Enabling and disabling factors in implementation of Studer Group's Evidence-Based Leadership initiative: a qualitative case study

Abstract

Up to two-thirds of organization change initiatives fail. Current management literature on successful change implementation offers some advice; however, the focus is on sectors other than healthcare. This case study provides new insights about the implementation of Studer Group's Evidence-Based Leadership (EBL) change initiative in a health system by identifying specific enabling and disabling factors associated with successful implementation. Furthermore, it demonstrates varying relevance of these factors at different stages of implementation. Qualitative research methodology was used in this single-case study design to analyze in-depth interviews with 30 healthcare leaders and managers within the system. Interview questions addressed enabling and disabling factors at three stages of implementation: initiation, implementation management, and maintenance. Four themes emerged in the assessment of the enabling and disabling factors of EBL implementation: (1) Leadership, (2) Organizational Processes, (3) People & Culture, and (4) EBL Tools. The highest reported themes for enabling factors were Leadership, People & Culture, and Organizational Processes, while the highest reported themes for disabling factors were Organizational Processes and People & Culture. Furthermore, the themes played varying roles at different stages of EBL implementation. Leadership-related factors were frequently identified enabling factors at all stages. Organizational Processes were often identified as an enabling factor in the implementation management stage and disabling factors in all three stages. The People & Culture theme was cited as enabling and disabling factors across the three stages. During the initiation stage, EBL tools were frequently reported as an enabling and disabling factor.