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What has change management in industry got to do with improving patient safety?
  1. Douglas J Noble1,2,
  2. Claire Lemer1,
  3. Emma Stanton2,3
  1. 1Healthcare Innovation and Policy Unit, Barts and The London School of Medicine and Dentistry, London, UK
  2. 2London Deanery, London, UK
  3. 3Commonwealth Fund, Harkness Fellow
  1. Correspondence to Dr Douglas J Noble, Healthcare Innovation and Policy Unit, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, Abernethy Building, 2 Newark Street, London E1 2AT, UK; d.noble{at}


Background Healthcare is often in a constant state of change - for political, technological, patient related, and scientific reasons. Yet, for a business where change is the norm, too little time is spent thinking theoretically about how change occurs. One area where change is still needed is in patient safety.

Methods Presented is an analysis of the literature on change to suggest how this may inform patient safety.

Results No one change approach guarantees success in patient safety. Success very much depends on selecting the best fit change framework and adapting it to local context. Well regarded change models, like that of Kotter, are not well tested within a healthcare context. Those that are, such as Pettigrew, do not specifically address all the issues associated with patient safety. Kotter's phases of change may be applied in a healthcare context to enhance patient safety.

Conclusion Kotter's model is well studied in non-healthcare contexts and has potential to be adapted for improving patient safety.

  • Health services administration & management
  • change management
  • health policy
  • organisation of health services
  • organisational development

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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