Aims To explore Emergency Department staffs’ perceptions of factors influencing change and change management at a university teaching hospital in the United Kingdom.

Methods Grounded theory methodology was used to perform secondary analysis of 41 interview transcripts from participants consisting of 20 physicians, 13 nurses, two support workers and six managers involved in paediatric emergency care at the university teaching hospital.

Results Leadership was identified as one of the major factors influencing change and change management in the study. Four major themes related to leadership were identified. They were; the role of leaders and followers, authority and influence, power and empowerment and building relationships. Good and credible leaders and followers’ trust in clinical leadership skills were discussed as important during changes. Leaders’ influence with the team, empowering the team and building relationships both within the team and with other services in the hospital were stated to be important for successful change management. Leadership interactions that foster positive emotions motivate staff to implement or manage changes rather than the formal authority as a leader. Participants identified that clear communications and providing education associated with the change process as important leadership activities.

Conclusion Credible trusted leadership, encouraged positive emotions and reduced negative emotions to changes. Change management in healthcare organisation should not only guide leaders in traditional leadership functions but also prepare and equip them to support staff and build relationships to successfully adopt change and drive organizational success while ensuring the quality of care and patient safety are improved.