Why Change Management Is a Core Leadership Skill
Healthcare organizations undergo constant change, from electronic health record upgrades to new coding guidelines. HIM leaders must guide their teams through transitions with minimal disruption to operations and morale. The RHIA exam expects candidates to recognize named change models and apply them to workplace scenarios.
Lewin Change Model
Kurt Lewin proposed a three-stage model: unfreeze, change, and refreeze. Unfreezing involves preparing staff for change by explaining the need for it. The change stage is the actual transition period, and refreezing stabilizes new behaviors so they become the standard way of working.
Kotter Eight-Step Model
John Kotter expanded change theory into eight steps, including creating urgency, building a guiding coalition, forming a vision, communicating that vision, removing obstacles, generating short-term wins, sustaining momentum, and anchoring changes in the culture. HIM directors implementing a new encoder system often use this model to structure a rollout plan.
ADKAR Model
ADKAR stands for Awareness, Desire, Knowledge, Ability, and Reinforcement. This individually focused model helps leaders understand why some employees resist change even when the organizational rationale is clear. It is especially useful for training plans tied to technology adoption.
Common Sources of Resistance
- Fear of job loss or role changes
- Lack of trust in leadership
- Insufficient training or communication
- Past negative experiences with change initiatives
Strategies to Reduce Resistance
Effective leaders communicate early and often, involve staff in planning, provide adequate training, and celebrate small wins along the way. Transparency about the reasons for change reduces anxiety and builds trust.
Applying This to HIM Practice
Consider a scenario where a hospital transitions from paper-based release of information to a fully electronic system. A leader using Kotter model would first establish urgency by highlighting turnaround time problems, then build a coalition of department champions before rolling out training.
Exam Tip
Expect questions asking you to identify which change model best fits a described scenario, or to sequence the steps of a given model correctly.