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Home | LITFL | SMILE2 | Change Leadership

Change Leadership

by Dr Chris Nickson, last update November 27, 2018

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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About Dr Chris Nickson

An oslerphile emergency physician and intensivist suffering from a bad case of knowledge dipsosis. Key areas of interest include: the ED-ICU interface, toxicology, simulation and the free open-access meducation (FOAM) revolution. @Twitter | + Chris Nickson | INTENSIVE| SMACC

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