for navigating change by focusing on the individual experience of transition rather than only organisational processes.

Medical Protection applies the ADKAR model in change work. Here’s a breakdown of the steps and how they can help you remain effective, resilient and patient‑focused during periods of change. 

Awareness: Understanding why change is necessary 

The first step in ADKAR is awareness of the need for change. In so many industries change initiatives often fail when people perceive them as imposed, poorly justified or disconnected from the customer. The customer here could be colleagues, members or patients. People are more likely to engage when they clearly understand the clinical, ethical or safety rationale behind a change. 

For example, when introducing a new electronic health record system or updated infection‑control protocol, leaders and clinicians alike should connect the change to tangible outcomes, such as reduced medication errors, improved continuity of care or compliance with updated evidence‑based guidelines. Awareness is strengthened when information is transparent, consistent and tailored to different professional roles. A consultant may need data on clinical outcomes, while nursing staff may need clarity on workflow impacts. 

We can actively support this stage by asking clarifying questions, seeking evidence and engaging in dialogue rather than resisting change based on assumptions. Awareness reduces anxiety by replacing uncertainty with understanding. 

Desire: Building personal and professional commitment 

Desire refers to the individual’s willingness to support and participate in the change. Desire is not something that can be mandated; it must be cultivated. 

To build desire, change should be framed in terms of what this means for your patients and your practice.For instance, a shift toward multidisciplinary team meetings may initially feel time‑consuming, but when clinicians see improvements in decision‑making and reduced duplication of care, intrinsic motivation increases. 

We can strengthen our desire by identifying personal benefits – such as reduced cognitive load, improved patient safety, or enhanced professional development – and by voicing concerns early. Feeling heard is critical as resistance often reflects unaddressed fears about competence, time pressure or loss of autonomy. 

Knowledge: Learning how to change 

Once desire is present, individuals need knowledge about how to change. In many environments, inadequate training is a common barrier to successful change. Knowledge goes beyond knowing what is changing. It includes understanding how to perform new tasks safely and effectively. 

Effective knowledge transfer in healthcare often combines formal education (e‑learning, workshops, simulations) with practical guidance such as quick‑reference tools, clinical champions and peer‑to‑peer learning. For example, introducing a new prescribing protocol requires not only policy documents but also case‑based discussions and decision‑support tools embedded into daily practice. 

We should take ownership of this stage by engaging fully with training opportunities and acknowledging gaps in understanding. In a safety‑critical environment, asking for clarification is a professional responsibility, not a weakness.

Ability: Translating knowledge into practice 

Ability is the point at which change becomes real. It involves applying new knowledge consistently and often under pressure. In healthcare, this is where many change efforts falter. Colleagues may understand what to do but struggle to integrate it into busy workflows. 

Developing ability requires time, practice and psychological safety. Shadowing, supervised practice and phased implementation are particularly effective. For example, resident doctors adopting a new handover framework may initially need structured prompts and senior oversight before the process becomes routine. 

We often expect a temporary dip in efficiency during this phase. Recognising this as a normal part of change helps prevent frustration and self‑criticism. Leaders and peers play a crucial role by providing constructive feedback, adjusting workloads where possible and reinforcing learning through real‑world application. 

Reinforcement: Sustaining change over time 

The final stage, reinforcement, ensures that change is sustained rather than abandoned under pressure. In healthcare, where staff shortages and emergencies can pull teams back to old habits, reinforcement is essential. 

Reinforcement can include audit and feedback, recognition of good practice, clinical outcome data and ongoing refresher training. Celebrating small wins – such as reduced incident reports or improved patient satisfaction – helps embed new behaviours. Importantly, reinforcement should be aligned with professional values, emphasising quality of care rather than mere compliance. 

We can also contribute to reinforcement by role‑modelling new practices, supporting colleagues and challenging outdated behaviours in a respectful way. When change becomes part of professional identity, it is far more likely to endure. 

Conclusion 

ADKAR offers a structured yet flexible way to understand and navigate change in complex environments. By addressing awareness, desire, knowledge, ability and reinforcement at the individual level, colleagues can move beyond passive compliance toward meaningful engagement. Ultimately, applying ADKAR helps ensure that change initiatives not only succeed operationally but also enhance patient care, professional wellbeing and clinical excellence. 

This article provides a high‑level overview of the ADKAR model as developed by Prosci. ADKAR® is a registered trademark of Prosci Inc.