The Role of Leadership in Driving Change

By Kara Gormont, EdD, RN, Access Leader

Leadership is the make-or-break factor in the transition from a hospital-focused system to the ambulatory enterprise playing a central role. Ambulatory leaders must not only oversee operations – they must anticipate what’s next, activate technology, and empower teams to adapt. In heavily matrixed and often siloed organizations, this means working across boundaries to implement and sustain change.

Vision alone isn’t enough; execution is everything. Tools like Kotter’s 8-Step Process (ASHP, 2016) offer structure, but leadership also demands real-time communication and culture-building. To succeed, leaders need a tactical playbook:

1. Assess Organizational Readiness: Take the time to assess your unique infrastructure and workforce capabilities before implementing changes. While visionary thinking is a critical part of leadership, it’s important for leaders to understand the potential of their health system in the context of change management. Barwick’s (2011) 8-step readiness model can help identify both strengths and barriers, providing a framework for action.
2. Engage Stakeholders: Engagement is critical – especially with groups who are often overlooked, like frontline staff and patients – because change only sticks when people feel seen and heard (PME, 2020). It’s the responsibility of leadership to create the tools to track stakeholder engagement – not just at the outset, but throughout the lifecycle of an intervention.
3. Pilot Before Scaling: Leaders should jump on the opportunity to test initiatives in controlled environments. For example, if you want to implement a change across the ambulatory environment – testing its validity at a single clinic can allow you to address bottlenecks while minimizing the risk to patients’ safety. Trial-runs allow us to spot flaws in our approach and refine the finer points of a change initiative (Winkless, 2024).
4. Invest in Training: In the end, the change must be adopted by the end users – and even the best-designed change will fail if they aren’t prepared. High-performing leaders view their initiatives as an ever-evolving cycle, and the commitment to consumers must reflect that. Training is more than a one-time event; it’s an ongoing practice, reinforcing new behaviors and building long-term adoption.
5. Use Metrics that Matter: Begin with the end in mind. Identify which key performance indicators your project aims to influence. Whether it’s appointment availability, no-show rates, or digital tool usage – design your approach around those outcomes and continue to track their progress as the initiative evolves.

The health systems of the past won’t meet the needs of the future. Ambulatory care is no longer optional; it is an essential component of care delivery. The path forward depends on leadership that can pivot, prioritize, and push onward through uncertainty.

By embracing change and leading by example, today’s healthcare leaders have the unique opportunity to create systems that not only expand access – but also redefine care for decades to come.

Are you ready to be the ambulatory access leader your health system needs?

Want to take your career to the next level? Get certified with us: https://www.patientaccesscollaborative.net/products/capacity-management-leaders-course

References

American Society of Health-System Pharmacists (ASHP). (2016, August 18). Leading change in your ambulatory practice. Retrieved from https://www.ashp.org/-/media/assets/ambulatory-care-practitioner/docs/sacp-leading-change-in-ambulatory-care-practice.ashx?la=en

Barwick, M. (2011). Checklist to Assess Organizational Readiness (CARI) for Evidence-Informed Practice Implementation. Toronto, ON: Hospital for Sick Children.

Postgraduate Medical Education (PME). (2020, March 11). Gaining leadership buy-in for organizational change in health care. Retrieved from https://postgradmed.org/leadership-buy-in-healthcare

Winkless, N. (2024, September 16). How Philips CEO Roy Jakobs is turning the company around after a major recall. The Verge. Retrieved from https://www.theverge.com/2024/09/16/philips-ceo-roy-jakobs-turnaround