​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Organizations that are adept at implementing change tend to develop more innovative, risk-tolerant cultures and have greater agility in implementing new strategic initiatives. A change-ready culture is a foundational element for practices that are interested in successfully implementing new services.

Establish a learning and growth culture among staff, which benefits both the individuals and the practice. Practices should:

  • Support and provide resources for individual staff to grow professionally and achieve outcomes that are important to them and to the practice. This investment communicates that there is an expectation for growth and learning at all levels and helps to build an atmosphere of curiosity and forward thinking.
  • Encourage practice leaders to demonstrate their commitment by investing in their own learning and growth, admitting when they don't know something, and utilizing errors or negative feedback as opportunities for learning and process improvement - as opposed to only for punitive or disciplinary measures.

Review the practice’s mission, vision, and value statements with practice staff, and modify as needed. These statements should convey the values of the practice, inspire and encourage employees, sound reasonable and plausible, and be as specific and relevant as possible in a concise sentence. Involve staff in review and revision of the mission, vision, and value statements to ensure a more comprehensive statement, and increase staff investment and buy-in. Also consider involving patients and families in this process.  


Evaluate and assess the practice’s environment. Obtain feedback from staff and/or patients/families on whether the practice's current environment is consistent with the mission, vision, and values statements. An anonymous survey tool can be used to encourage honest feedback; and consideration should be given to whether slightly different questions are needed for staff and patient/family audiences. Share a high-level summary of the survey results with survey respondents and consider offering a small incentive for participation.


Identify what needs to be changed. ​Review the survey results with staff and/or patients/families and develop a prioritized list of the changes the practice will need to make in order to align with the mission, vision and value statements of the practice.

Identify members of a staff team, including a team leader, that will plan and lead the change process. Care should be taken to keep the team relatively small and to select individuals from all levels of the organization who are well-respected and open-minded. A team leader should be identified to facilitate staff team meetings and lead the implementation process. The staff team can review the prioritized list of changes, and brainstorm ways to address gaps. Consider using the Plan-Do-Study-Act cycle to begin the change process in your practice.

Communicate and implement the change. When ready to begin, schedule a staff meeting where you can present the vision and plan. Everyone should hear the message the same way, at the same time. Implement changes incrementally and integrate into daily procedures. Staff should receive training and support to implement changes and have a clearly outlined mechanism to provide feedback on what is/is not going well.

Manage resistance. There are some who don't like change and the uncertainty it can bring. Seek to understand and address the root cause of resistance, and gain everyone’s cooperation so change results are not compromised. It is crucial for leaders to meet individually with staff that are most vocal about sabotaging efforts to implement change. It may require some real negotiating finesse and should be a two-way dialogue, so that there is a clear understanding of how they feel and what is expected of them.​​

Regularly solicit feedback from staff and patients/families. Regularly scheduled sessions with two-way communication that is transparent, genuine, and consistent helps staff to feel like they are part of the process. Additionally, informal communication is also needed to emphasize expected behaviors and results. Use these sessions to clarify plans, answer questions, address rumors, and reduce drama.​

Honestly evaluate change, celebrate successes, and acknowledge failure. Share and celebrate progress in a transparent manner as a standard part of regular communication activities. Confront reality when improvements don't go as planned, identify what can be learned from the experience, and re-engage your team to prioritize adjustments that need to be made.

​Change is not about personal gain, it's about gain for the entire practice. Keep everyone focused on this, celebrate steps of progress along the way and show appreciation for a job well done.

Last Updated



American Academy of Pediatrics