Abstract
Purpose. The purpose of this study was to identify and determine the extent to which each of Kotter's 8 steps to effective change was present in the implementation of the Kaiser Permanente Southern California Healthy Bones Model of Care as perceived by physician champions and Healthy Bones care managers. A secondary purpose was to identify effective steps to change that were not expressed. A third purpose of the study was to identify incidents or strategies that occurred that refute the importance of one or more of Kotter's change strategies. Methodology. The subjects in the study included 20 physician champions and 35 Healthy Bones care managers employed in the Kaiser Permanente Southern California Healthy Bones Model of Care. Twenty-five had been employed in their current role since the implementation of the program. Of those, 16 agreed to participate. The interview instrument was an e-mail interview. Findings. Examination of qualitative data resulted in 8 major findings. Among the findings were the following: 9 effective and 6 ineffective themes were identified, 10 best practices emerged, 6 ineffective strategies confirmed Kotter's list of common errors, and nothing in the narrative responses from participants refuted Kotter's 8-step change model as an effective model for managing change. Conclusions. The results of the study supported the conclusion that Kotter's 8-step change model, coupled with the findings of this study, can be an effective guide for healthcare reform initiatives at the national, corporate, and medical center levels. Recommendations. Proponents of improvements to the American healthcare system can use Kotter's change model and recommendations from this study to remove obstacles and barriers to change and foster supportive participation from participating healthcare professionals.