CEO Blog: Start with the WHY

In my last blog I discussed the current environment of the health care system in Ontario, one where change is now constant, a transition from where change was once considered to be episodic.   With so much change would we not be expecting resistance, burnout, and perhaps errors in execution?   Yes to all, however I have come to realize that leading change can be successful if we always start with the WHY.

John Kotter, wrote an article entitled Leading Change[1]  why transformation efforts fail.  In the article he noted that a key first step is to get people out of their comfort zone, an understanding WHY the status quo is no longer appropriate.  Understanding where our performance is in relation to our vision and more importantly the expectations of our patients/residents/clients.

The WHY supporting the need for change can emanate from a number of sources, including ARH corporate documents, legislation, funding imperatives, and feedback from the patient/resident/client but regardless of the source, the WHY needs to be explicit. If it isn’t…. we need to make it so.

The vision of Arnprior Regional Health is “to be recognized for exemplary care, making your health our priority.”To achieve this vision we will follow our values of Honesty, Accountability, Respect, and Teamwork.   Our mission, vision and values form a foundation for the WHY.

When we are proposing any new change, connecting back to the vision statement will help to confirm that even though it may be hard to make the changes we are proposing they are related to our aspirations.

Accreditation Canada provides more than 2000 standards to guide health care organizations in pursuit of the highest quality of care.   A number of the standards propose the use of best practices; in particular those contained under priorities processes for decision support. For example, “The team uses current research, evidence-based guidelines, and leading practice information to improve the quality of its services.”  This standard confirms that the WHY for the introduction of the quality improvement is sourced from the research, is evidenced based and leading practices.

In a recent report by the Ontario Hospital Association[2]-the authors concluded the need to say WHY –  “a shared purpose (mission, vision and values) with the active participation by all stakeholders promotes ownership of the common agenda and helps to ensure that work is driven by a shared platform of consensus and commitment to common objectives.”


[1] Leading Change – Why Transformation Efforts Fail – John P Kotter 2006 Harvard Business Review

[2] Fostering Effective Working Relationships Between Hospitals and Physicians, Ontario Hospital Association, October 2015

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