Becoming the Change

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Two renowned healthcare transformation experts provide a blueprint for implementing the principles and behaviors leaders at all levels must embrace in order to create lasting change.

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Topics: Executive Leadership, Line Management

Two renowned healthcare transformation executives reveal how you can implement the principles and behaviors that leaders at all levels must embrace in order to create lasting change.

Healthcare is on the brink of a quality revolution—one that requires deeply personal as well as organizational changes. In Becoming the Change, two pioneers in the healthcare transformation movement show you how to cultivate principle-driven behaviors that can turn the tantalizing possibilities on the healthcare horizon into reality.

Transformational improvement has often been aimed at frontline healthcare workers rather than leaders at all levels, resulting in “islands of excellence” that are unsustainable. Toussaint and Barnas demonstrate how change needs to start at the top—whether you’re an executive, a governing board member, a manager, or a physician.

Drawing on a wealth of case studies, they explore how change actually happens, and reveal how healthcare organizations led by people who are compassionate, principled, and engaged can undergo profound and lasting transformation.


“In Becoming the change, John and Kim takes us through a process on how to create and sustain lean thinking across an entire organization. Supported by strong field research and evidence from several healthcare systems, this book offers great insights and playbook for every healthcare leader at various phases in their lean journey.”

–Aravind Chandrasekaran (AC)
Professor of Operations, The Ohio State University

“True organizational excellence, in healthcare and every other industry, requires much more than just a set of tools. It requires the right behaviors guided by the right principles.Becoming the Changeteaches leaders what behaviors they need to adopt to change their healthcare organizations and set them on a path of excellence. This book explores the role of each person in the organization from the caregivers to the board. This book emphasizes the importance of going to where the care is provided to gain a correct understanding of what is really happening, and how that understanding can lead to significant improvements. This book provides excellent case studies from which all healthcare professionals can benefit. I encourage all to take these lessons to heart and be the change.”

–Ken Snyder, Executive Director, Shingo Institute, Utah State University

“A practical guide for leaders at every level as they take on the leadership challenges of today and tomorrow. This book describes the journey from idea to results and shares the tools to design and move forward to a new culture and system for caring.”

–Maureen Bisognano

“A wonderful resource for leaders with case studies and ideas harvested from organizations with results key to success today. The framework and tools are helpful for leaders at all levels and in all sites for health care.”

–Maureen Bisognano

“With this book, Toussaint and Barnas address the elephant in the room by calling for a radically new way of leading our nation’s healthcare organizations. They aim to start nothing short of a revolution. Do you lead with humility; ask a lot of questions; not pretend to have the answers; and create an organization where everyone is a problem solver? If not, you read this book at your peril. You are being asked to change a large part of who you are”.

–Stephen M. Shortell, PhD, MPH, MBA Distinguished Professor of Health Policy and Management Emeritus and Dean Emeritus Co-Director, Center for Lean Engagement and Research (CLEAR) in Healthcare, School of Public Health, UC-Berkeley

“Becoming the Change provides much needed practical advice to health care leaders at all levels on both the reflection and actions required to change their leadership behaviors.   The book is filled with examples throughout and provides a template for a personal A3 that guides the leader through his or her leadership transformation.  Written by two accomplished leaders in healthcare improvement, the book is a compelling read that fills a real development need from the board of directors to the frontline.”

–Peter Ward, Richard M Ross Chair in Management
Director, Center for Operational Excellence, Ohio State University

Publisher:McGraw-Hill
ISBN-13:978-1-260-46168-8
SKU:1688
Publication Date:September 01, 2020
Number of Pages:168
Weight:1.13 lbs
Dimensions:9.250 × 6.000 × 0.750 in
Kim Barnas|John Toussaint

About John Toussaint

John is an Internist, former healthcare CEO, and is one of the foremost figures in the adoption of organizational excellence principles in healthcare. He founded Catalysis a nonprofit education institute in 2008.  Catalysis has launched peer-to-peer learning networks, developed in-depth workshops, and created many products – including books, DVDs, and webinars.

In addition, Catalysis was a founding member of the Center for Lean Engagement and Research (CLEAR) at U.C. Berkeley. Catalysis sponsors the Lean Healthcare Transformation Summit each year – both in the U.S. and in Europe. The Catalysis team has built C-suite coaching capability and partners with many organizations throughout the world advancing healthcare value by supporting teams that are transforming healthcare delivery.

He was the founding chair of the Wisconsin Collaborative for Healthcare Quality and of the Wisconsin Health Information Organization, as well as the non-executive leader of the Partnership for Healthcare Payment Reform in Wisconsin. He has participated in Institute of Medicine subcommittees and has directly worked with CMS leaders to broaden their understanding of lean for government.

Dr. Toussaint’s healthcare improvement work has been well documented in articles published in Mayo Clinic ProceedingsHealth AffairsThe Journal of Patient SafetyThe Journal of Healthcare ManagementHealthcare: The Journal of Delivery Science and InnovationHarvard Business Review and Frontiers in Health Services Management. His work on payment reform and the transparency of provider performance data has been featured in The American Journal of Managed CareThe Journal of the American Medical AssociationHealth Affairs, and the Commonwealth Fund publications.  News publications such as TIMEThe Wall Street Journal, the CNBC BlogThe Milwaukee Journal Sentinel, and Healthcare Finance News have featured articles about Dr. Toussaint’s work.

Dr. Toussaint has been recognized for his work in transforming healthcare by organizations including The Business Healthcare Group of Wisconsin, which awarded him the “Driving Meaningful Change” award in 2014, The Association of Manufacturing Excellence (AME), which inducted him into its 2012 Hall of Fame, and the Jon M. Huntsman School of Business at Utah State University, which hosts the Shingo Prize for Organizational Excellence. Dr. Toussaint was named a lifetime member of the Shingo Academy in 2011. Wisconsin Governor Jim Doyle also honored Dr. Toussaint with a Certificate of Commendation for Innovation from the State of Wisconsin in 2005. Dr. Toussaint is also the winner of ACHE’s 2014 Dean Conley Award for his article “A Management, Leadership and Board Road Map to Transforming Care for Patients,” published in the Spring 2013 issue of Frontiers of Health Services Management. He is also the recipient of the 2018 Cornell College Leadership and Service Award.

Dr. Toussaint has been a featured speaker at the Association for Manufacturing Excellence, The Agency for Healthcare Research and Quality, the Center for Medicare and Medicaid Services, The Shingo Prize, The Lean Enterprise Institute, the Institute for Healthcare Improvement, and many international conferences. He has presented extensively to legislators, Medicare leaders, and government staff on the topic of healthcare value.

Dr. Toussaint has written three books all of which have received the prestigious Shingo Research and Publication Award. His groundbreaking first book, On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry reveals how healthcare can be fundamentally improved at the point of delivery using the proven principles of enterprise excellence. His second book, Potent Medicine: The Collaborative Cure for Healthcare, describes the three core elements necessary to transform healthcare and deliver better value; delivery of care designed around the patient; transparency of treatment quality and cost; and payment for outcomes. His third book, Management on the Mend: The Executive Guide to System Transformation is a study of eleven organizations and the successful attempts to apply enterprise excellence principles in healthcare.

About Kim Barnas

Kim Barnas is the chief executive officer of Catalysis, in Appleton, Wisconsin.

Before her role at Catalysis, Kim served as a senior vice president for ThedaCare, and president of Appleton Medical Center and Theda Clark Medical Center, where she learned about operational excellence and implemented this work in hospital operations.

As the journey continued, a new challenge emerged—the need for a systematic method to sustain improvement, clarify daily continuous improvement opportunities, and deliver on strategic deployment. To meet this need, Kim and her team led the development of a management system. This lean management system is designed to deliver improved performance through a predictable process that develops leaders, identifies defects, solves problems, and develops people. In 2014 Kim authored a book titled Beyond Heroes: A Lean Management System for Healthcare based on this journey. Her latest book, co-authored with John Toussaint, M.D., is Becoming the Change.

Kim is actively teaching, mentoring, and supporting healthcare executive teams around the world. Her current focus is a principle-based approach to executive management. This system builds a new set of competencies in senior leadership teams who are looking to improve organizational performance. Kim has a master’s in healthcare administration.

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