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Implementing strategic change in a health care system: The importance of leadership and change readiness

Caldwell, David F.; Chatman, Jennifer; O'Reilly, Charles A. III; Ormiston, Margaret; Lapiz, Margaret

doi: 10.1097/01.HMR.0000304501.82061.e0

Background: Shifts in the environment can compel health care organizations to change their strategies. However strategic change frequently fails because individuals do not adopt the behaviors necessary to successfully implement the new strategy.

Purpose: This study explores how three variables-agreement with new strategy, leaders' actions, and groups' general orientation toward change-can influence members of physician teams to take actions supporting a strategic shift aimed at improving patient satisfaction.

Methodology: Physicians in 37 specialty departments in a large health care organization were surveyed regarding their support for a new customer service initiative, the actions of department leaders, and generalized norms supporting change. The results of the survey were linked to changes in patient satisfaction for the department.

Results: Normative support for the specific strategic change was directly related to increased patient satisfaction 1 year later. The interaction between norms supporting change readiness and the quality of leadership was positively related to change in patient satisfaction.

Practice Implications: Successfully implementing a strategic change often requires getting individuals to change their behaviors. Leaders can enhance the results of the change by working to develop general norms such as teamwork and tolerance for mistakes that increase general readiness for change with the group.

David F. Caldwell, PhD, is Professor, Leavey School of Business, Santa Clara University, California. E-mail:

Jennifer Chatman, PhD, is Professor, Haas School of Business, University of California, Berkeley.

Charles A. O'Reilly III, PhD, is Professor, Graduate School of Business, Stanford University, California.

Margaret Ormiston, PhD, is Assistant Professor, London Business School.

Margaret Lapiz, MPH, MBA, is Vice President and Regional Administrator, The Permanente Medical Group, Oakland, California.

© 2008 Lippincott Williams & Wilkins, Inc.