title: Studer Group® ' s evidence-based leadership initiatives.
abstract: OBJECTIVE
  The purpose of this paper is to analyze the implementation of an organizational change initiative--Studer Group®'s Evidence-Based Leadership (EBL)--in two large, US health systems by comparing and contrasting the factors associated with successful implementation and sustainability of the EBL initiative.
  
  
  METHODS
  This comparative case study assesses the responses to two pairs of open-ended questions during in-depth qualitative interviews of leaders and managers at both health systems. Qualitative content analysis was employed to identify major themes.
  
  
  RESULTS
  Three themes associated with success and sustainability of EBL emerged at both health systems: leadership; culture; and organizational processes. The theme most frequently identified for both success and sustainability of EBL was culture. In contrast, there was a significant decline in salience of the leadership theme as attention shifts from success in implementation of EBL to sustaining EBL long term. Within the culture theme, accountability, and buy-in were most often cited by interviewees as success factors, while sense of accountability, buy-in, and communication were the most reported factors for sustainability.
  
  
  CONCLUSIONS
  Cultural factors, such as accountability, staff support, and communication are driving forces of success and sustainability of EBL across both health systems. Leadership, a critical factor in several stages of implementation, appears to be less salient as among factors identified as important to longer term sustainability of EBL.
authors.affiliation: Masters of Public Health Program, University of North Dakota, Grand Forks, Dakota, USA.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Schuller
authors.forename: Bita A
authors.initials: BA
authors.lastname: Kash
authors.forename: Larry D
authors.initials: LD
authors.lastname: Gamm
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D006739:Hospital Administration / Q000379:methods / Q000592:standards*; D006740:Hospital Administrators / Q000523:psychology / Q000592:standards*; D006784:Hospitals, Teaching / Q000458:organization & administration / Q000592:standards; D006786:Hospitals, Urban / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D017146:Models, Organizational; D009096:Multi-Institutional Systems / Q000458:organization & administration / Q000592:standards; D019982:Organizational Case Studies; D015279:Organizational Culture; D009936:Organizational Innovation; D015397:Program Evaluation; D036301:Qualitative Research; D000078329:Workforce
keywords: Health services; Hospital management; Organizational change; Organizational theory; Qualitative research