Original ArticlesThe Power of the Frame Systems Transformation Framework for Health Care LeadersScott, Kathy A. BSN, RN, MPA, PhD; Pringle, Janice PhDAuthor Information Kathy A. Scott & Associates, Phoenix, Arizona (Dr Scott); and Program Evaluation and Research Unit, University of Pittsburgh, School of Pharmacy, Pittsburgh, Pennsylvania (Dr Pringle). Correspondence: Kathy A. Scott, BSN, RN, MPA, PhD, Kathy A. Scott & Associates, 27437 N 59th Dr, Phoenix, AZ 85083 ([email protected]). The research was partially funded by the Agency for Healthcare Research and Quality (AHRQ).The authors declare no conflict of interest. Nursing Administration Quarterly: January/March 2018 - Volume 42 - Issue 1 - p 4-14 doi: 10.1097/NAQ.0000000000000261 Buy Metrics Abstract Health care leaders are responsible for oversight of multiple and competing change interventions. These interventions regularly fail to achieve the desired outcomes and/or sustainable results. This often occurs because of the mental models and approaches that are used to plan, design, implement, and evaluate the system. These do not account for inherent characteristics that determine the system's likely ability to innovate while maintaining operational effectiveness. Theories exist on how to assess a system's readiness to change, but the definitions, constructs, and assessments are diverse and often look at facets of systems in isolation. The Systems Transformation Framework prescriptively defines and characterizes system domains on the basis of complex adaptive systems theory so that domains can be assessed in tandem. As a result, strengths and challenges to implementation are recognized before implementation begins. The Systems Transformation Framework defines 8 major domains: vision, leadership, organizational culture, organizational behavior, organizational structure, performance measurements, internal learning, and external learning. Each domain has principles that are critical for creating the conditions that lead to successful organizational adaptation and change. The Systems Transformation Framework can serve as a guide for health care leaders at all levels of the organization to (1) create environments that are change ready and (2) plan, design, implement, and evaluate change within complex adaptive systems. © 2018 Wolters Kluwer Health, Inc. All rights reserved.