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Becoming the Change: Leadership Behavior Strategies for Continuous Improvement in Healthcare


John Toussaint, MD and Kim Barnas, two renowned experts in healthcare transformation, show how leaders are implementing behavior-driven strategies to ensure quality care and create lasting change.

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Product Description

Healthcare is in the midst of a massive disruption. With financial structures in tatters and the future uncertain, this is the moment to begin the revolution. But first, leaders need to learn how to support staff at all levels as they make transformational improvements in care. This book demonstrates that real change is very personal and has to start at the top―whether you’re an executive, governing board member, manager, or physician.

A powerful new approach to healthcare leadership, this book showcases executives in health systems around the world as they:

• Practice behavior-based solutions to organizational problems

•  Learn how to support continuous improvement

•  Be more present in their leadership role

•  Learn how to reflect and assess themselves as leaders

• Achieve better results for patients

Drawing on a wealth of behavioral research, industry case studies, and personal insights from healthcare professionals, John and Kim explore how change actually happens—from the inside out, top to bottom, throughout the whole organization. You’ll learn how healthcare systems led by people who are compassionate, principled, and engaged can undergo profound and lasting transformation. Find proven strategies for cultivating principle-driven behaviors that can turn the remotest possibilities on the healthcare horizon into a new working reality.

This is more than a leadership guide to revolutionizing healthcare. This is about being a force for change that makes life better for patients, caregivers, and all stakeholders. If you want to take the lead in making change happen, start with Becoming the Change.



  1. Maureen Bisognano


    A wonderful resource for leaders with case studies and ideas harvested from organizations with results key to success today. The framework and tools are helpful for leaders at all levels and in all sites for health care.

    Maureen Bisognano
    President Emerita and Senior Fellow

  2. James P. Womack, PhD


    John Toussaint and Kim Barnas have instigated and observed more experiments in organizational transformation in healthcare than anyone anywhere in the world. Over many years they have found that the key element in any sustainable transformation is new beliefs and management practices by leaders. In Becoming the Change they offer a plan for every healthcare leader to truly become the change in the quality and productivity of their organization — along with enhanced patient and employee experience — by first changing their own behavior. It isn’t easy and it requires perseverance. But it is possible, and Becoming the Change shows how. Perhaps the reader can be an example of creative change in the next volume as their research continues!

    James P. Womack, PhD
    Founder and Senior Advisor
    Lean Enterprise Institute

  3. John Shook


    The argument presented so powerfully in this book is more than yet another set of leadership principles; it is a manifesto for direct action via observable leadership. Personal transformation without organizational transformation is difficult – it isn’t easy to be an island of lean thinking surrounded by a turbulent sea of conclusion-jumping followed by analysis paralysis. But its opposite – sustained organization transformation without profound personal change – is impossible. Becoming the change means exactly that – the transformation we so desperately need today will occur only when those of us who lead embrace the transformation personally.

    John Shook
    Lean Global Network

  4. Ken Snyder


    True organizational excellence, in healthcare and every other industry, requires much more than just a set of tools. It requires the right behaviors guided by the right principles. Becoming the Change teaches leaders what behaviors they need to adopt to change their healthcare organizations and set them on a path of excellence. This book provides excellent case studies from which all healthcare professionals can benefit. I encourage all to take these lessons to heart and be the change.

    Ken Snyder
    Executive Director, Shingo Institute
    Utah State University

  5. Stephen M. Shortell, PhD, MPH, MBA


    With this book, Toussaint and Barnas address the elephant in the room by calling for a radically new way of leading our nation’s healthcare organizations. They aim to start nothing short of a revolution. Do you lead with humility; ask a lot of questions; not pretend to have the answers; and create an organization where everyone is a problem solver? If not, you read this book at your peril. You are being asked to change a large part of who you are.

    Stephen M. Shortell, PhD, MPH, MBA
    Distinguished Professor of Health Policy and Management Emeritus and Dean Emeritus
    Co-Director, Center for Lean Engagement and Research (CLEAR) in Healthcare School of Public Health

  6. Peter Ward


    Becoming the Change provides much needed practical advice to health care leaders at all levels on both the reflection and actions required to change their leadership behaviors. The book is filled with examples throughout and provides a template for a personal A3 that guides the leader through his or her leadership transformation. Written by two accomplished leaders in healthcare improvement, the book is a compelling read that fills a real development need from the board of directors to the frontline.

    Peter Ward, Richard M Ross Chair in Management
    Director, Center for Operational Excellence
    Ohio State University

  7. Aravind Chandrasekaran


    Supported by strong field research and evidence from several healthcare systems, this book offers great insights and playbook for every healthcare leader at various phases in their lean journey.

    Aravind Chandrasekaran (AC)
    Professor of Operations
    The Ohio State University