Change and Barriers to Change

  1. Relate the concept of Ability presented by author Hiatt in the ADKAR model with the concept of enable action in the Cohen and Kotter model.

The concept of ability presented by Hiatt in the ADKAR model is focused on what people learn as they try to get to the point where they are able to realize new goals (PROSCI, 2017). Change in this case is a result of people adjusting their performance to match the new goals of the organization. The concept of enable action in the Cohen and Kotter model is concerned with the organization creating an environment that allows the employees to adopt change (Mulder, 2014). It entails the organization training employees and teaching them new skills, giving them time to adopt to new systems and generally facilitating change in the organization. In the Cohen and Kotter model, enabling action can also be likened to removing obstacles of change.

When adopting change, the organization should ensure that any change adopted is to improve the quality of services or products. For instance; a hospital should adopt change with the aim of treating patients better and reducing readmission rates where necessary. The hospital can invest in training more nurses on after care services and get better equipment for the comfort of the patients. The hospital management should train nurses and give them time to adjust to new systems of handling their patients. By so doing, it is now going to be easier to evaluate the change and find out whether it is effective or not. Going back to the ability and enabling action concepts, the people involved in guiding change in both models have to be hands on. They have to show that they are being part of the change by practicing the new ways of operations. This is a way of enabling change and showing that change can be achieved. If it is a new way of collecting patient information, the change manager should practice it so that the rest of the hospital staff can also follow the same path.

  1. Briefly define the four main barriers to change (Structure, Skills, Systems and Resistant Management). Give an example of how to get through, under, over or around these barriers to your goal of seeing a change implemented. 

The barriers to change are many but the four major ones are; structure, skills, systems and resistant management. Skills entail the knowing how to professionally perform tasks in the professional work space. Skills are necessary in any work place, they differentiate professionals and even within the same professions, some people are better than others (National Institute for Health and Clinical Excellence, 2007). Skills as a barrier to change can be overcome by training people on new skills so that they can be confident enough to adopt change. Like when a change in how Caesarean section operations were performed was made, the surgeons, doctors and nurses had to be retrained in order to prevent them from resisting the change.

Structures are the arrangements put in place to help organizations achieve their goals. Some of the structures like the admission procedures may be very natural for nurses who have worked for a long time in the hospital. Changing this may lead to resistance by the nurses who find learning new ways of performing the tasks tedious and confusing. This can be overcome by having new nurses perform these tasks together with the old nurses so that they learn together. This will reduce the resistance to change over time. 

Systems are the interconnections of the various departments of the organizations that put together from the seamless operations of the organization. The systems may be slow to adopt change or rigid to change in a way that hinders barriers. In a hospital setting, the process of admitting patients to the time of discharging them may need to change but the departments in the chain may make it difficult to change. The human resource may propose that the finance department be discharging patients with small hospital bill balances while the finance department objects. In order to avert such a clash in the departments, communication is important (National Institute for Health and Clinical Excellence, 2007).

Resistant management is the type of management that is not accepting to change. Such a management can only be managed with the members of staff presenting their proposals for change in a way that the management is convinced and any questions they may have can be answered. For instance; a change in the rotation of nurses in their shifts may be necessary to ensure that patients get to rest well and offer quality care to their patients. A rigid management may turn down such a proposal citing reasons like the nurses wanting shorter shifts and less working days. Communication at this point is very important (National Institute for Health and Clinical Excellence, 2007).


Mulder, P. (2014, January 8). Kotter’s 8 Step Change Model. Retrieved from ToolsHero:

National Institute for Health and Clinical Excellence. (2007). How to Change Practice. In N. I. Excellence, How to Change Practice (pp. 19-40). High Holborn: National Institute for Health and Clinical Excellence.

PROSCI. (2017). What is the ADKAR model. Retrieved from Prosci:

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