Fig. 1.

AdventHealth Clinical Transformation (ACT) cycle.

Design

•Demonstrate change needed now (evidence, data)

•Assemble guiding team, powerful coalition of active clinicians (written consensus algorithm)

•Develop motivating vision (best for patient)

•Communicate vision (urgency, honesty, clarity, passion)

•Identify and remove/mitigate barriers/obstacles (key measures)

Pilot

•Short run win (results, deviations, iterate)

Implement

•Maintain focus, build (education)

Sustain

•Institutionalize into culture (behaviors, attitudes, processes, ongoing measures)

Performance

•Continual feedback