ABSTRACT
Machiavelli’s quote embodies the challenges associated with leading change. First of all, it says change is hard. Few in healthcare would disagree. It is very dif¤cult to bring about change because people tend to settle into their comfort zones. The change agent’s objective is to constantly push people to the point where they are uncomfortable. Change requires discomfort. The challenge is to not push past the comfort zone into anxiety. The next important lesson of this quote is the fact that the change agent is challenged by those who bene¤t by maintaining the status quo, who far outnumber those who would bene¤t from the future state. Unfortunately, the change agent usually has a more dif¤cult time moving past the initial resistance due to the fact that it is very dif¤cult for others to initially adapt to the change agent’s vision. As it turns out, getting others to see, share, and eventually embrace your vision is the art of changing culture. This art is driven by the change agent’s ability to gradually allow outsiders to see and experience the future state. As this experiential learning occurs, the future state gradually unfolds. In this chapter, we will reveal the art of leadership and the science of change management as it pertains to healthcare and emergency medicine.
