Change Management and Lean’s Three Basic Rules
Recently, I was in Atlanta for the Healthcare Systems Process Improvement Conference, #HSPI2026. As I walked out of a presentation, it suddenly occurred to me how the Basic Rules of Lean were related to Change Management. Now, maybe this has already occurred to you, but it was a revelation for me.
Let’s start with the Three Basic Rules:
1. Go See
2. Understand Why (Some people have this as “ask why”, but I believe understand why is more descriptive of the intent.)
3. Show Respect
Why don’t we take each one in turn and look at its relationship to change management? But first, we need to define change management. The American Society for Quality says, “Change management is defined as the methods and manners in which a company describes and implements change within both its internal and external processes. This includes preparing and supporting employees, establishing the necessary steps for change, and monitoring pre- and post-change activities to ensure successful implementation.” According to their research, “Changes usually fail for human reasons: the promoters of the change did not attend to the healthy, real, and predictable reactions of normal people to disturbance of their routines. Effective communication is one of the most important success factors for effective change management. All involved individuals must understand the progress through the various stages and see results as the change cascades.”
So, how do the three basic rules of Lean factor into Change Management? The first rule is Go See. When we go to the workplace, be it a factory floor or a Radiology department, we prove to staff that we are seeking to understand their situation, their reality. All change comes with anxiety, uncertainty, and doubt. Being on the floor with the staff and seeing the various situations that present themselves encourages them to know that we at least understand some of what they face on a day-to-day basis. This eases some of their anxiety that change is driven by some nameless, faceless individual in an ivory tower somewhere.
Understand Why – We start by talking with staff and asking why. Allowing staff to give their perspective on what is going wrong or what the problem is, engages staff. It lets them be a part of the process, and everyone feels better when they take part. It also allows them to offer suggestions for the solutions at the proper time.
Show Respect – While the first two are part of the diagnosis process to understand the problem, the final rule is about how we treat people. The idea of show respect is about first showing respect to the front-line staff for their knowledge and contributions. In my opinion, it starts with being humble.
Let’s look at some of the first steps in change management. I’m going to use a model we use at Kinetic Resolution, based on John Kotter’s book, Leading Change. In our model, there are five steps:
1. Understand the common needs
2. Communicate the future state
3. Build a guiding coalition
4. Develop a change strategy
5. Create a supporting infrastructure
For contrast, let’s look at Kotter’s 8-step model and the GE CAP model. Both of these models, I consider, are more tactical than strategic and very well suited to process improvement efforts.
Kotter’s 8-step model:
1. Create a sense of urgency
2. Build a guiding coalition
3. Develop a vision and strategy
4. Communicate the change vision
5. Empower broad-based action
6. Generate short-term wins
7. Consolidate gains and produce more change
8. Anchor new approaches in the culture.
GE CAP Model:
1. Create a shared need
2. Shaping a vision
3. Mobilizing commitment
4. Making change last
5. Monitoring progress
These models share a number of concepts, but our focus here prevents me from going into more depth. A later post will examine popular change management models and their application in more detail.
The Kinetic Resolution model is a tactical model intended for use as part of a process improvement project or a technology implementation. It skips some steps in the Kotter 8-step model, which I think are redundant, especially if we are already involved in a process improvement effort. As I have said in several of my presentations on leveraging simulation or reducing staff stress during technology implementation, the most important thing is to have a model and to follow a methodical change management process. The particular model is far less important. I’ve used the Kotter model many times, and during my time at GE Healthcare, I used the CAP model extensively.
Let’s look at how the three basic rules of Lean support the first two steps, the last three are more of a function of the change management process itself:
Understand the common needs – This is woven into Understand Why. By talking with people at the front line, we are gaining an understanding of the problem and the common needs regarding what countermeasures may mean to front-line staff. We can ask questions that help us gain perspective on how this problem affects the staff in terms of making work more difficult, taking more time, increasing stress, etc.
Communicate the future state – This will be done through several communication channels, but one of these is usually direct interaction with the front-line staff. Our initial efforts of Go See, Understand Why, and Show Respect set a framework for the staff that we have taken the time to understand the process, understand how the problems affect them, and engage with them to get their perspective on the issues. These things, in addition to having shown respect, makes us a more credible source, because we have taken the time to begin understanding.
To me, this reinforces the importance of the Three Basic Rules. In my last three conference presentations, where I covered various aspects of change management, I did an informal survey of the participants who were using a formal change management process. The response was surprising in the first two cases, it was practically zero (zero out of 20 participants and 2 out of roughly 150 participants), and in the last case, at the Healthcare Systems Process Improvement Conference, about 1/3 of the participants indicated using a formal change management process, with many using the ADKAR model. Given the well-known statistics on project failure due to resistance to adoption, I find this concerning. In later posts, I’ll take up the topic of Organizational Change Management in much more detail.
As I said at the beginning, this revelation to me may have been obvious to you all along, but in case it wasn’t, I hope this reinforces the need for going to the workplace (or Gemba, as Lean practitioners say) and putting human eyeballs on the process, and for the need for humble inquiry of the staff. And for integrating the change management process into these activities.