Table 1.

Stages of Organizational Change: Project I-Test^a

Concept		Definition	Application
1. Define problem (Awareness Stage)	1. Sense unsatisfied demands on a system 2. Search for possible responses 3. Evaluate alternatives 4. Decide to adopt course of action	Problems recognized and analyzed; solutions sought and evaluated	Involve management and other personnel in awareness-raising activities
2. Initiate Action (Adoption Stage)	5. Initiate action within system	Policy or directive formulated; resources for beginning change allocated	Provide process consultation to inform decision makers and implementers about what is involved in adoption
3. Implementation Stage	6. Implement the change	Innovation implemented; reactions occur and role changes occur	Provide training, technical, and problem-solving assistance
4. Institutionalization Stage	7. Institutionalize the change	Policy or program becomes entrenched in organization; new goals and values internalized	Identify high-level Champion (someone with decision making power or influence, beyond the implementation Champion), work to overcome obstacles to institutionalization, and create structures for integration

^aExcerpted from Glanz, K., & Bishop, D. B. (2010) [32]