Change Management and Adaptive Leadership

Change management involves the selection of strategies to facilitate the transition of individuals, teams, or organizations from a current state of operation to the new, desired state. It is a framework to guide how leaders of change to prepare and support those impacted by a change initiative. In addition to managing the technical aspects of change, change management involves managing the feelings, perceptions, and reactions of the people that may impact, or are impacted, by the change.

Most change management frameworks, such as Prosci’s 3-Phase Process or Kotter’s 8-Step Change Model, involve processes for creating an environment for change, facilitating the transition, and reinforcing or sustaining the change. A large part of successful change management is understanding all the people or stakeholders involved and adequately communicating in a transparent way.

Performance improvement (PI) initiatives involve the introduction of a change project to improve some aspect of organizational performance. Therefore, change management should always be exercised in concert with PI. For example, quality improvement projects involve testing and adopting an intervention to improve a particular process or outcome; accreditation may require an organization to revise practices so work is being documented; or performance management may involve staff to monitor and track their performance against standards.

Adaptive Leadership is a practical framework that helps individuals and organizations adapt and succeed in challenging environments. It increase the ability, both individually and collectively, to take on the gradual but meaningful process of change. Adaptive Leadership was developed by Drs. Ron Heifetz and Marty Linsky at the Harvard Kennedy School and was designed to identify and deal with consequential change in uncertain times.

The concepts and principles of Adaptive Leadership have broad applications in the field of public health. The framework can be beneficial in managing organizational change management, implementing community health improvement planning, developing leadership and workforce, strengthening community partnerships and navigating changing political, social and economic climates.

Adaptive Leadership techniques include:

  • confronting status quo and creating enough heat to motivate and encourage productive change
  • identifying adaptive and technical components of challenges
  • exploring themes of values, loss and loyalty for self and stakeholders
  • designing deliberate conversations for confrontational high risk change points

Featured Resources:

  • Adaptive Leadership in Public Health: a 5-minute introductory video that gives a sense of how the framework can be applied in the context of public health
  • Leading Adaptive Change in Public Health: a 9 week elearning course designed to help local health departments and their partners tackle the complex challenges facing the field of public health
  • Adaptive Leadership Core Concepts for Public Health: an in-person training designed to introduce public health professionals of all levels to the basic concepts and help them make progress on a real life challenge they are facing in the workplace.  Trainings can be offered in multiple formats, ranging from half day sessions to full two day workshops.
  • Adaptive Leadership Worksheets: a series of practice oriented worksheets that explore four of the basic concepts of the framework
  • Adaptive Leadership Coaching: a tailored coaching experience for organizations or individuals to apply the framework to grow leadership capacity and manage organizational change


It is critical to gain buy-in for PI initiatives from staff and external stakeholders, including community partners, funders, and governing entities. This Guide to Communicating about Performance Improvement provides a step by step approach to crafting messages and implementing strategies that build support for PI. 

In order to access the guide, you must download it through NACCHO's Toolbox by clicking the link above. NACCHO's Toolbox is free and open to the public, but you must register for a NACCHO account to download items. Instructions for creating an account are available during the download process.

Access the Performance Improvement Communication Worksheets

Building an organizational culture of quality is a transformational change that requires deliberate change management. Systems and processes must be in place to support and sustain QI while also empowering staff to embrace and engage in QI. NACCHO’s Roadmap to a Culture of Quality (Roadmap) guides organizations through six phases of QI maturity using change management strategies. Visit the Roadmap to learn more about change management and QI