About the Leading Change Toolkit
Index
Welcome to the Leading Change Toolkit: To help change agents and change teams make lasting improvements in health care. The Leading Change Toolkit is an 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.
The Leading Change Toolkit consists of four sections: About this toolkit, The Social Movement Action Framework, The Knowledge-to-Action Framework and Engaging persons with lived experience.
Dig deeper: Social Movement Action Framework
The Social Movement Action (SMA) Framework (Grinspun et al., 2022; Grinspun et al., 2020; Leading change through social movement) includes 16 elements that we categorize as Preconditions, Key Characteristics and Outcomes. Each of these elements includes content to strengthen your knowledge and advance your skills to apply SMA to a change initiative.
To strengthen your knowledge:
| Name of the subsection | Description |
|---|---|
| What is the element? | Defines the element and its key concepts. |
|
Why is the element important? |
Discusses the importance of the element in relation to social movement action. |
| More about the element | Details additional characteristics of the element. |
To advance your skills:
| Name of the subsection | Description |
|---|---|
| Considerations for getting started | Provides ideas on how to get started using the element. |
| Case studies | Describes case studies or examples from literature and/or organizations, including RNAO Best Practice Spotlight Organizations® (BPSO®), of how the element has been applied to achieve change. |
| Common problems | Details examples of common problems that you and your change team may come across and some suggestions to address them. |
| Check your progress | Helps you and your change team know whether you are on the right track. |
| Worksheets | Provides links to downloadable files of practical tools, checklists and other resources. |
| Linkages | Links the element to others in the SMA Framework, and to some of the action cycle phases in the Knowledge-to-Action (KTA) Framework. |
| Additional resources |
Provides a list of some relevant resources to support ongoing learning. (Please note that RNAO's inclusion of a resource in one of these lists does not imply an endorsement from RNAO.) |
Dig deeper: Knowledge-to-Action Framework
The Knowledge-to-Action (KTA) Framework (Graham et al., 2006) includes a seven-phase action cycle to support the implementation and sustainability of a knowledge tool, such as an RNAO BPG. As with the SMA Framework, it is essential that change teams and change agents develop the knowledge and skills to be able to use the KTA Framework effectively.
To strengthen your knowledge:
| Name of the subsection | Description |
|---|---|
| What is this action cycle phase? | Defines the action cycle phase and its key concepts. |
| Why is this action cycle phase important? | Discusses the importance of the phase in relation to the process of evidence uptake and sustainability. |
| More about this action cycle phase | Details the characteristics of the action cycle phase. |
To advance your skills:
| Name of the subsection | Description |
|---|---|
| Considerations for getting started | Provides ideas on how to get started in the action cycle phase |
| Practice tips | Gives you and your change team practical tips on how to get started with the action cycle phase. |
| Tools | Provides summaries of pragmatic and valid tools (for example, surveys and questionnaires) to assess a component of an action cycle phase. (Please note that this list is not exhaustive and the inclusion of a tool in one of the action cycle phases does not imply an endorsement from RNAO.) |
| Case studies | Describes examples of how the action cycle phase has been used by organizations, including RNAO BPSOs and others, as well as examples from the literature. |
| Check your progress | Helps you and your change team know if you are on the right track. |
| Worksheets | Provides links to downloadable files of practical tools, checklists and other resources. |
| Linkages | Links the action cycle phase to some of the elements of the SMA Framework. |
| Getting ready for the next phase | Prepares you for the next action cycle phase and indicates how the current phase informs the next one. |
| Additional Resources |
Provides a list of some relevant resources to support ongoing learning. (Please note that RNAO's inclusion of a resource in one of these lists does not imply an endorsement from RNAO.) |
Dig deeper: Engaging persons with lived experience
The "Engaging Persons with Lived Experience" section describes intentional partnerships with persons to take up and sustain the knowledge needed to enhance health outcomes, quality and safety. In order to engage persons with lived experience effectively, change teams and change agents must develop knowledge and skills in this area.
To strengthen your knowledge:
| Name of the subsection | Description |
|---|---|
| What is this? | Defines what is meant by engaging persons with lived experience. |
| Why is it important? | Discusses the importance of this type of engagement in relation to knowledge uptake and sustainability. |
| More about this component | Describes the characteristics of engaging persons with lived experience. |
To advance your skills:
| Name of the subsection | Description |
|---|---|
| Getting ready to engage persons with lived experience | Provides practical suggestions on how to gauge you and your change team’s readiness for engaging persons with lived experience. |
| Engaging advisors and advisory councils | Offers a description and tips on engaging advisors and advisory councils. |
| Considerations for getting started | Gives you and your change team practical tips on how to get started and ensure success engaging persons with lived experience. |
| Evaluating engagement | Describes indicators to assess the degree of engagement. |
|
Case study |
Describes case studies from the literature on how persons with lived experience have been engaged. |
| Check your progress | Helps you and your change team know if you are on the right track. |
| Additional resources |
Provides a list of some relevant resources to support ongoing learning. (Please note that RNAO's inclusion of a resource in one of these lists does not imply an endorsement from RNAO.) |
Who is the Leading Change Toolkit for?
The Leading Change Toolkit is for anyone who cares about making evidence-informed changes to improve outcomes in health care. This includes:
Change agents:
- informal and formal leaders of change initiatives
- health providers and clinicians of all disciplines working in any health sector or setting
- educators and students
- persons with lived experience and their families
- other people who work within health organizations and communities and want to make a difference including researchers, administrators, and policy makers
Change teams:
- people who share a common vision for change
- may also be referred to as implementation teams, implementation committees, steering committees or project teams
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Who makes up your Change Team? #LeadingChangeToolkit
What is the purpose of the Leading Change Toolkit?
To give change agents and change teams the evidence, tools and strategies they need to make lasting improvements in health care. Outcomes of using the toolkit include:
- accelerated change;
- excellence in care;
- positive outcomes for persons/patients, providers, and organizations;
- vibrant engagement of staff at the point-of-care;
- meaningful participation of persons/patients and families to support the change process; and
- the development of evidence-informed cultures and safety cultures.
How will my change team benefit from using the Leading Change Toolkit?
The Leading Change Toolkit combines approaches from two unique but complementary implementation frameworks. This can help you:
- use an organized and planned approach to making change
- use social movement approaches to build motivation and commitment to change
- create meaningful partnerships with persons/patients and families to make positive change
- strengthen your own skills and confidence in using evidence to achieve change
Using these approaches can also maximize the impact of your change initiative by:
- improving teamwork
- bridging the evidence-to-practice gap
- improving outcomes
- making positive changes that will last
Who developed the Leading Change Toolkit?
The Registered Nurses’ Association of Ontario (RNAO) developed the Leading Change Toolkit in partnership with Healthcare Excellence Canada (HEC). An Expert Panel of international experts in clinical practice, academia, policy and people with lived experience led this project. An RNAO/HEC project team supported development, which was also informed by multiple stakeholders and organizations.
How was the Leading Change Toolkit developed?
The RNAO research team conducted four reviews to find reliable evidence for the Leading Change Toolkit. We engaged future users and experts throughout its development for guidance and feedback.
Dig deeper: The Leading Change Toolkit was developed and tested by people like you. Learn more about who was involved and what processes were used.
