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Ebola broke out in Congo last summer for the 10th time in 43 years. Doctors had a powerful toolkit for fighting the disease, but without change management their efforts would have had little success. 

Doctors in Goma Use Change Management to Save Lives

This summer, an outbreak of Ebola raged through the Congo. On July 14th, the first case was diagnosed in Goma, one of the largest cities and transit centers in the Democratic Republic of the Congo. The World Health Organization declared the outbreak an international public health emergency, and the response was an influx of funds, resources, and health workers.

NPR describes what came next. Citizens of Goma “threw rocks at health workers, suspicious that they were profiting off the response… They barricaded roads; they refused to wash their hands.” This was the same response health workers received in the countryside, but in a city of 2 million the stakes were far higher. 

Here’s the thing: in the past couple years, scientists have made significant advances in the treatment and prevention of Ebola. In addition to two new treatments, an experimental vaccine looks to be highly effective. The last outbreak in the Congo was contained in a matter of months. Health workers had all the tools they needed to stop the outbreak, except for cooperation from the people in need of treatment.

Health workers used change management to provide life-saving interventions to a community that was resistant to change, potentially saving millions.

Enter change management, stage left. Prosci, an international leader in change management training, lists 7 best practices:

— Mobilize an active and visible executive sponsor
— Dedicate change management resources
— Apply a structured change management approach
— Engage with employees and encourage their participation
— Communicate frequently and openly
— Integrate and engage with project management
— Engage with middle managers

To foster cooperation with the people of Goma, health workers embraced these best practices. “They went deep into the neighborhoods, explaining the disease and the treatments. They talked to leaders. They convinced more than 1,000 people to take an experimental vaccine.” Within months, they were able to control the outbreak in Goma. 

With sponsorship by the WHO, health workers were able to dedicate adequate resources to the problem. They then engaged with the community and developed advocates for change. They communicated with citizens, educating them on the disease and the treatments. In doing so, they were able to build momentum and encourage enough people to receive the vaccine.

Health workers used change management to provide life-saving interventions to a community that was resistant to change, potentially saving millions. Change management is well-worth our attention. 

Change Management: How Did We Get Here? 

The field of change management is young but complex. How did we get here? It will help to briefly travel back in time to understand the foundations of the formalized practices that flourish today.

Today, there are as many models for change management as there are consulting organizations.

Rooted in Psychology

Change management has roots in the study of human behavior. The intellectual beginnings trace to the early 1900’s, into the work of the anthropologist Arnold van Gennep. When looking at rites of passage in different cultures, Gennep began to notice common behaviors. 

Even though he was looking at a variety of different cultures, he noticed that there were three overall states that ran common in the experience of social change. The first state was a “pre-liminal” stage, where the coming change was acknowledged and prepared for by the community. 

The middle state was the “liminal” stage, which he defined as a threshold of ambiguity and disorientation. Change managers everywhere will chuckle at the accuracy of adjectives like “ambiguity” and “disorientation” when describing the liminality of change. 

The final state in a rite of passage was “post-liminal,” where the transition in status was recognized and normalized in the community. Across cultures and belief systems, Gennep was able to identify these common movements in the human experience of change. 

By the mid-20th century, when psychology began to blossom into a robust and complex discipline of study, Gennep’s three states gained popularity. In the 1940’s, Kurt Lewin became a pioneer in social and organizational psychology by turning his attention to understanding change.  Lewin borrowed from Gennep’s structure and described a three step process for change: unfreezing, changing, and refreezing.

Business Consulting & Change Management: A Love Story

There was some academic buzz from several sources in the years following Lewin’s work, but no substantial leap from psychology to business had yet been made. This changed in 1982, when a consultant at McKinsey named Julien Phillips published an article in the journal Human Resource Management. 

In his article, Phillips introduced a model for organizational change management specifically designed with businesses in mind. His model defines four steps that were intended to build momentum for change within an organization: creating a sense of concern, developing a specific commitment to change, pushing for major change, and reinforcing the new course of action. 

In the years following, change management took off. Books were published; articles became more frequent; new models were advanced. Businesses were in need of assistance with change, and consultants pursued thought leadership that would help address this need and grow their business. Peters, Waterman, Kotter, and dozens more developed robust philosophies and methods for change, and organizations bought in and helped the field to grow.

The Gunter Group does not subscribe to any one framework. Our clients are too unique for a single set of steps to be the answer.

Today, there are as many models for change management as there are consulting organizations. Looking for a 4 step process? Try PDCA. Interested in 5 steps? Try ADKAR. How about a 6 step approach? Try Pulse. Need more? Try Kotter’s 8 Steps, or Prosci’s 9 Steps. There are symposiums and communities of practice such as Prosci and ACMP; and naturally a veritable cornucopia of certifications abound. Change management is so saturated with models and approaches that some even try to push “beyond change management,” whatever that means. 

100 Frameworks, 1 Idea

The Gunter Group does not subscribe to any one framework. Our clients are too unique for a single set of steps to be the answer. We proudly proclaim ourselves to be “methodologically agnostic,” much more interested in understanding the organization than blindly peddling a process that fails to fit the people it is meant to help. 

Often the stakes of change management are higher than the bottom line.

That is not to say that we don’t know the methods. Our consultants have expertise in Prosci and ADKAR; we are trained in Six Sigma; we attend local ACMP events. We do not, however, learn a method to become disciples. Rather, we expose ourselves to frameworks and study methodological vocabulary to leverage those aspects of the frameworks that might be helpful for our work. Our clients appreciate a tailored approach that is grounded in the best practices of 100 frameworks.

This approach to consulting reveals something obvious: all change management methods are basically the same. Decades of scholarship and praxis have not changed the core phases of change, and wisdom that dates back a century still lies at the heart of responsible change. There are 3 basic phases in change (before, during, and after), and every change management framework simply iterates on the approach taken within those three phases.

So what runs common throughout all change management? What activities should you keep in mind as you tailor the process to your specific organization? We’ll run through the basics below.

Step 1: Pre-Change

Change is coming. Perhaps it is a changing regulation, a new technology, an upcoming merger, or a poor quarterly report; whatever the reason, you see change on the horizon and understand that preparation should naturally precede. Though the various frameworks approach this preparation differently, three key activities take place during pre-change: analysis, planning, and influencing.

Analysis comes first. Before you can plan for change, you have to understand the people and processes that will be impacted. Who will be your champions, sponsors, and resistors? Helpful tools for this phase include stakeholder matrices, process maps, and change impact assessments. The change manager must also understand the change itself. Without a powerful grasp on the “why” that is causing the change, planning and execution will absolutely fall short. 

Plans come next. Change management often occurs somewhere between an intersection of strategy, people, and execution, and planning is the bridge that brings these three elements into alignment. This includes planning  for the change itself, communication that will accompany the change, and the training that will make the change possible. 

Influencing should follow. ADKAR describes this as fostering awareness and desire. Prosci speaks of sponsors and champions. Others schools of thought suggest using concepts like vision or need, and still others recommend introducing guilt and anxiety. We have found that a cocktail of all these approaches is usually the best way forward.

Step 2: Change

You’ve spent time interviewing stakeholders, mapping processes, and planning training sessions; now it’s time to introduce the change. This is messy, confusing, and difficult for the people impacted so change managers often rely most heavily on a methodology in this phase. However, mid-change is where a generalist approach could be most advantageous, adapting to the ongoing needs of the situation. There are four activities that always occur in any well-managed change approach: communication, training, changing, and reinforcement.

The most important activity surrounding change is communication. This is where you lean heavily on the results of your analyses. You know who needs communication, what they need to hear, and how it will affect their work flow. Armed with this information, you can plan accordingly, communicating the upcoming movements to the right people, early and often.

Another helpful activity is training. This often goes hand-in-hand with communication, and is best when designed from the viewpoint of those impacted. Recent developments of tools such as Human Centered Design help maximize the value of training.

At a certain point, the change will happen. Kotter recommends an approach of small-slicing the change to create short term wins, but often the change manager is not the one driving the project timeline. When it comes to go-lives, change managers serve a thousand roles. They become SME’s for elements of the change impact; they serve as blockers attempting to remove obstacles from stakeholders; they act as cheerleaders or bulldogs, whatever is called for in the moment. 

As change occurs, another important activity is reinforcement. This activity truly begins in pre-change and extends through the end of post-change, but it becomes extremely important in the midst of the change. There are approaches coming out of organizational psychology that can be helpful here, such as Vroom’s Theory of Motivation, McClellan’s Theory of Three Needs, or McGregor’s Theory X and Theory Y.

Step 3: Post-Change

Follow-through is a must. As Gennep would say: the new status must be confirmed and the change must be reincorporated as the new norm. This is done a little differently in each framework, but necessary activities include reinforcement and reanalysis. 

As said above, reinforcement is heavily featured in post-change activities. The goal is longevity, driving the change through ongoing champions and dwindling resistance. Success is celebrated, momentum is reinforced, and improvements are consolidated. Through these activities, the new order is anchored in behavior.

One often-forgotten activity that takes place after the change occurs is reanalysis. Throughout this whole process, you’ve generated a mountain of information, from stakeholder input to process metrics. Current-state assessments performed before, during, and after the change are a great way to analyze that information, evaluating the effect of the change. 

Let’s go back to Ebola in Goma. Upon review, we can find the three stages of change management in this case study. In advance of providing saving care, health workers analyzed the neighborhoods they would need to enter, planned ways to connect people with treatments, and influenced communities by winning over their leaders. They communicated the need and effect of the cure, trained communities to embrace treatment through a successful pilot of an experimental vaccine, and built momentum for changing attitudes. After change began to take effect, their efforts were reinforced by positive clinical outcomes and they reanalyzed future need for treatment with ongoing screenings. 

Change management is the study of human behavior. Human beings hate change, yet change is unavoidable. As professionals in change management, we bring a people-centered approach to our work.  This is undeniably good for business, as evidenced by a flourishing market of change management consultants and frameworks. But often the stakes of change management are higher than the bottom line, and the WHO’s heroic efforts in Goma are a testament to that.