Process Improvement
Georgetown University


Psychology of Change in Process Improvement

Introduction to Change Management

There Is More Than One Way To Skin A Cat

Total Quality Management is one method of bringing about change in the organization. There are many more. This section reviews some of the more common ones and presents data concerning whether these approaches work.

Too many alternatives

There are many approaches to change. Some come with new names. You may have heard about Learning Organizations, Socio-technical Systems, Leadership Challenges, Thriving on Chaos, Value-based pay systems, Re-engineering, and so on. Some of the proposed alternatives are nothing but renamed approaches. Some are new and do not have sufficient data about their effectiveness. We briefly review some of these alternatives. We choose to review the alternatives discussed and evaluated in academic literature, because we wish to know what works. Ideas that seem great in a book, may be difficult to implement, once implemented may fail to achieve the promised behavior changes.

The reviews are brief. You can write a book about any one of these methods of change. The purpose of this section is to make you sensitive that alternatives to Continuous Quality Improvement exist. This lecture does not prepare you to apply these alternatives.

Is management common sense?

There are many theories of change. Some of these are based on the experience of successful executives. Science believes that you cannot learn from experience of one company, that you have to look at the application of a theory across many organizations. Science believes that you can learn from mistakes, i.e. you can prove a hypothesis wrong, but there is little to learn from success. Unfortunately, executives that fail are not writing books. I like to read books titled "What did I do wrong." Our fascination with success may mislead us. When people succeed you do not know why. What people attribute to their own skills may be due to other factors. People often fail to see how environment helps them. They mistake good writing with truth. They believe and get involved with the examples of the application of the theory. They believe in the analogies that are embedded in good writing. Slogans that make the point of a theory may make the reader believe in the method of change without looking at the data. In short, many executives put out books and advice that derives its logic from an appeal to our common sense.

Some people go as far as thinking that management is common sense. You do not really need to go to school to learn it. You can do it.

I do not agree with these contentions. I believe that we should look at data. We should see what works. Without such corrections of our intuitions, the science of management will not progress. We will remain permanently victim to the next fad.


  • Describe what works in changing behavior.

  • Assess potential likelihood of a TQM project succeeding.

Self Interest Motivates


Value Expectancy and Expected Utility

Two theories of how individuals change is based on the notion of self-interest. These theories are Value Expectancy and Multi-attribute Expected Utility. Both theories have their historical roots in psychology, economics, and business research. In the Value Expectancy it is assumed that when decision makers face several outcomes, they decide on the course of action based on the value of these outcomes and their subjective probability or 'expectation' that a particular action will achieve the outcome. In short, decision makers choose the course of action that maximizes their expected value. In the health care area, the health belief model is an example of a Value Expectancy model. The Health Belief model has been applied extensively to predict patients' behavior. The Health Belief model uses notions such as perceived susceptibility to disease, perceived severity of illness, perceived benefits, perceived barriers to change, and self efficacy to predict patients' behaviors.

The Multi-attribute Expected Utility model is also based on the same notion of self interest. It assumes that the decision makers evaluate the outcomes they face based on a number of attributes. Given the relative weight of each attribute, the decision maker arrives at an overall judgment of the value of each outcome and selects the outcome of highest value to them. People choose what to do based on their perception of their own self interest.

Does it work?

It does. Both Expectancy theory and Expected Utility Models predict individual behavior accurately. Glanz, Lewis and Rimer edited the book "Health Behavior and Health Education" in which the authors review the ability of both models in predicting patients' behavior. The studies they reviewed strongly supports the notion that either model can predict patients' behavior. Here are some example results. In one study, the Expected Utility model accurately predicted 82% of the decision to get flu vaccination for a randomly selected high risk patients of a clinic. In another study, the Expected Utility model accurately predicted 68% of patient's compliance with follow-up recommendations for abnormal pap smears.

Problem with self-interest

  1. Not all individual behavior can be predicted by self interest. There are many examples of behaviors when individuals do not do what they wish to do. A good example is all the resolutions we make at the beginning of a new year. Why do people fail to do what they wish? Neither Expectancy theory nor Expected Utility model give us a clear answer . Additional models of change help explain this paradox better than either of these two models.
  2. Individuals do not always decide what to do. Sometimes, they decide out of habits. Habits that endure despite the changing attitudes of the individual. Other times, our peers heavily influence our decision. Many change by imitating the behavior of individuals they admire. While self-interest is an important component of how we change, group influences on the individual are ignored by this approach to change.
  3. Both theories assume that the individual is aware of the outcomes of his/her decision and is willing to gather the necessary information. Often the information about the impact of the decision on the person's self interest is not available. These theories assume an ideal person willing to gather information and decide in a rational manner, and that is just how what most people do.
  4. When we look at people's behavior from the perspective of self-interest, we are likely to blame people who do not act in their own self interest. At the personal level, this leads to blaming the victim and at the organizational level this contradicts the TQM principle of blaming the system and not the people. It creates an environment of fear.

Help Them Understand


Consumer Information Processing

A thorough explanation of consumer information processing was provided by Bettman in his book titled "An Information Processing Theory of Consumer Choice" (Addison Wesley, 1979). In this book he suggests the basic elements of the model include:

  • Information processing capacity is limited and search for information requires both internal (memory) and external costs.
  • Motivation determines how extensively we search for information. Motivation changes because of clues available from the environment. When motivation changes, the information we pay attention to changes and the decision processes we use changes.
  • Attention to various sources of information changes. Important stimuli may be ignored, if the individual consciously or unconsciously chooses not to pay attention to it.
  • Perception of information may differ from the actual information.
  • Information acquisition and evaluation go hand in hand. People do not gather information before evaluating it. They evaluate the information as they gather it. They stop when the information gathered so far gives them a level of confidence with their judgment. Sometimes, they may stopped prematurely. Other times, the early pieces of information may inadvertently influence where they search for information and they may miss important information. Still other times, the framing of the information affects its evaluation.
  • Decision processes and rules do not follow an optimization procedure. People do not maximize their self interest. They satisfy the constraints (e.g. the amount of resources they have) they face. The nature of how information is gathered also affects what decision rules are followed. When many options are available, it is more likely to follow heuristics that simplify the task quickly.
  • People choose but fail to effectively learn from experience. Because many decisions are self fulfilling prophecies, because often the information on effectiveness of a choice is not available and because, even when available, negative information is often ignored by decision makers, many fail to learn from their experiences.

The implications of Consumer Information Processing theory for a manager planning to change an organization is clear. He/she must organize the information and communicate it effectively. He/she should think through the frequency of communications, the amount of the information, the channels for distribution of information, cognitive styles of the target population, the appropriate framing of the information, and point of choice summary labels for the information.


A good example of how decision making is affected by information search is the patients' decisions about choosing a provider. Glanz and Rudd in their 1989 article in "Advances in Health Education and Health Information Policy Review, " and subsequently in their chapter in the book titled "Health behavior and health education," arrived at the following conclusions concerning how patients use information about quality of care:

First, it appears that most individuals do not actively seek out health care information. The cost of seeking information may deter information-seeking behavior. Both information seeking and information processing for use will not only require knowledge but also motivation, skills, and peer or social support.

Second, studies of consumers reasons for choosing and changing health providers indicate that consumers often rely on the recommendations of friends and relatives because of lack of information about quality of care, the difficulty of evaluating such information, and/or the belief that lay opinion is an adequate substitute for expertly developed indicators.

Does it work?

Information processing limitations have been well established and researched. The extent to which these limitations affect business decisions are not known. The use of organized information and clear communication to bring about changes has also been documented. Data show that successful implementation of change is associated with clear communications.

Problem with information processing model

  1. The extent to which limitations in information processing affects our behavior is not known. Obviously, despite the limitations in information processing human beings have had a great deal of accomplishments. Furthermore, studies of information processing ignore the role of decision aids, such as paper and pencils, in overcoming processing limits.
  2. Our peers heavily influence our decision. Information processing theories do not explain how group judgments affect the formation of decision processes and individual's habits.

Explain Your Reasons


Attribution Theory

Attributions are the causes people generate to explain events. Two people faced with the same information may act differently because they attribute to different causes. In our minds, a complex process helps human beings decide what is the cause of an effect. In part, causes should precede effects, should be co-occur with effects and should not be co-occur with other spurious events. The types of attributions people generate can be classified along four dimensions:

  • Locus of causation. Is the person the cause or events outside the person?
  • Controllability. Could the person have controlled the cause?
  • Stability. Is the cause stable or changing over time?
  • Globallity. Does the cause affect a wide variety of outcomes or specific events?

When change occurs people have a mix of failures and successes. To the extent that an optimistic view helps individuals remain open to change, it is important that we manipulate how we attribute early success or failures. Data show that attribution of a failure to stable or internal causes leads to expectations of more failures and loss of self esteem. In contrast, attribution of a success to a stable or external causes leads to expectations of more successes. When failure is attributed to controllable events, additional effort can be expected in the future. In contrast, when failure is attributed to uncontrollable events or to global causes, future effort will diminish. Agents of change need to develop a therapeutic relationship with people undergoing change. They need to understand how do people perceive the reasons for change. To the extent that these reasons highlight external, controllable, stable and specific causes, optimism will prevail, more effort may be exerted and change is more likely. Furthermore, the agents of change can enhances the chances of proper understanding of the need for change by clearly communicating their own understanding of the reason for change.

If the objective is to make sure that difficult tasks are initiated and continued despite early obstacles, it is important to attribute success to the person's effort and failure to events outside the control of the person.

Does it work?

The effect of attribution on employee behavior have been demonstrated. But the question of how one can change employee's attribution has not been addressed. It is assumed that optimism is a precursor for change, but such assumptions have not been tested in an organizational setting.

Problem with changing attributions

  1. As mentioned above, data on key assumptions of this method of change is missing. It is not clear how attributions could be changed, once changed does it always lead to more optimism, and does more optimism lead to more effort in face of adversity . Attribution theory helps us understand behavior but does not tell us how to change behavior.
  2. Attribution like all models of individual change focus attention on the individual and ignore how relationships affects attributions.

Change Work Norms


Reasoned Action and Social Learning Theory

The theory of Reasoned Action suggests that human behavior is influenced by two factors: attitudes towards the behavior and the influence of social environment and general subjective norms on the behavior. Social norm is determined by examples that significant others set for us and by the attitudes they convey to us. Social Learning theory suggests that:

  • Behavior dynamically influences the environment and personal constructs. Likewise, the environment and personal characteristics affect each other and the person's behavior.
  • For a person to perform a particular behavior he needs to know what the behavior is and know that he/she has the skills to do the behavior.
  • Individuals learn what to expect through their own experience and through their social groups.
  • Individuals act in their self interest to get likely outcomes they value.
  • Individuals learn through imitating the behavior of others around them.
  • Individuals learn through reinforcements and rewards they receive from their behavior.

A key element of both Reasoned Action and Social Learning theories is the importance of social norms in changing the individual's behavior.

Does it work?

The effect of social norms in influencing behavior has been demonstrated in many studies. An example, is the study reported in the dissertation of Baker at University of Wisconsin in 1988. He studied condom use among patients in a sexually transmitted disease clinic. He found that 36% of variations in intentions to use condoms was explained by the Reasoned Action model. The belief that one's health care provider believed in the use of condoms was one of the most important predictors, demonstrating that norms could have a significant influence on our behaviors.

Problem with social norms

  1. While the influence of social norms on behaviors are known, our ability to manipulate these norms is unclear.
  2. It is difficult to understand what comes first, the social norm or the employee behavior. Since behavior and social norms are dynamically influencing each other, it is difficult to discern the relative importance of each on the other.

Give Them a Shoulder to Cry On


Theory of Social Support

There are a variety of overlapping theories about how support affects behavior.

  • Buffer hypothesis: One of the earliest theories was based on the concept that poor social ties reduces feedback and as a consequence one becomes confused; this confusion increases susceptibility to errors. According to this theory social support protects the individual and acts as a buffer to environmental stresses.
  • Direct effect: This theory assumes that practical and financial assistance from friends can alleviate or prevent some stressful life events. A sense of belonging and positive reinforcement can improve satisfaction with life. As a consequence, one might have fewer physical and mental disorders. In contrast to the buffer theory, this theory assumes that social support has an effect even in the absence of stressful events.
  • Personality characteristic: People differ in how they react to help. Individuals with a sense that they are well accepted by others are more likely to establish positive relationships and receive help. Similarly, those who feel that they are not accepted are less likely to feel they have friends and may fail to get help even when help is available to them. Not only does the availability of help differ by the sense of acceptance but also positive sense of acceptance leads to better coping skills. Individuals reassured about their social support worry less about where help might come from and spend more time facing their problems. Because a sense of acceptance is a personality trait learned early in one's childhood, this theory assumes that social support is a relatively enduring characteristic of the individual rather than a changing feature of the environment.
  • Transactional. The ecological model sees social support as a feature of neither the individual nor the environment, but as a transaction between the two. The person must maintain relationships by providing support to others when needed. In return, others will provide support when the individual is in need. Over time, the transactions of helping and being helped must balance, otherwise social ties change. Thus, in stressful situations sometimes relationships break and other times strengthen, depending on whether the support has been reciprocated. This interdependence in helping each other need not involve the same types of support, one may provide financial support to others and in turn receive emotion support. The theory also predicts that a person with good personal skills is more capable of helping others and therefore has more good will to rely on when he himself endures a series of stressful events. In the transactional model, social support limits the individual's future behavior by requiring him to reciprocate.

A statement of how support affects propensity to change was given by Gustafson, Cats-Bariel and Alemi in Systems To Support Health Policy Analysis in 1992:

Successful change is more likely to occur when those attempting the change believe the people they respect are also changing, wanting them to change, and will help them succeed. Moreover, they need to believe that if they fail, they fail not only themselves but also their social support group. Social ties with people committed to the change need to be established within and between organizations. Ties can extend beyond their won industry.

In a rational world there would be no need for social support. People would implement the things they believe in. But in reality, social support is essential to continued success.

Does it work?

Extensive evidence points to the fact that individuals who have naturally occurring social support are more likely to succeed. There is some evidence that it is possible to organize support for an individual and that such artificially occurring support will lead to new relationships and benefits similar to naturally occurring support groups.

Problem with social support

  1. It is not clear the causal direction. Does support lead to successful change or does success lead to more support. The relationship between support and success may be due to the fact that people prefer to befriend successful people.
  2. It is not clear why and how people change their support groups.

Adoption Dominos


Innovation Research

Researchers refer to implementation of innovations over time as diffusion. Diffusion is assumed to occur in two steps. During the first steps early adopters think through the benefits of the proposed innovation and select to try it. In the later stages, others see early adopters using the new innovation and decide to try it. Implementation of an innovation may fail for several reasons including:

  • Innovation failure. The proposed innovation fails to meet customer needs.
  • Communication failure. Customers are not aware of the innovation, how to use it and what to expect from it.
  • Adoption failure. Because of resources or differences in perceptions and values, customers are deciding not to adopt the new innovation.
  • Implementation failure. The organization fails to implement the innovation despite choosing to adopt it. Usually, because the adoption decision was made by people who are not affected by the implementation.
  • Maintenance failure. The organization fails to keep up with changes needed to maintain the new innovation.

Does it work?

The concept that adoption of innovations should be examined over time and that customers differ in their rate of adoption is so basic that needs not be tested. Nevertheless, this concept was tested in several studies. Despite the common sense behind this concept and the data supporting it, it is missing from many other theories of managing change, including Total Quality Management. Innovation diffusion started from research on adoption of agricultural techniques. It quickly spread to other fields including management. At the core of this research are factors that promote adoption. On the section on "organization climate," we return to the innovation research and use proven predictors of successful change to assess readiness for organization-wide change .

Problem with innovation research

  1. It is assumed that the innovation itself does not change. Research shows this is not correct. Overtime, as a consequence of implementation, often the innovation itself changes.
  2. It is assumed that customers either adopt or not adopt an innovation. Research shows this is not the case. Adoption and internalization of innovations is a matter of degree. Some customers believe in some innovations much more strongly than others. Some make it part of their lives while others pay only a lip service to it.

Change Work Experiences


Organization Development

Organization Development is not one approach to change. It is a group of approaches mostly organized to improve work life. French and Bell in their book titled "Organizational Development" outline the following underpinnings of this approach:

  • Organization development is a planned process of changing and is based on the research done on the change process. Key among these was the research done by Kurt Lewin that identified three stages for change: Unfreezing, wherein the organization realizes the need for change, gathers new information and establishes new relationships, Moving, wherein the organization acts and brings about the change, and re-freezing, wherein the organization internalizes the change, maintains existing social ties, and resists subsequent changes. A key contribution of Lewin to the study of change was understanding the role of social relationships in bringing about and maintaining change.
  • Organization development interventions are based on a system theory perspective. General system theory was first articulated by Ludwig and Bertalanffy in 1950 and was first applied to business management in 1966. Organization Development believes that organizations are open systems, with well defined input, thorough-put and output. Input could be labor, information, capital, and other resources. Throughput are the processes that transform the input. Output is what the organization provides to its environment. Open systems have a boundary that separate it from its environment. Open systems have goals and a tendency to reorganize themselves through the feedback they receive. Without reorganization all open systems will degenerate into random chance behavior. Open systems thinking is the basis of learning organizations.
  • Organization Development interventions are based on participation of the employees in search of solutions to organizational problems. Empowerment is either a goal for or a method by which Organization Development interventions are implemented.
  • Organizational Development interventions are based on teamwork, sometimes cross functional team work.
  • Organizational Development interventions create a parallel learning structure for the organization, where ideas can be tried and discarded without jeopardizing the life of the organization.
  • Organizational Development interventions bring about change not through power and coercive techniques but through setting organizational norms and educating employees.
  • Organizational Development is based on applied behavioral science and action research.

The inventory of Organizational Development interventions is quite extensive and it includes:

  • Diagnostic activities, where facts are gathered about the way things are. This might be done through asking employees to project their image of themselves or through questionnaires and interviews.
  • Team building activities that relate to organizational tasks or to interpersonal relationships.
  • Inter-group activities designed to improve effectiveness of interdependent groups.
  • Education and training activities.
  • Survey feedback activities, wherein employees review the data and design action plans.
  • Structural work redesign, wherein the organization's formal structure is changed or new ways are organized for working across divisions within the organization.
  • Process consultation activities wherein employees are helped to understand how they decide, how they communicate the decision, what roles each plays, and what problems the organization faces. Process consultation involves an outside expert who helps the process by asking questions about the organization.
  • Peacemaking activities, wherein a third party consultant intervenes to reduce work conflicts among two employees or two groups of employees.
  • Coaching and counseling activities, wherein employees are asked to define learning goals, describe how others see them, and review non-evaluative feedback they receive from others in the organization.
  • Planning and goal setting activities, wherein organizational employees set objectives for themselves and the group.

This is not an exhaustive list of interventions. It is set out here to give you a taste of the breadth and depth of interventions that fall under this approach to change.

Does it work?


  1. Organizational Development is not one set of interventions,
  2. many interventions are not publicly reported,
  3. there is no valid objective criterion for evaluating some interventions

it is hard to examine whether as a whole these approaches work. Nevertheless, over the years there have been many meta-analysis or survey research of the various organizational development interventions. French and Bell summarized the reviews of these approaches, suggesting that in 51 to 70 percent of cases Organizational Development techniques led to significant improvements in reducing cost, improving quality or improving profit margins.

Problem with Organizational Development

  1. Organizational Development tends to emphasize the work life experience and not the customer's experience of the product, as such it may more readily lead to happier workers than to better quality products and larger market shares.
  2. Data reporting the effectiveness of Organizational Development interventions is primarily based on published studies. Since studies of no impact are usually not published this data may be misleading and biased.

Use Mass Media


Internal /Social Marketing & Media Advocacy


Increasingly, managers use mass communication to reach their own employees and to manage them more efficiently. Such mass communications include simple activities such as an employee newsletter, a Total Quality Management story board, mass mailings, cybercast e-mails, broadcast to employee voice mails, video exchanges, television broadcasts and other channels of mass communication. One way to bring about change is to sell it through mass communication. Marketing is effective in setting organization wide agenda and expectations. It can create a positive image for change. The process of marketing to employees is referred to as Internal marketing. The process of marketing specific products from which a social good is likely to emerge is called Social Marketing. And the process of advocating a change through encouraging mass communication companies to cover it is called Media Advocacy. In marketing, data are used to make effective points to the target population. The message is organized to make a lasting impression and to help the target population identify with the needed change.

Does it work?

Of course it does. Or so we believe. There is considerable evidence that marketing works. Products and ideas are sold through marketing efforts. Data on use of marketing techniques to help employees change is not as widely available. Several organizations that advocated life style changes through Social Marketing of these ideas to their employees report success.

Problem with marketing

  1. Marketing reduces complex change issues to slogans. Hence many who change, may relapse to old habits as they have not understood the entire issues behind the change.
  2. Many managers are not trained in effective marketing campaigns and cannot mount such activities on their own.
  3. Marketing is excellent for setting agenda but not as effective for empowering people to change.

Redo the Technology


Business process reengineering

Reengineering uses technology to redesign business processes. The objective is to create a fundamental and radical improvement. The business process may be combined with other processes, eliminated, or restructured. Reengineering is a top down system of improvement with no required involvement from the employees. Reengineering may lead to layoffs or displacement of employees but does not always lead to such actions. 

Does it work?

We are not aware of data across organizations showing that reengineering leads to significant improvements of organization's profit or market share. Nevertheless, there are numerous examples of companies who have tried reengineering and report savings. Many are reported by Hammer and Champy in their book "Reengineering the corporation: A manifesto for business revolution."

Problem with reengineering

  1. Reengineering appears to pay little attention to the interaction between social systems and technical issues. In particular, the non-participatory nature of re-engineering may lead to problems in full integration of the technology in the company operations afterwards.
  2. Many benefits of technology is not materialized when some parts of business process or customer interactions occurs without the technology.

What Do You Know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing. When you write you not only recall what you have written but also may need to make inferences about what you have read.  Please answer the following questions;

  1. What strategies are used at your work to encourage change. What does your manager do to encourage you to change? Make a numbered list. List at least 5 things your manager does.
  2. List the recommendations made for bringing about change in the reading in this lecture and for each item describe to what extent the approach is used by your manager at your work.
  3. Given the material you have reviewed, what do you need to help you keep up with your personal resolutions? Make a list of all recommendations made in the lecture and discuss how they apply to your personal improvement.
  4. Select a on going project at your work or alternatively a project at a friend's work and assess its chances for success.  More 

Please send an email to your instructor with your responses to the above questions.    Make sure that the email subject line includes the course number, topic name and your name, otherwise it will not get to the right place.  For example, subject line could be:  "Joe Smith from HAP 586 responses to questions in lecture on Psychology of Change"   If you wish to receive a receipt that the instructor has received your email, you may request the receipt from your email program.  Please respond to all of the questions within the same email.  Do not attach a file to your email.  Keep a copy of all your emails to the instructor till the end of the semester.  Email►


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Copyright 1996 by Farrokh Alemi, Ph.D. Created on Tuesday, September 17, 1996. Sunday, October 06, 1996 4:20:30 PM Most recent revision 01/15/2017. This page is part of the course on Quality / Process Improvement.  Main Page►