Executive Brief 3: Storytelling in Change – Four Populations

In healthcare organizations, change has become constant as organizations attempt to adapt to the patient’s needs, new technologies, and other laws. Therefore, an organization must meet organizational conditions to prepare for change if the change initiative succeeds.

The Four Roles of Change Model developed by Daryl Conner is an effective tool for assessing and retelling the processes in an organization since it involves four roles: The Sponsor, Targets, Change Agents, and Advocates (Etareri, 2022). These brief narratives demonstrate the positions these four groups take when a large healthcare system is implementing a new EHR system to enhance care coordination and connectivity in line with the 21st Century Cures Act.

The Story

• The Sponsor – Chief Medical Officer (Dr. Maria Thompson)

“Having been working as the Chief Medical Officer for some time now, I have realized that the system has numerous shortcomings that make it difficult to provide integrated care to the patients. One of the things I’ve learned in the past two years is that our departments were not sharing information, which led to duplicate lab tests, wrong medication prescriptions, and delayed discharges. When the board decided to go for a central EHR system, this was a chance to change the face of patient care.

Sponsoring this change is not limited to providing the $6M for implementing and signing this vendor contract; it is about embracing the vision and being accountable for its results. I have been explaining ‘why’ many times: to improve the safety of patients, to make data more truthful, and to meet the requirements set by the authorities.

In line with this undertaking, we ensured it aligned with the corporate strategy and created an executive sponsorship committee to oversee the effort. As Conner noted, I stayed in the public eye and engaged in activities, thus guaranteeing our company’s presence at the meetings of each department. And not only did I support this alteration but actively promoted it.”

• The Targets – Frontline Nursing Staff (Angela, RN, BSN)

I’ll be honest. When I first heard the new EHR, I felt a sinking feeling in my stomach. Even with the last system update, it is still difficult to adapt, and there are always some forms of hitches. As a bedside nurse, I have a very busy schedule—now a learning curve. It felt overwhelming. But this time, something was different – something which was most unexpected. It does not matter that our nurse manager gave us a manual to read: she implemented a communication feedback system.

Engaging frontline staff early in the change process increases their sense of ownership, reduces resistance, and enhances the overall effectiveness of implementation efforts (Ominyi et al., 2025). The week beginning 8/2/21, we held our weekly huddles, and for the first time, management listened to us and our concerns. I recall my example of discharge documentation being entered into three systems and how it was a problem.

A week later, it brought in a demo of the new and improved workflow. That was a turning point for many of us. That is the system we are using right from the minute level. Conner refers to us as ‘Targets’- the most affected. It’s true. We have also become interested because we were active initially and not passively informed at the end. Even when annoyed, we understand we are part of the decision-making process.”

• The Change Agents – Project Implementation Team (Jacob Reed, Health IT Manager)

“Being a change agent isn’t about pushing buttons—it’s about pulling people together. I lead the EHR implementation team, a group of 12 IT specialists, trainers, and workflow analysts. Our mission? Make the system work for them, not just roll it out and hope for the best. From the start, we used an adaptive change model.

We didn’t just drop the software and walk away. We embedded trainers on the floors for two months. We held simulation labs. We created user personas to test workflows for nurses, physicians, case managers, and more. We had to manage resistance, sure. But we saw it as a signal, not an obstacle. We logged into every concern and built an iterative process. If something didn’t work, we fixed it. That flexibility-built credibility. Change Agents, as Conner describes, must be respected, resilient, and responsive. We had to earn trust every day.”

• The Advocates – Clinical Nurse Educator (Tina Morales, MSN, RN)

Advocates play a crucial role in organizational change by leveraging trust, communication, and informal leadership to influence others and build grassroots support for new initiatives (Kuehne et al., 2022). “As the clinical nurse educator, I wasn’t directly tasked with building the system—but I saw its potential. I became one of its strongest advocates because I believe in what it can do for patient outcomes and staff satisfaction. I began organizing informal lunchtime talks where staff could bring questions and test features in a low-pressure space.

I gathered success stories—like the new care summary tool that helped a nurse catch a medication allergy—and shared them during shift reports. Advocacy, as Conner notes, is about influencing others through credibility and connection. I used my relationships with staff to build momentum, helping turn skeptics into supporters. I wasn’t part of the executive decision-making, but I was essential in bridging the gap between leadership’s vision and the reality on the ground. Advocacy isn’t just about promotion, it’s about belief. And I believe this system will make our work better.”

Conclusion

This story clearly shows the processes that must be in place and the interrelatedness of those processes to effect change in a healthcare environment. Applying the Four Roles of Change Model by Daryl Conner, one can see how Sponsors, Targets, Change Agents, and Advocates are all interrelated and how each contributes to the change process. It was not just about planning. It was about preparing the organization for change, getting people on board, communicating with employees, and supporting them.

The second element incorporated the human side of change, as storytelling helped to bring the people into the foreground and tell their stories of change. Considering that many organizations experience changes daily from regulatory requirements to technology advances –the narratives that matter most for preparedness are those that promote it. Every voice plays an important role in the change story, and when all these voices are in harmony, change is possible and effective.

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