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The Four Phases of Change


In preparing our staff for an EMR implementation, I am reminded of the four phases of change staff typically go through. Here’s how to handle the phases.

The institution I work for is preparing to implement a new electronic medical record (EMR), and we recently had a leadership meeting updating us on the timeline of the implementation. As I was listening to the overview I thought I better start preparing for change and its operational effects.

During change it is easy to take the staff’s feelings personally. There are four phases of change that people commonly move through when facing change. I have found understanding these four phases helps me deal with change more effectively and not take staff comments and feelings personally.

Phase 1: Denial

In this stage individuals go through withdrawal and focus on the past. There is activity but not much work gets done. Address this stage with information. Let staff know change will happen and why the change is need.

Phase 2: Resistance

In this stage be prepared, because you will see anger, blame, anxiety and depression. This will be the most difficult stage for you as a manager. Use active listening to effectively deal with resistance. I encourage you to get your staff to talk about their feelings. If you do not encourage staff to express their feelings, this stage will only last longer.

Phase 3: Exploration

In this stage there will be confusion, over-preparation, chaos and energy but you will likely notice a lack of focus. To deal with exploration you must set short term goals to channel energy and get the staff focused.

Phase 4: Commitment

In this final phase of change the staff will start working together. You will see better cooperation from the staff and improved focus. When you feel the staff have reached the commitment stage you can then start setting long term goals and looking ahead to the benefits that will occur as a result of the changes.

In addition to understanding the four phases of change, there are two other strategies I prefer to use when implementing change. When initiating change I prefer to communicate as much as possible in person. In the age of electronic communications, it’s easy to use email to carry your message. However, email doesn’t allow employees to express their feelings directly.

Finally, I have found it helpful to let staff know my feelings about the change. For example, when I communicated about the new EMR to the staff at one of my imaging centers I stated: “Sure, when we first start using it we will be slower in our processes, but the integration and functionality will make us more efficient in the long run.” The staff does want to know what you are feeling and often this will help them feel more comfortable about opening up and expressing their feelings.

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