Creating a sustainable model for stroke system change

Purpose The purpose of this paper is to develop an infrastructure and leadership capacity for a sustainable approach to collaborative change in a complex health-care system. Design/methodology/approach An infrastructure for system change and a mechanism to build capacity for change leadership was developed. This involved (1) using a community of a practice model to create a change community, (2) developing an iterative engagement and change process and (3) integrating collaborative change leadership skills and knowledge development within the process. Change leadership was evaluated using Wenger's phases of value creation. Findings A change community of 62 members across 19 organizations codeveloped a change process that aligns with Cooperrider's 4D Cycle. The change community demonstrated application of change leadership learnings throughout the change process. Originality/value A tailored approach was required to support sustainable transformational change in the Toronto stroke system. This novel methodology provides a framework for broader application to systems change in other complex systems that support both local and system-wide ownership of the work.