The Leading Change Toolkit (Fourth edition)

The Leading Change Toolkit is a free, online, open-access evidence-informed implementation resource. It focuses on the uptake and sustainability of knowledge – or evidence – and uses two complementary frameworks to help you accelerate your success including the Social Movement Action and Knowledge-To-Action Frameworks. The toolkit also includes a section on how to engage persons with lived experience in a change initiative and/or as a member of a change team.

SMA and KTA banner with logos
Planning for change

In this part of the change journey, the practice change is planned with a goal of achieving and, ultimately, sustaining it.

Learn more
Making change happen

In this part of the change journey, the practice change is achieved through mobilized staff engagement and strategic and tailored actions.   

Learn more
Sustaining change

In this part of the change journey, the practice change is sustained through strategies to support ongoing staff engagement and tailored actions.   

Learn more

Accelerate your success with two complementary frameworks

The Leading Change Toolkit features two complementary frameworks: the Social Movement Action (SMA) Framework and the Knowledge-To-Action (KTA) Framework. To get started on the path to success, you can use components of both of these implementation frameworks as tools to guide your process. Look for the linkage icon and other tips and tools throughout the toolkit for examples of links between the SMA and KTA Frameworks to help you apply both frameworks together to accelerate your success.

venn diagram with logo

Social Movement Action Framework

The Social Movement Action (SMA) Framework (Grinspun et al., 2020; Grinspun et al., 2022) is a collection of 16 elements that illustrate how grassroots, people-led social movement action can be used to achieve knowledge uptake and sustainability. The framework is structured according to “preconditions”, “key characteristics” and “outcomes”. It depicts change that develops in response to:

  • a shared concern or strongly desired change, and
  • a receptivity to change fueled by energy for change that results in mobilized actions by engaged individuals, groups and/or organizations.  
SMA with logos

Knowledge-to-Action Framework

The Knowledge-to-Action (KTA) Framework (Graham et al., 2006) provides a structured and systematic change process that includes a seven-phase action cycle to support the implementation and sustainability of a knowledge tool, such as an RNAO best practice guideline. The KTA Framework is based on more than 30 change theories and includes two main parts – the knowledge creation process and the action cycle phases.  

kta framework with logos

Engaging persons with lived experience

Engaging persons with lived experience means intentionally partnering with persons/patients, families and/or communities throughout the planning, delivery and evaluation of health services to improve quality and safety (CPSI, 2017; RNAO, 2015).

people with lived experience

Case studies

Case studies are included to illustrate one or more components of the two frameworks or the journey process. Many of the examples are of RNAO’s Best Practice Spotlight Organizations® (BPSO®)  that participate in a global social movement of knowledge translation. 

Social Movement Action Framework, Intrinsic motivation Making change happen
Championing clinical excellence in acute care

Vall d’Hebron Barcelona Hospital Campus championed clinical excellence through nurses' and other staff's leadership and intrinsic motivation. 

Tips and tools to support your change

Tips and tools to give you and your change team the know-how to achieve and sustain a practice change including case studies, checklists, worksheets and resource pages, and valid tools for the KTA framework. 

Case studies

Demonstrates usage of components of one of the frameworks or the journey process

Implementation tools

Checklists, worksheets and resources to aid discussions, decision-making and planning for change    

Valid KTA tools

Valid and reliable tools to aid decision-making for change teams that can be applied to many of the action cycle phases