title: Leading change: a concept analysis.
abstract: OBJECTIVE
  To report an analysis of the concept of leading change.
  
  
  BACKGROUND
  Nurses have been called to lead change to advance the health of individuals, populations, and systems. Conceptual clarity about leading change in the context of nursing and healthcare systems provides an empirical direction for future research and theory development that can advance the science of leadership studies in nursing.
  
  
  METHODS
  Concept analysis.
  
  
  METHODS
  CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Health Business Elite and Business Source Premier databases were searched using the terms: leading change, transformation, reform, leadership and change. Literature published in English from 2001 - 2015 in the fields of nursing, medicine, organizational studies, business, education, psychology or sociology were included.
  
  
  METHODS
  Walker and Avant's method was used to identify descriptions, antecedents, consequences and empirical referents of the concept. Model, related and contrary cases were developed.
  
  
  RESULTS
  Five defining attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance. Antecedents were external or internal driving forces and organizational readiness. The consequences of leading change included improved organizational performance and outcomes and new organizational culture and values.
  
  
  CONCLUSIONS
  A theoretical definition and conceptual model of leading change were developed. Future studies that use and test the model may contribute to the refinement of a middle-range theory to advance nursing leadership research and education. From this, empirically derived interventions that prepare and enable nurses to lead change to advance health may be realized.
authors.affiliation: Department of Nursing, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Heather V
authors.identifier: http://orcid.org/0000-0003-2088-7801
authors.initials: HV
authors.lastname: Nelson-Brantley
authors.affiliation: Department of Nursing, University of Kansas Medical Center, Kansas City, Kansas, USA.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Ford
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003210:Concept Formation; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology*; D009732:Nursing Care / Q000458:organization & administration* / Q000523:psychology*; D009740:Nursing Staff / Q000523:psychology*; D015279:Organizational Culture; D009936:Organizational Innovation
keywords: advance health; concept analysis; leadership; leading change; nursing; nursing administration; organizational change; systems