Change Leadership

OVERVIEW

Change leadership is required for effective introduction of innovations, growth, new technologies and change of culture

70% of all major change efforts within organisations fail
John Kotter describes an eight-step approach to change management success

KOTTER’S EIGHT STEP APPROACH

Step 1: Establishing a Sense of Urgency

Help others see the need for change and they will be convinced of the importance of acting immediately.

Step 2: Creating the Guiding Coalition

Assemble a group with enough power to lead the change effort, and encourage the group to work as a team.

Step 3: Developing a Change Vision

Create a vision to help direct the change effort, and develop strategies for achieving that vision.

Step 4: Communicating the Vision for Buy-in

Make sure as many as possible understand and accept the vision and the strategy.

Step 5: Empowering Broad-based Action

Remove obstacles to change, change systems or structures that seriously undermine the vision, and encourage risk-taking and nontraditional ideas, activities, and actions.

Step 6: Generating Short-term Wins

Plan for achievements that can easily be made visible, follow-through with those achievements and recognize and reward employees who were involved.

Step 7: Never Letting Up

Use increased credibility to change systems, structures, and policies that don’t fit the vision, also hire, promote, and develop employees who can implement the vision, and finally reinvigorate the process with new projects, themes, and change agents.

Step 8: Incorporating Changes into the Culture

Articulate the connections between the new behaviours and organizational success, and develop the means to ensure leadership development and succession.

References and links

Journal articles and books

Kotter J, Rathgeber H. Our Iceberg Is Melting: Changing and Succeeding Under Any Conditions. St. Martin’s Press, 2016.
Noble DJ, Lemer C, Stanton E. What has change management in industry got to do with improving patient safety? Postgrad Med J. 2011 May;87(1027):345-8. doi: 10.1136/pgmj.2010.097923. Epub 2011 Mar 25. PMID: 21441166.
Scott T, Mannion R, Davies HT, Marshall MN. Implementing culture change in health care: theory and practice. Int J Qual Health Care. 2003 Apr;15(2):111-8. Review. PMID: 12705704. [Free Full Text]
Stoller JK. Implementing change in respiratory care. Respir Care. 2010 Jun;55(6):749-57. Review. PMID: 20507659. [Free Full Text]

FOAM and web resources

Kotter International — The 8 Step Approach for Leading Change
Kotter International — Our Iceberg Is Melting

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Chris Nickson

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

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