This article deals with the question of how change processes can create ergonomic improvements in small- and medium-sized industrial enterprises. Drawing on experiences from two described and analyzed case studies in small- and medium-sized enterprises (SMEs) and from ISO 9000 implementation processes previously studied, a hypothetical change framework is suggested through a theory generating approach. It separates change into action-driven change, which is an active experiential improvement process, and into vision-driven change, which is of a visionary design character. The ability to bring about problem solving into action was important for the success of the change processes. Furthermore, the nature of different hampering mechanisms concerning ergonomic improvements is discussed.