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Functional framework for change leaders: results of a qualitative study
  1. Amanda L Woods1,
  2. Margaret M Luciano2,
  3. Thomas A Aloia3,
  4. Vijaya Gottumukkala4,
  5. Eduardo Salas1
  1. 1 Psychological Sciences, Rice University, Houston, Texas, USA
  2. 2 W P Carey School of Business, Department of Management and Entrepreneurship, Arizona State University, Tempe, Arizona, USA
  3. 3 Department of Surgical Oncology, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4 Department of Anesthesiology and Perioperative Medicine, Division of Anesthesiology and Critical Care, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Amanda L Woods, Psychological Sciences, Rice University, Houston, TX 77005, USA; alw13{at}


Background Healthcare organisations are increasingly placing the onus on care providers to lead change initiatives to improve patient care. This requires care providers to perform tasks in addition to their core job roles and often outside of their formal training. The existing literature provides few insights regarding the functions required of change leaders in healthcare organisations.

Objective To identify the core functions required of effective change leaders in healthcare organisations.

Design Qualitative interview study.

Participants Data were collected from semistructured interviews with 31 individuals employed by a large cancer centre in a variety of different positions (eg, surgeons, anaesthesiologists, nurse anaesthetists, nurses, project consultants and research coordinators) who had been involved in successful quality improvement initiatives.

Results Using inductive content analysis, we identified six core pillars of leading change, which are supported by a foundation of effective communication. Within these six pillars, there were 12 functions, including explain why, demonstrate value, create consensus, align efforts, generate enthusiasm, motivate commitment, institute structure, explain how, facilitate taskwork, promote accountability, enable adjustment and sustain effort. Our model offers unique insights on leading sustainable change in healthcare organisations.

Conclusion Using inductive content analysis of semistructured interviews, we have identified 12 important change leader functions and have organised them into a conceptual framework for leading change in healthcare. Individuals involved in leading change initiatives or developing training programmes to help others become effective change leaders can use this framework to ensure they are comprehensively addressing the necessary tasks for sustainable change.

  • effectiveness
  • improvement
  • behaviour
  • multidisciplinary
  • multiprofessional

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  • Contributors ALW, MML, TAA, VG and ES provided substantial contributions to the conception of the work and interpretation of data. TAA recruited the sample. ALW and MML conducted the interviews, led the analyses and drafted the paper. TAA, VG and ES provided feedback and revised the manuscript critically. All authors approved the final manuscript. ALW is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics approval was granted by the Rice University Institutional Review Board (IRB-FY2018-204).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Interview protocol is available upon request from the first author. Complete interview transcripts are not available to protect interviewee confidentiality.