Leading change: why transformation efforts fail.
Kotter JP. Harv Bus Rev. Mar/April 1995;59-67.
Kotter, a professor at Harvard Business School, outlines the eight stages of a successful change process, as well as common mistakes and pitfalls at each of the stages. These mistakes include not establishing a great enough sense of urgency, not creating a powerful enough guiding coalition, lacking a clear vision, under-communicating the vision by a factor of 10, not removing obstacles to implementation of the vision, not systematically planning for and creating short-term wins, declaring victory too soon, and not anchoring changes in the corporation’s culture. He uses examples of failures from transformation efforts in large and small businesses.
IT vulnerabilities highlighted by errors, malfunctions at veterans' medical centers.
Kuehn BM. JAMA. 2009;301:919-920.
Bar-code technology for medication administration: medication errors and nurse satisfaction.
Fowler SB, Sohler P, Zarillo DF. MedSurg Nursing. 2009;18:103-110.
Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.
Katz-Sidlow RJ, Ludwig A, Miller S, Sidlow R. J Hosp Med. 2012;7:595-599.
Electronic health records and National Patient-Safety Goals.
Sittig DF, Singh H. N Engl J Med. 2012;367:1854-1860.
View all related resources...
Find Related Resources by...
Health Care Executives and Administrators
United States of America
Produced for the
Agency for Healthcare Research and Quality
team of editors
University of California, San Francisco
with guidance from a prominent
. The AHRQ PSNet site was designed and implemented by Silverchair.
Contact AHRQ PSNet
Terms & Conditions
Freedom of Information Act
The White House
USA.gov: U.S. Government Official Web Portal
Agency for Healthcare Research and Quality • 540 Gaither Road Rockville, MD 20850 • Telephone: (301) 427-1364