Grassroots Change + Personal Accountability in Healthcare

Imminent Impact - Richard PluckBlog post by Colin Hung

Change is never easy. It takes courage, hard work and a bias for action. In healthcare, change is especially difficult. The risk-adverse culture, hierarchical organizations and ready willingness to blame “the system” rather than accept personal accountability are powerful headwinds that would-be-change-agents face in healthcare.

In a recent blog post, Richard Corder – Assistant Vice President for CRICO, talks at length about the concept of accountability and how it is a critical first step to any real change:

In healthcare, we are currently spending a lot of time (and money) talking about and pondering the ‘accountable entity’. We wax and wane poetically about the who, what, why, when and where, when all the time it’s staring back from the mirror. We are the accountable entities.

What Corder is saying that each of us has the power to affect change – but to unlock it, we must first be willing to hold ourselves accountable for our own actions. We need to answer to ourselves. Once we do so we can be a contagious source of inspiration within our organizations, leading change with clarity and conviction.

USA Change DayThis notion that individual effort and personal accountability can drive change is one of the key pillars of a new grassroots initiative in healthcare – USA Change Day:

USA Change Day harnesses the passion, commitment, and innovation that we see every day across organizations. It uses the power of shared purpose to challenge the status quo and to try something simple yet different in order to improve healthcare.

USA Change Day builds on the work done in 2013 by the UK’s National Health Service (NHS) where a small group challenged everyone in the organization to make a pledge to make one change to improve healthcare.

I learned about USA Change Day through none other than Richard Corder. He invited me to join a small group of passionate and motivated individuals based in the US who were planning similar pledge-for-change initiatives in their healthcare organizations. What I learned was truly inspiring.

All across the US, people like:

  • Chris McCarthy, Founding Director of the Innovation Learning Network and Co-Lead at the Innovation Consultancy at Kaiser Permanente
  • James Rawson MD, Warren Professor and Chair of Radiology at Georgia Regents University
  • Ted Eytan MD, Director in The Permanente Federation, Kaiser Permanente
  • Debra Barrath MN, Healthcare Consultant and Executive Coach
  • Amy Woodrum, Program Associate at Robert Wood Johnson Foundation

…along with dozens of others are encouraging people to commit to making a single change that will improve healthcare and to share that pledge for change on the USA Change Day website. There are well over 150 pledges already on the website and more are added each day. Some organizations, like Kaiser Permanente took the concept further and are in the midst of a 100days-of-change (launched March 11th).

McCarthy wrote about how USA Change Day got started on his blog. In it he talks about how a small group of people formed a “coalition of the willing” to import the NHS Change Day concept to America. What this small group has accomplished is amazing.

I had the chance to ask some of the people involved in USA Change Day why they believe in this grassroots movement. Below are some of their responses:

Why do you believe that a grassroots change initiative, like USA Change Day, will work in healthcare?

USA Change Day taps into what people really think, feel, say and do; rather than a leader or organization telling us what we should think, feel, say and do. This inherently sets the tone of trust, respect and dignity. USA Change Day will be successful because it places thousands of micro-bets, not one large, bet-the-farm approach. We set the bar low so anyone can participate, and yet the very simple act of stepping forward to make a pledge sets a high accountability to follow through.

– Chris McCarthy

I got involved with USA Change Day to raise an army. I want to enable others to improve healthcare one step at a time, one pledge at a time. That is the essence of grassroots change. Just remember how you eat an elephant – one bite at a time.

– Jim Rawson MD

I am involved in Change Day USA because I have a vision for the future of health care and would love to be in conversation with other people who are visionary, committed to healthcare transformation and innovations in healthcare delivery. It was important to align with people who had a similar energy or values around collaboration and partnerships to create healthcare change. One of my pledges for NHS Change Day 2014 was to be part of a group of people committed to creating USA Change Day. That is now a reality!

– Debra Barrath

When you hear the passion and conviction in their voices, it’s truly inspiring…which brings us full circle back to personal accountability. All of these people have looked in the mirror and decided that they can be the change they want. They have taken that all-important first step in making change happen in their organizations and are inspiring others to do the same.

On Tuesday March 24th Chris McCarthy, Jim Rawson and Richard Corder will be guests on #hcldr. They will lead us in a conversation about grassroots change in healthcare and provide insights from their work on USA Change Day. It will be an amazing conversation.

Please join us Tuesday March 24th at 8:30pm EDT (GMT – 5, for your local time click here) as we discuss the following topics:

  • T1 What are the barriers that prevent grassroots change in healthcare? Structural? Financial? Political?
  • T2 What can organizations do to encourage grassroots change & personal accountability?
  • T3 As leaders, how would you measure the success of a change initiative?
  • T4 What changes in healthcare will you commit to? What change should organizations commit to?


“An Americanized British Import”, Chris McCarthy, March 11 2015,, accessed March 15 2015

USA Change Day,, accessed March 15 2015

NHS Change Day,, accessed March 15 2015

“Has NHS Change Date made a difference six months on?”, Damian Roland, The Guardian, September 13 2013,, accessed March 15 2015

“Personal Accountability”, Richard Corder, November 21 2014,, accessed March 15 2015

“Let’s Bring Back Accountability”, Deborah Mills-Scofield, Harvard Business Review, July 30 2012,, accessed March 15 2015

“7 Ways to Build Accountable Organizations”, Henry Browning, Forbes, February 28 2012,, accessed March 15 2015

“Why Changing Health Care Is Hard”, Roy Smythe, Forbes, February 24 2014,, accessed March 15 2015

“Creating a Culture of Accountability in Health Care”, Joshua O’Hagan and David Persaud, The Health Care Manager, April 2009,, accessed March 15 2015

“The Radical Leap: A Personal Lesson in Extreme Leadership”, Steve Farber, Mission Boulevard Press, September 7 2014, ISBN-13: 978-0989300216,, accessed March 15 2015

Steve Farber, Extreme Leadership,, accessed March 15 2015

“The 85% Solution: How Personal Accountability Guarantees Success”, Linda Galindo, Jossey-Bass, October 12 2009, ISBN-13: 978-0470500163,, accessed March 15 2015

Linda Galindo, The Accountability Blog,, accessed March 15 2015

Image Credit

Imminent Impact – Richard Pluck,



  1. Personal accountability is incredibly transformational. In these many years that I have had the opportunity to teach the concept in healthcare to everyone from physicians to nurses to billing departments, ICUs, PICUs, you name it! … Personal accountability changes lives. When you have someone who does not use someone else as their excuse not to live up to what they are capable of you see amazing changes in patient care. When you see a manager learn they are letting others use them as their excuse and the manager stops rescuing poor performance…BAM! Everyone starts to “notch it up!” Fantastic post! Thank you!

  2. Reblogged this on HealthcareVistas – by Joseph Babaian and commented:

    Affecting change in Healthcare – don’t miss this – a special #hcldr collaboration and chat.

  3. Reblogged this on Richard Corder and commented:
    Deep gratitude to Colin Hung for this piece, and for being the catalyst for spreading the mindset of personal accountability

  4. […] Grassroots Change + Personal Accountability in Healthcare. […]

  5. Reblogged this on bigadata healthcare software solutions kathmandu nepal lava prasad kafle and commented:

  6. […] March, along with several others who were the “instigators” of in USA Change Day. Check out the blog and the Storify for more […]

  7. […] – as he is about patients. Dr. Rawson was involved in the USA Change Day initiative and was a guest on #hcldr earlier this year along with Chris McCarthy and Richard […]

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