Brief Summary of Findings, Analysis, and Recommendation for Action – Board of Directors

The executive brief synthesizes findings from an important change initiative under the healthcare organization’s centralized Electronic Health Record (EHR) system. The transition to an EHR system was necessitated by compliance drivers, namely the 21st Century Cures Act, as well as improvements in clinical efficiency, communication, and patient safety (Gellert et al., 2024).

Daryl Conner’s Four Roles of Change Model was used to guide the process, outlining the Sponsor, Target, Change Agent, and Advocate populations (Etareri, 2022). Each group significantly shaped the path and impacts of the initiative. From each population’s stakeholders, this brief captures pivotal narratives, analyzes the convergent patterns, and builds the case toward recommendations to preserve efforts and facilitate further progress.

Summary of Findings

In the previous three evaluations, we analyzed the impacts of change on different organizational populations within a healthcare system changing due to the integration of a centralized EHR system. Within the healthcare organization, the implementation of a centralized EHR system represented a change that emerged as a “transformational” per McLeran’s classification driven by the 21st Century Cures Act aimed at improving patient safety, mitigating information silos, and enhancing care coordination (Gellert et al., 2024).

Daryl Conner’s four roles of change model provided the framework for this analysis, using the interdependent contributions of four key organizational populations to delineate organizational change (Etareri, 2022). As a Sponsor, Dr. Maria Thompson controlled critical strategic resources like institutional alignment, funds, and oversight, as well as fiscal control commensurate with strategic institutional objectives.

As a Target, bedside nurses participated in the change but showed a great deal of resistance owing to disruption of familiar workflows and low-level competence (Ominyi et al., 2025). This perception changed in large part due to the participation strategies and aligning the new system with existing routines at the unit, along with the new system being implemented into workflows.

Change Agents, as led by health Information Technology (IT) manager Jacob Reed, played a crucial part in interacting with clinical staff by putting in place support structures and integrating feedback mechanisms, transforming technical specifications into user-focused design interfaces. Alongside these initiatives was clinical nurse educator and Advocate Tina Morales, who, with her advocacy work, narrative craft, and peer mentorship, lowered anxiety and elevated confidence within the nursing workforce.

These roles supported an atmosphere of trust, learning, and adaptability, all of which enabled the smooth transition (Ominyi et al., 2025). All together demonstrate the need for leadership in the integration of multidisciplinary participation and attention to organizational culture as a method for accomplishing change in the healthcare system.

Analysis of Findings

The new EHR system implementation highlighted some factors that contributed to the initiative’s success and the collective work of the sponsor, targets, change agents, and advocates. Resistance was initially mitigated at the strategic alignment level by the sponsor, who framed the transformation as critical for meeting regulatory compliance and patient safety, addressing staff concerns proactively, and communication focused on navigating meeting issues (Hong et al., 2023).

Participation of the targets was optimally conducted through feedback forums, which were designed with participatory workflows and thus staffed with early robotics as the non-hierarchical coordinators to ensure reduced resistance. End user trust enhancement reinforced enhanced trustworthiness through trainers placed in situ and simulation labs, adjustable to enhance faculty trust, as was executed by the change agents (Worley et al., 2022).

Grassroots advocacy by the clinical nurse educator played a vital cultural role, using informal peer support, storytelling, and knowledge sharing to shift staff attitudes from skepticism to optimism. Ultimately, all aided enabling both informal power and formal hierarchy as organizational faculties blend, moving beyond the system resistance hurdles for achieving adoption together.

Recommendations for Actions

Moving forward with change initiatives within the organizational context will be more effective if the four roles of the change model (Sponsor, Change Agent, Advocate, Target) are adopted as a basic model of reference. This model ensures role definition encourages clarity and responsibility across the project while also providing guidance (Gellert et al., 2024).

Teaching each person the relevant components of the role helps in understanding their influence and responsibility within the change process (Gellert et al., 2024). Meetings, digital communication, and personal interactions provide forums for the needed credible communication which is needed about and for the change process (Wannheden et al., 2022). Fostering real-world challenges and experiences, frontline voices must be included actively in planning and decision-making.

With a shift in user-centered approaches to change supported alongside flexibility, the adaptive models that can be tested with feedback loops will be more responsive towards the staff’s needs as well as the dynamics of the organization (Wannheden et al., 2022).

Enhanced access to informal leaders as advocates empowers change with a demo tool and success stories (Wannheden et al., 2022). Providing these resources fosters grassroots support. After the change is implemented, maintaining said momentum requires targeted effort like feedback, placing, recognition activities, and modifying engagement for sustained attention-focused improvement.

Conclusion

Implementing the EHR system was a reconfiguration of clinical workflows, communication channels, and organizational culture. Collaborative efforts led to success: alignment of leadership and engagement of frontline staff through planning, as well as the influence of informal advocates. Advocacy coupled with direct engagement from the system’s sponsors and change agents ensured that all workflows were streamlined and barriers to effective system use were proactively resolved.

Emphasis on active resistance mitigation ensured that the system was usable, functional, and supportive rather than detrimental. This underscores the need for employing purposeful change management, feedback cycles, and consensus from all stakeholders. As the organization forges ahead, these insights, alongside managed innovations, will strengthen tailored approaches to integrated patient care at all organizational levels.

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