When You’re Asked to Lead a Change
For the people responsible for leading change, the real work of implementation often begins once a plan has to become practice.
A new clinical guideline is ready to roll out. A new program is supposed to be used across a team. A new initiative has leadership support. On paper, the direction is clear. In real life, someone still has to figure out how to make it work.
That job often falls to people in the middle of an organization: a quality improvement lead, a mid-level manager, or an implementation team trying to move something important forward while also managing deadlines, staffing issues, competing priorities, and the reality that not everyone is equally ready for change.
That is the audience The Center for Implementation (TCI) keeps in view.
TCI’s work is built around a practical question: when someone is responsible for helping people adopt, implement, or scale a change, what will actually help them do that well?
They need a place to start. They need help figuring out whether the problem is readiness, resistance, capacity, role confusion, or something else entirely. They need support choosing a response that fits the situation instead of defaulting to whatever strategy feels most familiar.
That is why tools matter so much in this work. They can help people move through complexity with more structure and less guesswork.
As Dr. Julia Moore, Executive Director of TCI put it, “Navigating change is challenging. There are so many factors to think about. You can’t just plug-and-play an approach that worked in one setting in another.” That’s where tools and good implementation support come in.
What Support Looks Like in Practice
TCI helps people use implementation science and ideas from related fields to make better decisions about how to introduce, support, and scale change. That can mean many different things, for example: helping a team assess readiness before launching something new; identifying barriers that might make adoption harder, or; helping teams think through who needs to be engaged, what strategies fit the problem in front of them, and how to support change over time instead of treating rollout as the finish line.
Many change efforts do not fail at the level of intention. They stall when the people responsible for leading them do not have the right support to help them take the best next step in real time.
TCI’s practical value lies in bringing the science closer to the work itself. Instead of asking people to interpret research on their own, it helps translate that thinking into tools, processes, and supports that are easy to use in the middle of a real implementation effort.
Using Tools to Find New Solutions to Familiar Challenges
Teams often respond to barriers in predictable ways. When progress slows, they schedule more training, send more reminders, communicate more often, or ask for more accountability. Sometimes that helps. Sometimes it does not.
The problem is not that these strategies are always wrong. The problem is that they are often chosen before anyone has clearly identified the true barriers.
A reminder can help if the main issue is memory. It will do very little if the real issue is overload, low confidence, weak leadership support, unclear roles, or skepticism about the change itself. More training can be useful when people genuinely do not understand what they are being asked to do. It is less useful when they understand the request but do not have the time, support, or conditions to act on it.
This is why the StrategEase tool is so impactful.
TCI’s StrategEase tool is designed to help users identify barriers to change and connect those barriers to implementation strategies that are more likely to address them. Rather than asking someone to sort through theory on their own, the tool draws on established implementation science frameworks and translates them into a guided, usable format to help them choose the best strategies more effectively.
As Dr. Sobia Khan, TCI’s Director of Implementation, put it, organizations have increasingly realized that “scaling is hard – building good, usable tools can make the process easier. Focusing on tools can help organizations better support more people across the system.” That shift matters because it moves strategy selection away from instinct and toward a more structured process of matching the problem to the response.
What Applying Tools Looks Like in Practice
TCI’s partnership with Solutions for Kids in Pain (SKIP) makes this point more concrete.
Through SKIP, a national knowledge mobilization network focused on children’s pain management, healthcare organizations are being asked to adopt evidence-informed national standards that are well established but unevenly applied in practice. The challenge is not just getting agreement on the value of better pain care. The challenge is helping the people inside hospitals carry that guidance into daily work.
That means real people have to do real implementation work. A quality improvement lead may need to figure out where to begin. A manager may need to understand where resistance is likely to show up. An implementation team may need to decide who should be involved, how ready the organization is, which workflows will be affected, and what kind of support staff will need once the early momentum wears off.
The interactive implementation guide being developed through the SKIP partnership is meant to support that work in a practical way. It helps organizations move through implementation more deliberately by supporting steps like assessing readiness, identifying barriers, and selecting strategies that fit the situation they are in.
The guide does not replace the harder parts of implementation. What it does is give the people leading the work a clearer path.
The People Carrying Change Are the Focus
Too often, change efforts are described at the level of systems and strategy while the people carrying them are treated as secondary.
But implementation happens through people. It happens through the manager trying to get a team aligned. It happens through the quality improvement lead trying to move a guideline into practice. It happens through the implementation team trying to keep a difficult effort moving when time is short and conditions are imperfect.
TCI’s work and its practical tools help people lead change with more structure, more confidence, and better support than they would otherwise have. For the people doing that work, that kind of support can be the difference between a change effort that stalls and one that gains momentum.
