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Life sciences executive leadership’s perspective on organizational change

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Life sciences executive leadership’s perspective on organizational change

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Life Sciences Executive Leadership’s Perspective on Organizational Change
By
Samantha Presley

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

December 2023

© Copyright by Samantha Namphon Presley 2023
All Rights Reserved

The Committee for Samantha Namphon Presley certifies the approval of this dissertation

Maria Ott
Marcus Pritchard
Monique Datta, Committee Chair

Rossier School of Education
University of Southern California
2023

iv
Abstract
Organizational change is an indisputable certainty, particularly within in the life sciences
industry, where the ramifications directly affect human lives. The necessity to adeptly maneuver
the unavoidable reality of changes amplifies the significance attributed to the attainment of
successful efforts aimed at profound transformations. This study employed Kotter’s (2012) eight
step model for major change to understand current best practices and approaches of
organizational change from the perspective of executive leaders within the life sciences industry.
Drawing on a comprehensive review of the existing literature identified presumed methodologies
for major change. To capture perspectives of influential executive leaders who are currently
overseeing organizations within the life sciences sector, in-depth interviews collected qualitative
data. Findings validated Kotter’s eight step change model and outlined approaches and methods
the leaders use to navigate change. Additionally, the findings suggested prerequisite steps for
leaders to undergo as a precursor to embarking on major change initiatives. The
recommendations serve as guiding principles for leaders to consider during major change which
transcends beyond the confines of the life sciences industry, intended to enhance the probability
of achieving lasting organization change transformation.

Keywords: organizational change, leadership, organizational culture, life sciences, medical
devices, pharmaceuticals, biotechnology

v
Dedication
To my husband, I could not have achieved this without your love, support, and encouragement.
Many long days of writing (typically before dawn), the constant travel, and endless zoom
classes, you were steadfast and held down our fort. From the moment we met 20 years ago in
that Barnes & Noble, you have always encouraged me and have been in my corner in the pursuit
of achieving my dreams. You recognized potential within me that eluded my own perception and
fostered my belief in myself. With all my heart… Thank you Daver, I love you.

To my beloved daughter Roonie, you are my heart that beats outside of my body. Thank you for
your bright light and tender soul. You have imparted lessons on love, hope, joy, and life that
transcend any literature. I love you.

Finally, a tribute to my grandfather Dr. Samuel Kim. Your unwavering desire for our pursuit of
higher education remains etched in our hearts, and while you are now in a better place, recognize
this journey is a dedication to you.

vi
Acknowledgements
To my esteemed chair Dr. Monique Datta and my committee members Dr. Marc
Pritchard, and Dr. Maria Ott, Thank you. Dr. Datta, your guidance and advice have surpassed the
role of a dissertation chair, you are a cherished and dear friend. Dr. Pritchard, your mentorship,
responsiveness, kindness, and understanding during this journey have been invaluable. Dr. Ott,
your brilliance and belief in me have been a constant source of motivation. Your words of
wisdom and encouragement sustained me during this process and molded my trajectory in my
dissertation focus.
To my fellow classmates of epic cohort 20! Proud to be part of this outstanding group of
leaders. We banded together immediately and supported each other through every peak and
valley. I have made bonds and friendship that will last a lifetime! No doctor left behind. #NDLB.
Heartfelt appreciation to my husband and daughter, to whom this achievement is
dedicated. Their understanding and support have been paramount. Thank you to my parents and
sister Pennie for their constant support during every phase of my journey.
In closing, special gratitude to my mom, whom I speak to daily. She has been my
sounding board, confidant, and at times, therapist. Her enduring love, patience, and continued
support have been immeasurable. Together, we discovered a quote by Walter D. Wintle (n.d.) for
a speech I gave many years ago in junior high to my graduating class. The sentiment resonates as
strongly today as it did then:
If you think you are beaten, you are.
If you think you dare not, you don’t.
If you like to win, but you think you can’t.
It is almost certain you won’t…

vii
Life’s battles don’t always go, to the stronger or faster man.
But sooner or later the man who wins, is the man who thinks he can.
FIGHT ON!

viii
Author Note
The University of Southern California (USC) Institutional Review Board (IRB) (Study ID:
UP-22-01085) registered the study. There was no conflict of interest to disclose. Address any
correspondence concerning this study to the author at spresley@usc.edu.

ix
Table of Contents
Abstract ........................................................................................................................................... iv
Dedication ........................................................................................................................................ v
Acknowledgements ........................................................................................................................ vi
List of Tables .................................................................................................................................. xi
List of Figures ............................................................................................................................... xii
List of Abbreviations ................................................................................................................... xiii
Chapter One: Overview of the Study .............................................................................................. 1
Background of the Problem ................................................................................................. 2
Life Science’s Purpose and Mission .................................................................................... 3
Statement of the Problem .................................................................................................... 4
Purpose of the Study ............................................................................................................ 5
Significance of the Study ..................................................................................................... 5
Theoretical Framework ....................................................................................................... 6
Definition of Terms ............................................................................................................. 7
Organization of the Study .................................................................................................... 8
Chapter Two: Review of the Literature ........................................................................................... 9
Evolution of Organizational Change ................................................................................... 9
Organizational Change Failures ........................................................................................ 13
Current Trends Within the Life Science’s Industry .......................................................... 14
Change Failure Errors and Consequences ......................................................................... 15
Conceptual Framework ..................................................................................................... 34
Conclusion ......................................................................................................................... 36
Chapter Three: Methodology ........................................................................................................ 38
Overview of Design ........................................................................................................... 38

x
Sample and Population ...................................................................................................... 39
Instrumentation .................................................................................................................. 40
Data Collection .................................................................................................................. 41
Data Analysis ..................................................................................................................... 42
Credibility and Trustworthiness ........................................................................................ 43
Ethics ................................................................................................................................. 44
Researcher Reflexivity ...................................................................................................... 44
Summary ............................................................................................................................ 46
Chapter Four: Results or Findings ................................................................................................. 48
Participants ........................................................................................................................ 48
Data Analysis ..................................................................................................................... 49
Posteriori Codes ................................................................................................................. 77
Findings Summary ............................................................................................................. 81
Chapter Five: Discussion ............................................................................................................... 83
Findings ............................................................................................................................. 83
Recommendations ............................................................................................................. 87
Limitation and Delimitations ............................................................................................. 94
Future Research ................................................................................................................. 94
Conclusions ....................................................................................................................... 96
References ..................................................................................................................................... 98
Appendix A: Kotter’s Sources of Complacency ......................................................................... 110
Appendix B: Interview Protocol and Questions .......................................................................... 111

xi
List of Tables
Table 1: Summary of Perspective Change Models .................................................................... 11
Table 2: Leader Demographics .................................................................................................. 51

xii
List of Figures
Figure 1 Kotter’ s Eight-Step Model for Major Change ................................................................. 36

xiii
List of Abbreviations
CAO Chief administrative officer
CCO Chief commercial officer
CEO Chief executive officer
CFO Chief financial officer
COO Chief operating officer
COVID-19 Severe Acute Respiratory Syndrome Coronavirus 2019
CPO Chief people officer
DEI Diversity equity and inclusion
EVP Executive vice president
HR Human resources
IRB Institutional Review Board
KPI Key performance indicator
RQ Research question
SVP Senior vice president
USC University of Southern California
VP Vice president
WHO World Health Organization
1

Chapter One: Overview of the Study
Change is inevitable within the life sciences industry, wherein the strategic
implementation of organizational change holds considerable importance. The increasing
prioritization of the quality of healthcare in the areas of "efficacy, safety, patient-centeredness,
effectiveness, timeliness, and accessibility" has catapulted a greater need for adaptation and rapid
change both internally on the uptake of initiatives and externally to meet expected targets and
outcomes (Harrison et al., 2021, p.85). According to the authors, as life expectancy increases, the
needs of the population evolve, and health conditions become more complex, exerts considerable
pressure upon healthcare organizations. This pressure necessitates an expeditious response to
accommodate the demands imposed by the rapid and voluminous changes.
Greater than 70% of organizations are undergoing change, yet the failure rate of change
initiatives varies between 70% and 93% (Wanser & Luckel, 2021). Additionally, Clark and Estes
(2008) affirmed organizational change processes fail two out of three times. Imran and Iqbal
(2021) approximated 70% of change initiatives fail to achieve the required objectives blaming a
lack of appropriate leadership and poor management of resistance to change from employees.
This problem is significant because, despite the extensive training and development for executive
leadership on change within the industry, the frequency of unsuccessful change endeavors
remains considerable, thereby contributing to a substantial presence of change fatigue.
Inadequate change management remains a major factor in initiatives that come to nothing
(Harrison et al., 2021). Mismanaged organizational change results in high employee turnover,
decreased market share, and organizational demise (Imran & Iqbal, 2021). This study
underscores the gravity of the identified problem, as it addresses the pervasive issue of
organizational change failures within the life sciences industry.
2

Background of the Problem
The professional field of focus for this study is the life science industry, specifically
executive leaders within the biotechnology, medical device, and pharmaceutical sectors. With
less than a 30% success rate for major change, change management has become a focal point of
importance, and in response, numerous change models have emerged. Though, only some
methods apply to the varying change situations organizations face today (Al-Haddad & Kotnour,
2015).
The global economic impact of the life science sector is considerable. According to Duffy
(2020), the life science industry is one of the largest and fastest-growing sectors in the global
economy. In 2019, the United States exported $53 billion in pharmaceutical products, reflecting
a 191% growth over 15 years, while global medical exports grew approximately 185%. Imports
of life sciences into the United States have increased at the same rates or greater during the
identical duration, valued at approximately $127 billion (Duffy, 2020). The survival of these
companies in the global market requires hypervigilance on constant organizational culture
change, as culture is pivotal in determining the success of change initiatives to allow these
companies to adapt to the competitive global environment (Latta, 2019). The life sciences
sector’s global economic impact is substantial, indicated by its significant growth and export
figures, while maintaining focus on the essential role of organizational culture change for
adaptation and survival in the competitive global market.
In addition, research has shown a link between health and a country's economic
development (Maresova et al., 2015). The quality and productivity of work reflects the
investment in improved public health. Therefore, the imperative lies in investing in healthcare to
enhance the quality of life and extend the active lifespan of the working population. According to
3

the authors, approximately 23.5% of people employed suffer from chronic diseases constraining
their daily activities. As the population ages, the number of comorbidities increases, leading to
higher demand for care that magnifies the strain on the healthcare and social structures.
Furthermore, the investment on health may reduce future expenses for treating preventable
diseases (Maresova et al., 2015).
The life science industry is indispensable in diagnosing, preventing, monitoring, and
medical treating diseases to improve the quality of life for those with health issues. The
innovation of this sector dramatically raises the standard and effectiveness of healthcare
(Maresova et al., 2015). For the industry to run its operations to meet internal and external
demands, health leaders need to identify and prioritize change strategies that expect individuals
and teams to renew behaviors, quickly adopt, and integrate change initiatives (Harrison et al.,
2020).
Life Science’s Purpose and Mission
The focal industry of inquiry in this study pertains to the life sciences sector,
encompassing a collective of establishments dedicated to the exploration and advancement of
commodities and services aimed at enhancing the well-being of various living entities, including
humans, animals, and plants. The national employment in the United States was approximately
1.63 million in 2012, with jobs spanning over 73,000 different organizations, and the industry
continues to grow (Nugent & Lindburg, 2015). According to the authors, this year the medical
device global sector alone is expected to reach $400 billion.
This study focuses on biotechnology, medical device, pharmaceutical, and other
healthcare-driven organizations that support life sciences, such as consulting firms and scientific
instrumentation suppliers. The biotechnology and pharmaceutical industries develop and
4

distribute breakthrough medications to allow patients to do more, feel better, and live longer,
healthier, active lives, including providing therapeutics for life-threatening and rare diseases.
Similarly, the medical device industry aims to innovate health devices that are minimally
invasive and surgical to enhance patient care and benefit surgeons, as they are committed to
making healthcare better through revolutionary technology. When amalgamating the core
mission statements of these industries, each at its core centers around human life and patient
care.
Statement of the Problem
Change is a transformative process spanning entire organizations altering culture,
strategy, processes, structure, power distribution, and the roles and responsibilities of the people
affecting all levels of the organization (Le-Dao et al., 2020). This study addresses the problem of
organizational change failures within the life sciences industry. The life science industry
continually adapts to global societal, demographic, and epidemiological shifts. Addressing these
shifts requires effective leadership (Figueroa et al., 2019). The authors defined leadership within
change as the ability to appropriately identify priorities, provide strategic direction, and gain
commitment across sectors as they transition from what is existing to what is new. Technological
advancements, medical knowledge, and innovations necessitate leadership to obtain strong
change management practices. Quick and continuous examination of the changes and the impact
of the repercussions requires leaders to turn their analysis into a practical plan to bring about
change (Figueroa et al., 2019). The impact of consequences of organizational change failure
ripples beyond the life science organization seeking change, influencing not only the
organization itself but also impacting families, communities, and the broader society at large.
5

Whether the life science embodies a nascent start-up characterized by a minimal
workforce of five individuals or a colossal Fortune 500 entity with vast personnel of over
100,000, the pace of change remains swift and dynamic. Yet, according to Figueroa et al (2019)
executive leadership currently does not understand best practices for organizational change and
navigating current and emerging issues. The leaders across the healthcare sector hold tremendous
responsibility for their organizations to be agile and change quickly to keep up with the
competitive global markets which warrants further examination. Within the realm of healthcare,
the ramification of failure comes at a tremendous cost extending beyond the confines of the life
sciences corporations, encompassing broader societal implications and the overall health of
humankind.
Purpose of the Study
The purpose of this study is to examine and glean organizational change best practices
and approaches from current life sciences industry leaders, specifically from the medical device,
pharmaceutical, and biotechnology sectors. The following questions guide the study:
1. How do executive leaders approach organizational change within the life sciences
sector?
2. What are the industry’s best practices for ensuring success with organizational
change?
Significance of the Study
This study contributes as a conduit for extracting organizational change methodologies
from current leaders, utilizing Kotter's comprehensive eight-stage process for orchestrating major
change as a lens to provide guidance and a framework for other executive leaders navigating
transformative processes within the life Science industry (Kotter, 2012). The outcomes of this
6

study benefits leaders within life sciences but also hold relevance for leaders outside of the
industry’s purview. With the increased success of organizational change, the effects trickle down
to every part of the organization, allowing the companies to achieve internal initiatives and meet
external expectations. Ultimately fueling the achievement to meet the industry's mission to help
patients globally do more, feel better, and live longer healthier lives.
Theoretical Framework
The theoretical framework used is Kotter’s (2012) eight-staged process for creating major
change. It is the lens, foundation, and scaffolds the structure to inform this study (Merriam &
Tisdell, 2016). Kotter developed methods for successful organization transformation with the
following steps:
• establishing a sense of urgency
• creating a guiding coalition
• developing a vision and strategy
• communication the change vision
• empowering broad-based action
• generating short term wins
• consolidating gains and more change
• anchoring new approaches in the culture
The process of conducting major organizational change necessitates thorough execution
all eight steps outlined by Kotter (2012). Kotter determined bypassing any of these stages leads
to lost momentum and increased frustration. This study specifically looks at the use of Kotter’s
change model in the implementation of the process in life sciences companies. Through the
qualitative research, this inquiry delves into the perspectives of leaders, highlighting both
7

successful steps in effecting change and missteps when organizational change failed to take
shape.
Additionally, Kotter (2012) made the delineation of the role of a manager verse a leader
when conducting change. The author differentiates management as individuals focused on
planning, budgeting, controlling, problem solving, organizing, and staffing. Whereas leadership
motivates, inspires, aligns individuals, and establishes direction. Managers yield short-term
outcomes while leaders produce remarkable change. This framework provides the study with a
focused pathway to successful change. Drawing on insights from the life sciences leaders, the
investigation present established best practices and offers strategies aimed at improving
organizational change efforts for other life sciences companies to follow, thereby aiding in
upholding their competitive edge within the rapidly changing global landscape.
Definition of Terms
The following definitions provide clarity for key terms within the study:
Life sciences industry: In this study life sciences companies include pharmaceutical,
biotechnology and medical device. These are organizations focused on research, development,
and manufacturing to improve the lives of organisms (Eselius et al., 2008).
C-suite: Executive leadership position includes but not limited to chief executive officer
(CEO), chief financial officer (CFO), chief commercial officer (CCO), chief information officer
(CIO), chief learning officer (CLO) (Groysberg et al., 2011).
Organizational change: Stouten et al. (2018) defined organizational change as calculated
activities that transforms and organization from its present state to desired future state.
8

Organization of the Study
The dissertation employs the traditional five-chapter structure. Chapter One provides the
study's introduction and outline. Chapter Two highlights the pertinent literature and conceptual
framework. Chapter Three describes the research methodology. Chapter Four examines and
analyzes the qualitative findings. Chapter Five proposes recommendations for organizational
change.

9

Chapter Two: Review of the Literature
The literature review examines each stage of Kotter’s (2012) change model. It begins
with the evolution of organizational change and reasons for failures. The chapter outlines current
trends and issues affecting the organizations within the industry. After examining previous
literature on each stage of the Kotter model in detail, the chapter concludes with a summary of
the conceptual framework specific to the life sciences sector to frame the qualitative analysis
within this study.
Evolution of Organizational Change
The impact of globalization, advancing technologies, pressures from competition,
international economic integration, and an ever-changing workforce constitute driving influences
that necessitate organizations and their stakeholders to manage and embrace constant
organizational change (Appelbaum et al., 2012; Stouten et al., 2018). Current organizations adapt
to maintain their position in the market to continue to grow and survive (Appelbaum et al., 2012;
Boone & Williams, 2012). Organizations with the ability to flex and change are more likely to
sustain and endure tumultuous climates. Technological advancements and the hyper-speed of the
global market creates grand and complex changes requiring leaders to make decisions faster, in
less specific environments, with greater risks and sacrifices in the implementation of those
decisions (Kotter, 2012). Given the transformative imperatives brought forth by these
multifaceted factors, organizations find themselves compelled to adapt and evolve to maintain
their competitive stance in the market.
Organizational change is the reconfiguration of the components of an organization
altering its culture, strategies, routines, or structure. The change is either planned or unplanned
(Li et al., 2020). The authors defined planned change as a controlled systematic process that is
10

proactive, controlled measures such as innovation of new products or a modification to the
structure of the organization to enhance performance and effectiveness. Planned changes are
deliberate and manageable (Karasvirta & Teerikangas, 2022). Conversely, unplanned changes
are unexpected, internal, or external events, happenings which cause disruption to organizations
forcing reaction and transformation to curtail the negative impacts of the problematic situation.
Irrespective of whether changes are orchestrated or unexpected, the inevitability of change
remains apparent. Leaders armed with optimal methodologies and insights to navigate such
transformations are instrumental in ensuring an organization's adaptability and continued
viability.
A multitude of catalysts ignite planned and unplanned changes. Triggers encompass
factors such as mergers, growth, expansion, downsizing, competition, new political environment,
change in leadership, change in strategies, new products, and innovative technologies. These
triggers, as elucidated by Helms-Mills et al. (2009) propel the initiation of deliberate and
unforeseen transformations. According to the authors, the acknowledgement of change for an
organization’s survival has led to the development of systematic approaches known as change
management, with its origins traceable to the work of Kurt Lewin dating back to 1939. Lewin’s
concentration on change management served as the foundation, the cornerstone, for subsequent
change models. Models focused towards scrutinizing organizational transformation to address
issues such as motivation, resistance to change, leadership style, sensitivity training, and overall
productivity. While numerous change models have surfaced post Lewin (Figure 1 outlines a
summary of a select few), the current study centers around the theoretical framework delineated
by Kotter, specifically his comprehensive eights steps paradigm for orchestrating major change.

11

Table 1
Summary of Perspective Change Models
Summary of
change
Lewin (1948)
Beer
(1980,2009)
Cooperider and
Srisvastva
(1987)
Judson (1991)
Kanter et al.
(1992)
Kotter
(1996, 2012)
Hiatt (2006)
ADKAR
Assess
opportunity
Unfreeze
Mobilize
commitment to
change by
diagnosing
problems
Discovery
Analyze the
organization
and plan the
change
Analyze the
organization
and change
drivers; create
urgency
Establish a
sense of
urgency
Awareness
Create
coalitions

Line up political
sponsorship
Form guiding
coalition

Create vision Transition
Develop shared
vision of how
to organize and
manage
competition
Dream

Create a shared
vision and
separate from
the past
Create a vision

Communicate
vision

Foster
consensus for
new vision,
competence to
enact it, and
cohesion to
move it along

Communicate
change
Support a strong
leader role
Communicate
vision

Mobilize
energy for
change

Spread
revitalization to
all departments
Design
Gain acceptance
of required
behavior
changes;
transition to
new situation
Craft a plan for
implementing
the change,
involve people
and be honest

Design
12

Summary of
change
Lewin (1948)
Beer
(1980,2009)
Cooperider and
Srisvastva
(1987)
Judson (1991)
Kanter et al.
(1992)
Kotter
(1996, 2012)
Hiatt (2006)
ADKAR
Empower
others

Destiny

Empower
broad-based
action

Develop and
promote
change-related
knowledge and
ability

Knowledge
Ability
Identify short
term wins

Develop
enabling
structures
Generate short
term wins
Reinforce
Monitor and
strengthen
process
Refreeze
Monitor and
adjust strategies
in the
revitalization
process

Consolidate
new conditions
and promote
change to
institutionalize

Consolidate
gains and
produce more
change

Institutionalize
change

Institutionalize
revitalization
through formal
policies,
systems, and
structures

Reinforce and
institutionalize
change
Anchor new
approaches in
the culture

Note. Table adapted from (Stouten et al., 2018).
13

Organizational Change Failures
A mirid of reasons contribute to change failures. According to Ahn et al. (2004), among
the foreseeable causes of failures are lack of leadership commitment, poor project management,
need for training, and unclear justification for the change initiative. Moreover, leaders fail to
grasp the organizational capacity for change (Boone & Williams, 2012). Le-Dao et al. (2020)
denoted leaders’ deficiency in effective communication, inability to recognize incremental
improvements achieved over time, inadequate dedication of time and training for change
initiatives, and the absence of a guiding vision for the new culture. The vortex of inadequacies
leaves employees without a sense of urgency or understanding of the need for change.
Employees often feel unable to be engaged or accept change initiatives due to change fatigue
(Le-Dao et al., 2020). Identification of an optimal method for change is challenging due to the
complexity of the health sector industry. Le-Dao et al. postulated a universal solution for
intricate change within this industry is elusive and success necessitates malleable approaches.
In addition, there is a correlation between a lack of trust in management and resistance.
While there exist positive rationales for implementing change, such as flexing to the changing
environments or to remain competitive, changing a new status quo or situation opens employees
to feelings of vulnerability and uncertainty (Kähkönen, 2021). This susceptibility to change can
trigger resistance, a factor that significant contributes to change failures (Venus et al., 2019).
Resistance tends to be a common response, stemming from stress, anxiety, uncertainty, and
heightened pressure experienced by employees when confronted with change initiatives (Boone
& Williams, 2012). Emotional management is integral to organizational change (Luo & Jiang,
2014). The authors advised to cultivate effective emotional management, organizations need to
attentively monitor and address to the employee’s needs. One approach is to equip employees
14

with coping strategies to allow followers to fulfill the organizational change goals and neutralize
negative emotions by providing continuous communication of “hope, trust, optimism and
enthusiasm” (p.137). Emotional management is pivotal for successful major change because
there must be employee engagement from all levels of the organization to achieve it (Ahn et al.,
2004).
Current Trends Within the Life Science’s Industry
The life sciences organizations face constant challenges that call for change. However,
the added pressure of safeguarding the health of humankind demands an even greater obligation
for rapid adaptability to change. Examples include regulatory environment changes, change in
health care policies, mergers, strategic alliances, new products, new leadership and more (Nugent
& Lindburg, 2015). In addition, the life sciences companies are compelled to stay abreast with
advancements in technology and the paradigm shift toward digitization which entails artificial
intelligence, robotics, and automation. Such endeavors are requisite to sustain their competitive
advantage and uphold their relevance within the industry (Gbadegeshin, 2019).
In the wake of these multifaceted challenges, it is pertinent to delve into the effects of a
global crisis that unfolded in 2020. The World Health Organization (WHO) declared a global
pandemic signifying the novel severe acute respiratory syndrome coronavirus 2 disease 2019
(COVID-19) an international emergency (Stahel, 2020). An outbreak that resulted in substantial
global economic impact, forcing people to engage in remote work and imposed travel
restrictions. Supplemental to the declaration, authorities advised elective surgeries to cease for
fear the procedures would contribute to the spread of the virus and monopolize medical
equipment needed to manage the potential surplus of the virus. In some states, violations were
subjected to penalties including imprisonment and fines (Diaz et al., 2020). Consequently, the
15

unanticipated cessation of elective surgeries cast a substantial impact on medical device
companies, necessitating strategic adjustments to address the ensuing consequences.
Amidst the ongoing ramifications of the COVID-19 pandemic, there has been a shortage
and added complexity to the supply chain for pharmaceutical companies. To cut cost, many drug
companies source their manufacturing outside of the United States (Livingston & Mattingly,
2021). The researchers highlighted challenges with quality control and proper regulation. They
posited manufacturing and shipping disruptions become problematic with a large proportion of
medication produced in foreign countries. Other examples of an international disruption of the
supply during the pandemic was the immediate shortage of personal protective equipment such
as N95 masks, face shields, diagnostic kits, and complex medical products such as ventilators.
The shortage demanded healthcare leadership to implement crisis response frameworks in the
quest to boost their resiliency during the medical catastrophes (Antonini et al., 2021). The
medical device regulatory environment is one example where the segment had to significantly
modify processes to ensure prompt access to critical medical equipment for individuals in need
during the worldwide pandemic (Sahil et al., 2021). It is clear, the substantial impact of the life
sciences sectors on human health and the global economy highlights the necessity to remain
adaptable to global humanitarian needs. The ensuing section delineates prevalent errors
implementing change and their associated consequences. Additionally, it expounds upon Kotter’s
eight steps to effectively counteract their change related pitfalls, thereby facilitating successful
achievement of major change (Kotter, 2012).
Change Failure Errors and Consequences
Organizational change efforts fail due to the following common errors, according to
Kotter (2012):
16

• allowing complacency
• failing to build a guiding coalition
• underestimating the power of having a vision
• under communicating the vision
• new vision blocked by obstacles
• change is sans short-term wins
• prematurely claiming victory
• change unanchored into the culture
The vortex of errors reflects change failures met with resistance, frustration, and stalled
new initiatives, leading to reduced budgets, layoffs, and employee emotional distress. Research
has found regardless of the type of change, employees undergo stress, anxiety, and feelings of
uncertainty during the change process (Belschak et al., 2020; Dahl, 2011). The consequences of
the eight errors, per Kotter (2012), result in initiatives not implemented, acquisitions lacking
synergies, exorbitant costs, time-consuming re-engineering, downsizing that do not solve cost
issues, and programs that do not deliver desired results.
Beyond the error and consequence stated by Kotter, Brickman (2016) asserted that
effecting change is even more challenging in the healthcare sector than in most industries. The
literature has shown the importance and need for the life science industry to implement
successful organizational change to remain relevant and competitive; however, research
continues to show 70% of all change initiatives fail (Brickman, 2016; Wanser & Luckel, 2021).
The 30% success rate raises concern when considering the toll of forfeited competitive
advantage, eroded employee faith in the leadership, compromised quality, and squandered cost
savings. (Jones-Schenk, 2019). Large-scale change uncertainty and stress on employees result in
17

corrosion of employee change beliefs causing loss of change momentum, decreased work
engagements, and increases in turnover (Belschack et al., 2020). Significant change can also be
time-consuming to implement, averaging 5 to 7 years (Brickman, 2016). In addition, culture
change is an extensive undertaking per Le-Dao (2020), and its interventions touch every level of
an organization. Furthermore, the culmination of all efforts sustaining change improvements
accomplished remains a challenging task (Brickman, 2016). Based on the eight identified reasons
for change failures, the following are the eight steps for major lasting organizational change
(Kotter, 2012). The author emphasized the sequential execution of these steps as imperative for
realizing substantial and enduring transformative outcomes.
Establishing a Sense of Urgency
The primary phrase in the change model entails establishing a sense of urgency. Creating
urgency is necessary to transition an organization from its current state to achieve desired altered
state evoked by many stimuli such as technology disruptions, weak sales, or global health
pandemic crises. Instituting urgency involves assessing the market, competitive certainties,
recognizing and analyzing current and potential crises, and identifying opportunities (Kotter,
2012). In addition, establishing such accentuates the pressure to move quickly, renew creativity,
innovate, rejuvenate learning, and recharge employee commitment (Fredberg & Pregmark,
2022).
Urgency, however, operates as a double edge sword. Fredberg and Pregmark (2022)
warned the urgency pressure placed on employees could motivate or inhibit change initiatives.
When harnessed positively, it directs attention, heightens performance, and transforms
capabilities such as direction, shared understanding, engagement, entrepreneurship, learning, and
collaboration. Conversely, the researchers argued urgency could also serve as a detriment to
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change initiatives by causing negative emotions such as stress, pressure, and fear resulting in a
prevention focus. A prevention mindset aims to uphold the status quo, avoid error, and exhibit
risk aversion. Negative urgency, pressure, and emotion hinder creativity and learning. Such
impediments also diminish productivity which impedes change (Amabile & Kramer, 2011;
Edmondson & Lei, 2014).
Supplemental to cautioning leaders to be mindful of negative urgency is the awareness of
the antithesis of establishing a sense of urgency, which is complacency. Kotter (2012) posited
change initiatives suffer obsolescence upon arrival in complacent organizations. Low urgency
and the inability to strum up motivation or convince key stakeholders to endorse necessary
change with credibility and support, pose challenges for organizations. Examples from Kotter’s
definitions for complacency encompass situations where employees are burdened with stress and
occupied, a culture fostering aversion to honest feedback and confrontation, subpar performance
standards, the absence of evident crises, overly positive senior management communication, the
lack of internal system performance feedback measurement, misguided metrics focus, narrowed
employee objectives, and excessive visible resources (Appendix A). Kurt Lewin, a prominent
figure in organizational change theory prescribed a simple three-step approach to organizational
change. He asserted that to facilitate change, organizations need to "unfreeze" the organization's
current stable condition and overcome complacency and self-righteousness. The "unfreeze"
phase demands a purposeful emotional stirring (Lewin, 1947).
The method to circumvent complacency stems from leadership intervention. Intervention
examples include listening to customers (unhappy ones, disgruntled shareholders, dissatisfied
suppliers), using consultants, communicating concerning data to demonstrate weaknesses, and
use the crisis to find external opportunities (Shirey, 2011). Other strategies from the researcher
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included inducing a crisis by tolerating financial losses and eliminating overt excess expenses
such as private company jets, country clubs, and executive gourmet dining halls A means of
instilling urgency involves inundating employees with visions of forthcoming opportunities and
rewards, while simultaneously emphasizing the organization's present incapacity to realize those
prospects and rewards due to its existing negative circumstances (Kotter, 2012). After the
establishment of urgency, the process evolves into the formation of a core team of change agents.
Creating a Guiding Coalition
After instilling a sense of urgency and motivating followers, change necessitates multiple
influential individuals, including a CEO, to spearhead the change. The second step involves
assembling a team of credible leaders, encompassing both leaders and managers, possessing the
expertise to navigate the change process and wielding the authority within their positions to
combat resistance from others (Kotter, 2012). Karasvirta and Teerikangas (2022) stated the
coalition is the team responsible for guiding and achieving active change and obtaining a shared
level of trust and a common objective. They contended this network of change agents
collectively has greater influence, given their various organizational roles, and therefore have a
more significant impact than an individual’s change agent. Boone and Williams (2012) explained
leaders should build a support coalition by identifying opinion leaders and promoting them to
advocate for the change at all levels. Appointing leaders creates a support coalition characterized
by direct ownership of the change process by thought leader, due to their active participation and
decision making. This phenomenon contributes to enhanced success and facilitates a smoother
execution of the change initiative. Employing a solid change team requires established roles, a
substantial degree of mutual trust, and a shared objective within the team.
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The change team needs both leaders and managers to guide the organization to the
desired endpoints of change. Leaders develop the vision, empower, and provide direction, which
drives the change. In parallel with leaders, managers execute tactical plans to ensure control
during the process, such as budgeting, organizing, and staffing, to obtain defined objectives
(Ahn, 2004). According to Bennis (2009), management administers, maintains, focuses on
systems, structure, and the bottom line, while leadership develops, innovates, has a long-range
perspective, and inspires. An optimally guided coalition, per Kotter (2012), requires both leaders
and managers for their unique skills and contributions. Wee and Taylor (2018) referred to
managers as individuals who lead bottom-up dynamic worker-level changes that, over time,
accumulate and amplify changes that are substantial at an organizational level. The constituents
drive minute changes that accrue, resulting in continuous change.
Trust is foundational to any high functioning team, including a guiding coalition of
change agents. One definition of trust is a complex psychological state with an interrelation of
expectations, intentions, and dispositions (Fulmer & Gelfand, 2012). Fulmer and Gelfand (2012)
defined this as positive expectations and the readiness to be vulnerable with another. Maintaining
elevated levels of trust within teams is a deliberate revolving and continuous social process
between members, and breached trust requires immediate trust repair (Kähkönen, 2021).
Acknowledging the pivotal role of trust, and the on-going dedication required to cultivate and
restore it, ensures the sustained cohesion and productivity of the team of change agents.
Developing a Vision and Strategy
The third stage of the framework for change is developing a vision and strategy. The
vision is the principal mechanism, when communicated effectively, evokes employee readiness
for change. A vision is the idealization of an organization's future and its goals, incorporating
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visionary mental model images and descriptions of the organization's envisioned future state
(Haque et al., 2020). James and Lahti (2011) differentiated a vision from strategy or a mission as
it spans a longer time frame and is emphasis on innovation and change focused. Scholars agree
leaders use visions to inspire and persuade their followers to adopt change at an individual level
of contribution (Haque et al., 2020; James & Lahti, 2011; Seo et al., 2012; Venus et al., 2019).
The vision serves as a guardrail to frame change.
A compelling vision is conceivable, desirable, achievable, precise, agile enough for the
individual to make decisions, and is easy to convey (Kotter, 2012). The vision has the power to
overcome painful reluctance by instilling hope. It provides clarity of direction, allowing
followers to do without constant check-in, offering autonomy to make decisions and be creative
through team or individual innovation to achieve the organization's goals. The literature defines
seven attributes; brevity, clarity, abstractness, challenge, future orientation, stability, and
desirability or the ability to inspire (Baum et al., 1998; Haque et al., 2020; Kantabutra & Avery,
2010; Mahmood & Rehman, 2016). Kantabutra and Avery (2010) further elaborated on brevity,
emphasizing the message is concise and memorable, typically encompassing 11-22 words. These
crafted messages should be understood without necessitating additional explanation and
discussion. They defined abstractness as a vision that serves as an umbrella to address a wide
range of business activities over an extended time, not a one-time achievable goal or target. The
vision is abstract enough, so followers have the freedom to be creative, innovative, and left to
their interpretations. It is also challenging enough to stretch employees to attainable goals with a
level of difficulty to enhance self-esteem and encourage superior performance. Haque et al.
(2020) defined stability as the ability of the vision to survive advanced technology and shifts in
the market.
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A compelling vision has the power to move an entire organization regardless of the
number of followers if there is trust. An engaging vision creates a sense of obligation for
followers to reciprocate by supporting the organization’s goals. Haque et al. (2020) stated
leadership's ability to build trust impacted followers' acceptance and commitment to the leader's
vision. Management's level of trust with results in a greater acceptance of the change rational
presented by management (Oreg et al., 2011). The author indicated followers feel supported and
respected, accept the new vision, are willing to cooperate with the change, and believe the
change would be successful. The development of a well-crafted vision and strategy marks a
pivotal stage in the change process. The attributes that render effectiveness, an established
foundation of trust to inspire and guide the organization towards successful transformation and
foster a collaborative atmosphere conducive to successful major change adoption. This stage lays
the foundation for subsequent steps in Kotter’s (2012) framework, where the vision potency is
harnessed to propel the organization toward its desired future state.
Communicating the Change Vision
After formulating the vision and strategy, communication of the change becomes
paramount. An effective vision requires clear and eloquent communication. The communication
of a leader’s vision is the intrinsic ability to communicate future change and the persuasion to
empower employees to arrive at the realization and motivate them to follow it (Venus et al.,
2019). The authors asserted the change vision should emphasized the gaps in the current status
quo and idealizes the alternative. In doing so, creating the need for change by dismantling past
practices and building a case for a new future. Transformational leaders clearly articulate the
vision with passion and enthusiasm igniting followers to adopt and transcend their individual
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needs and work towards achieving a higher purpose for the greater good of the organization's
community (Seo et al., 2012).
Critical to change is quality communication to assist in allowing employees to adopt
change and cope with its uncertainty. Lewis (2011) defined communication as the method of a
message transferred from one person to another. The communication must convey the need, the
process, and the impact of the change (Li et al., 2020). Venus et al. (2019) characterized
exceptional leadership as a leader’s ability to communicate the vision effectively.
According to Kotter (2012), effective communication of a new vision or change consists
of simplicity, conciseness, and clarity, devoid of jargon and "technobabble" (p.92). Word choice
is crucial for memorable messaging. He also suggested using metaphors, examples, and
analogies are effective. Utilizing different arenas and platforms conveys the message, large and
small meetings, emails, newsletters, posters, one-on-one talks, and the intranet. Lewis (2018)
defined multi-communication channels as interpersonal channels (face-to-face) or mediated
channels (technology or mass media). Employees’ receptiveness of the change vision is
dependent on the leader’s choice of media (Jensen et al., 2018). The authors furthered effective
communication is transmitting the message to the receiver but corresponding the appropriate
media to the right message. They highlighted face-to-face dialogues are especially potent due to
the leader's ability to customize the message, receive immediate feedback, and amplify a
personalized quality of communication to get "through to the employees" (p. 358).
In addition to delivering the appropriate information, communication should be frequent.
Repetition is key as it requires individuals to hear the vision many times before the message
resonates (Kotter, 2012). Researchers have touted the importance of repeating messages that
encourage change and added when the vision is the center of conversations between managers
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and their employees it reinforces the message (Lewis & Sahay, 2018; Li et al., 2020; Stouten et
al., 2018).
In addition to repetition, leaders should lead by example. The leader’s behaviors should
be consistent with the communication of the new vision. Role modeling by executive leaders
helps in the transparent communication of the vision (Stouten et al., 2018). Leaders should also
be able to explain discrepancies and inconsistencies for employee adoption (Kotter, 2012).
Managers play a key role in communicating the change as well as providing employee
feedback. They assist in the digestion of new policies and procedures from leadership through
their translation of new changes (Luo & Jiang, 2014). The authors stated managers serve as the
conduit between leadership and employees by providing immediate feedback while encouraging
employees to voice their concerns which increases participation in the change process.
Two-way communication rather than a one-way didactic from organizational leaders is
optimal when communicating change. Li et al. (2020) referred to this process as participatory
communication practice, where leaders hear employees' voices and afford them the opportunity
to raise their opinions on the changes implemented. Participatory communication fosters greater
acceptance by employees, lowers their feelings of uncertainty, and increases satisfaction with the
organization (Li et al., 2020). Adaptive interactive approaches accommodate feedback,
argument, and engagement from stakeholders about the implementation efforts divergent from an
official top-down, one-way communication (Lewis, 2011). Actively involving employees to
participate in the collection, sharing, and development of the change process allows
organizations to deliver the most helpful and pertinent information to meet the demands of their
employees. By effectively addressing the components of communication, organizations can
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facilitate a smoother adoption of change, minimizing uncertainty and promoting a more receptive
organizational environment.
Empowering Broad-based Action
After the organization establishes a sense of urgency, appointed critical players in the
guiding coalition, created and communicated the vision, motivated employees often face
structure impediments that undermine the transformation. Kotter (2012) cautioned leaders to
remove barriers (structure, skills, system, and supervisors). The next stage in the eight-step
model is empowering employees to action by mitigating blockades. Fernandez and Moldogaziev
(2013) defined empowerment as an employee’s elevated belief in their ability to perform. It is a
heighten level of motivation and commitment to carrying out a task. According to the
researchers, empowerment is positively related to performance. Empowered employees have
higher jobs satisfaction, innovativeness, and job involvement instills a sense of responsibility for
fulfilling the change (Appelbaum et al., 2012). The authors furthered empowered first-line
bottom-up efforts aided change by creating a sense of ownership and control that profoundly
impacted the transformation process. The following describes how Kotter's framework identifies
three essential elements for facilitating broad based action: structure, training, and compatible
systems, alongside addressing supervisors' alignment.
Structure
The first barrier to disempowering newly enthusiastic followers is the current formal
organizational structure aligned to the former status quo. Kotter (2012) provided examples of
such as independent silos within departments inhibiting communication, lack of resources for the
new vision, critical middle managers disparaging motivated employees trying to make changes
and contradicting expenditures of the new vision. Such actions demotivate frontline employees'
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efforts causing them to "give up and revert to their old operating ways" (p. 109). Likewise,
Edwards and Saltman (2017) referred to the structural constraints as dysfunctional characteristics
and dimensions of most politically managed organizations.
Training
Training and development are criteria for organizational success. Scholars defined
training as the acquisition of information, abilities, and mindsets that together improve success in
a particular setting resulting in focuses on fostering long-lasting behavioral and cognitive
changes as well as the development of essential skills for job performance (Grossman & Salas,
2010; Salas et al., 2006). Further, effective training increases employee motivation and morale,
decrease the number of employee errors, supports higher productivity, gains greater
commitment, builds teamwork, and improves work quality. Conversely, poor training and failure
of programs do not reap intended behaviors and skills for change and are costly for
organizations. The scholars concluded regardless of learned skills, the training is not effective
when behaviors fail to transfer to the workplace.
Training allows employees to acquire new skills necessary to be proficient in handling
change. Olsen and Stensaker (2013) posited leaders must identify skills needed for change early
to equip employees to deal with the change. Training efforts are often insufficient without true
consideration for the skills, behaviors, and attitudes required to achieve change. This mentality
undermines the new training efforts to change employees’ habits developed over the years.
Training efforts fail because they focus on the wrong skills, technical skills rather than social or
the content prepares followers for what is to come without any follow-up to provide guidance.
Kotter (2012) warned training, if utilized incorrectly, could be disempowering to change if it
demands change and mutes followers.
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Post-training and follow-through are as significant as the training itself. The investment
of billions of dollars in training and development efforts occur each year to support change
initiatives; however, successful knowledge transfer to the job remains a pain point for many
organizations (Grossman & Salas, 2011). The authors coined this conundrum as the “transfer
problem” (p.104). Once trained, employees require hypervigilance from their managers to assess
how they can transfer the knowledge to their daily activities (Grossman & Salas, 2011).
Challenges surface in the post-training stage as employees try to figure out how to apply new
skills in the workplace (Olsen & Stensaker, 2013). Even with a high level of training and post-
training guidance, the authors noted employees remained uncertain in their new roles and unclear
on how to operationalize. Factors contributing to the successful transfer of training are
employees' cognitive aptitude, the belief they can perform new skills, motivation to learn,
perceptions, and belief there is value in the training received (Grossman & Salas, 2011).
Effective training programs that deliver desired skills and new behaviors are crucial to change
but the trainings are not the only factor to empower employees.
Compatible Systems and Confronting Supervisors
The organization's systems, such as human resources (HR) and rewards and disciplinary
systems, are just as essential to change as training. The new vision requires alignment with its
human resource systems, such as performance evaluation metrics, compensation, promotions,
hiring, and recruiting processes. Al-Haddad and Kotnour (2015) suggested a strong HR
department supports change by measuring and evaluating employee performance using gap
analysis of where the organization currently stands and where they need to be to achieve change.
Rewards and disciplinary systems are important to gain buy-in to change initiatives or diminish
resistance toward change. Reward systems incentivize the right behaviors and are a means for
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management to signal their commitment to change. Bonuses, salary increases, and other unique
incentive drive behaviors. At the same time, coercive measures utilized sparingly provide a clear
message of the need for change, such as firing employees and threatening the loss of promotion
(Boone & Williams, 2012).
Middle managers are in key positions to implement change from executive leadership to
first-line followers. They serve as a buffer between senior executives and the staff. However,
supervisors misaligned with the vision and change can be an additional barrier by actively
protesting, rejecting, and resisting (Gaubatz & Ensminger, 2017). According to Harding et al.
(2014), supervisors or individuals ingrained with historic status quo knowledge undermine
efforts of change before it begins if left unaddressed. Kotter (2012) referred to these individuals
as a “product of their own history” (p. 116). The obstructing supervisors rationalize their
behaviors and believe they are right and everyone else is wrong. They have significant power
thus they diminish change agents and discourage progress. Leadership needs to remove barriers
to empower employees. Conversely, Gaubatz and Ensminger (2017) noted barriers often present
change agents with the lens of consequences of what may emerge so they can charge forward
despite being fully aware. The researchers also determined resistance becomes a tool offering a
richer comprehension of how the change will come about. Listening to the concerns of followers
provides the opportunity for change agents to hear consequence to the change rather than
dismissing the concerns as mere resistance.
In summation, the empowerment of employees during an organization’s transformational
journey involves addressing several key elements. Enabling broad based action requires the
removal of barriers whether they pertain to structural impediments or misaligned supervisors
(Gaubatz & Ensminger, 2017). In parallel, the provision of proper training, encompassing, skills,
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behaviors, and attitudes significantly contribute to the employee broad base ability to navigate
and embrace change. Moreover, the compatibility of systems, particularly HR and rewards,
further aligned the organization with the envisioned change (Al-Haddad & Kotnour, 2015).
Active involvement of middle management holds substantial significance as they can either
hinder or catalyze the change progress (Kotter, 2012). Addressing any resistance that emerges as
a tool for deeper understanding of potential consequences heightened the change agent’s
adeptness to navigate challenges. The interplay of these factors shapes the empowerment of
employees in the transformative process.
Generating Short-Term Wins
Step six of major change is permeating the entire organization with a sense of
achievement and progress towards the change vision by celebration and recognition of short-term
wins. Major change takes time, the recognition of smaller victories is instrumental in reinforcing
the transformation's viability and builds momentum (Pollack & Pollack, 2014). However, short-
term wins are not synonymous with small wins. Appelbaum et al. (2012) stated leaders identify
and establish high-performance expectations to show the change is working. Additionally, the
role of the leaders is to model behaviors, which set the standards for the organizations to
emulate. Correll (2016) argued the value of small measurable wins, emphasizing the victories
display the feasibility of the change.
Whether short-term or small wins, the identification of these wins encourages followers
to continue their effort and commitment. Recognition of the work done provides visibility and
encourages change behaviors to continue fulfilling the vision (Appelbaum et al., 2012). Short
term wins are an opportunity for leadership to reward and celebrate followers working towards
the change. Wins widely communicated and celebrated prove the change is tangible (Calegari et
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al., 2015). Short term wins reinforce the efforts to progress the change into reality. The
reinforcement contributes to the transformation’s forward trajectory, allowing leadership gauge
change effectiveness within the business landscape and adjust if necessary (Galli, 2018).
Wheeler and Holmes (2017) stated wins might not be visible to the organization, therefore
calling attention to and recognizing the milestones across the broader organization is imperative.
Believers will stay on course. However, skeptics and doubters need data and proof to
answer the question, is the effort paying off? Short-term wins are observable, clear-cut, and
undeniably related to the change effort (Kotter, 2012). The author determined short-term wins
not only build momentum but equip leaders with proof the change is on track and worth the
sacrifice. Wins provide the guiding coalition milestones, data, and praise which bolstering
morale.
Conversely, short term wins offer evidence to the skeptics, making it challenging for
them to sustain the status quo. The wins provide clear evidence that the change is effectively
underway, igniting renewed momentum, and accelerates the change quest forward (Wheeler &
Holmes, 2017). Kotter (2012) advised short-term wins can add healthy pressure but can
inadvertently dimmish change if a sense of urgency is not sustained. Celebrating successes
towards the change is vital for organization-wide visibility. However, Appelbaum (2012) warned
against declaring victory prematurely as it undermines long-term wins and causes a loss in
change momentum. The practice of generating short term wins serves as a catalyst within the
change process, addresses skepticism, fosters commitment, and drives the transformation’s
momentum. Recognition and celebration of the incremental attainments reinforces viability of
the change effort, empowers the broader base workforce, and makes certain the continuity and
focus on the change initiatives while maintaining steadfast focus on long term change objectives.
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Consolidating Gains and Producing More Change
Acknowledging early wins is crucial. However, early change success is delicate and does
not eliminate the undercurrent of resistance. Kotter (2012) informed risk of regression if change
efforts slow and lose momentum. Moreover, re-establishing the change is problematic for
organizations competing in the rapidly changing global environment with lost momentum.
Calegari et al. (2015) warned not to celebrate too early, which allows complacency to set in and
gives way for old habits to settle back in and diminish the early change implemented.
Moving forward to step seven, the focus shifts to consolidating the gains and accelerating
change. Kotter (2012) outlined this step is harnessing the potential to obtain "more" change
recognizing the road to change is ongoing (p.150). To accelerate change, the organization needs
to create “more” change. The guiding coalition needs to leverage the momentum of the short-
term wins, go beyond the current change state, and parlay it into greater change projects.
Augmenting the guiding coalition with additional members through promotion and development
can amplify efforts. Concurrently, top-level leadership should continue to voice the overall
vision to sustain the sense of urgency. The sustained communication of the overall vision re-
emphasizes the critical need to change by reinforcing the importance by supporting and
encouraging the movement to continue (Calegari et al., 2015). While lower-level managers are to
ensure execution of change projects and eliminate unnecessary interdependences. In step seven
of the framework the focus shifts on capitalizing on the momentum generate by early successes
and purposefully leveraging it to drive substantial and lasting change. This phase of the change
emphasizing the importance of continuous leadership commitment, effective communication,
and persistent execution to solidify gains and move the organization to its change goals.
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Anchoring New Approaches in the Culture
Adaptation of the organization change in the culture is the last and final step. Culture is a
force that indoctrinates its members and permeates employees' actions without mindful intent.
Schein (2010) described culture as integration and patterning. Because of the power of the
corporate culture, transformative changes incorporation into the culture is imminent. First, define
culture, norms of behavior, and shared values. Culture is the social and normative adhesive
binding individuals in an organization together. It is the shared belief, interpretations, social
values, rituals, artifacts, and language (Alvesson & Sveningsson, 2015). Ostroff et al. (2013)
classified culture as a "psychological phenomenon," how employees observe, make sense, and
experience their work setting (p. 643).
Schein (2010) depicted three pillars for which culture manifests. The pillars include
espoused values, observable artifacts, and basic underlying assumptions. Values are shared
ideals, beliefs of appropriate behaviors, and aspirations, that transcend any situation. According
to the author, observable artifacts are the organization's physical environment, employee attire,
company rituals, and ceremonies. Observable artifacts also include language such as humor,
jargon, and slang. In opposition to observable artifacts are the unobservable unconscious basic
underlying assumptions. The three pillars are deeply ingrained into the organization and rarely
challenged.
Culture is a formidable force, and when there is a misalignment of change visions and the
culture, it serves as a conundrum. The challenge is to insert new practices into the old status quo
while eliminating inconsistencies (Kotter, 2012). The author outlined three primary reasons for
the organizational cultures’ authority. Culture indoctrinates, it influences the behaviors of
hundreds and thousands of people, and it occurs without thought, therefore, making it
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problematic to challenge or debate. When there is a disruption to the culture causes resistance,
anxiety, and fear as the culture is the organization’s structure of stability (Ostroff et al., 2013).
Managers are instrumental in instilling the new change vision into the culture. The
manager’s role is to promote short-term wins and demonstrate the wins align with the new
desired practices (Birken et al., 2012). Managers influence their teams by communicating the
need to journey from the old culture, acknowledging it served the company but has ceased to
serve in the current changing environment (Fernandez & Rainey, 2017). From an HR
perspective, tactics include offering attractive retirement packages while trying to retain
employees who are accepting of the new culture and ensuring to hire and promote those who
embrace the evolved culture (Kotter, 2012).
Kotter’s (2012) stages are vital to the realization in achieving an organization’s major
transformative endeavor. The apex of the multifaceted eight staged model culminates in
anchoring the change into the fabric of the organization’s culture. This integration holds
significant potency, given culture profoundly influences human behavior, often without
deliberate consciousness making it difficult to contest or engage in discourse. The undercurrent
of the power of culture necessitates that the manipulation of culture change occurs after
behaviors are altered (Kotter, 2012). He indicated, culture change unfolds gradually as new
action emerge over time, and employees recognize a correlation between new actions and
demonstrated superior performance to the old practices. Therefore, the integration into the thread
of the organization’s culture occurs as the final step rather than the first, in the change model,
and demands unwavering leadership from many.
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Conceptual Framework
According to Maxwell (2013), the conceptual framework embodies a system of concepts,
assumptions, beliefs, expectations, and theories to support and inform the relationships to the
studied phenomena. The framework provides guardrails to the research design, sampling
procedures, and data collection analysis (Merriam & Tisdell, 2016). The conceptual framework
suggests a structure, relationship, and model reflecting the researcher’s initial understanding of
how the world functions. The framework draws on experiential information, existing theory,
exploratory study, and thought experiments (Maxwell, 2013).
Drawing from related literature, the conceptual framework represented in graphic form
details Kotter’s eight steps and the industry’s leader’s utilization or lack of to bring about major
organizational change. The focus of this dissertation is to examine which of the eight steps are
relevant and capable of driving lasting organizational change in the life science industry. Given
the prevailing literature indicating the frequent failure of change initiatives, comprehending the
effective change strategies employed by current healthcare leaders can offer valuable insights for
other organizations within the sector seeking to enhance their change implementation (Harrison
et al., 2021).
Figure 1 illustrates best practices and approaches of executive leadership within the life
sciences industry impacting Kotter’s eight step model to achieve major change. The diagram
reads left to right and begins with life sciences executive leaders. The gray solid triangular arrow
represents current best practices and approaches from the leader’s personal lived experiences
feeding into Kotter’s model to achieve change. Numerically ordering each stage in the eight-
phased model captures the sequential steps. The gray dots and lines between circles signify
progression between steps from ‘establishing a sense of urgency’ to the culminating stage of
35

anchoring the change within the culture. Differing sizes of the graphic circles visually illustrates
the varying effort and focus required to achieve various types of major change initiatives within
each step (Kotter, 2012). Overlap of spheres represent the fluidity between stages.
The conceptual framework presupposes life science leaders do not use all eight steps and
still results in major organizational change. Assuming the validity of the presupposition, this
study seeks to comprehend the most frequently employed among the eight steps and the
underlying reasons. Gaining both achievements and setbacks in organizational change offers
valuable guidance to leaders, whether they operate with or beyond the confines of the life
sciences industry, accomplishing substantial transformative organizational shifts.
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Figure 1
Kotter’s Eight-Step Model for Major Change

Conclusion
The research shows Kotter’s (2012) eight stages are influences in an organization’s
success to achieve major change. Creating a sense of urgency, building a team, developing a
vision and strategy, effectively communication the vision are the primitive steps to spark change.
To ignite acceleration of successes towards the change the literature reflects celebrating small
wins and permeating the milestone successes brings visibility and quells naysayers to the change
initiative. To fuel the momentum, scholarly sources emphasize sustained focus on change and its
37

integration into the core fabric of the organizational culture, boosts the drive towards major
transformation. Chapter Three outlines the methodology for extracting pertinent approaches and
best practices from executive leadership. This approach utilized Kotter’s framework to guide the
conceptual framework underpinning of this study.

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Chapter Three: Methodology
This chapter describes the research design and methods used to identify, collect, and
analyze pertinent data to answer the research questions. The following are specific details
regarding the sample and population, data collection, procedures, instrumentation, and data
analysis utilized in this study. The chapter addresses validity and reliability, ethics, and my
background and positionality.
The purpose of this study is to examine and glean organizational change best practices
and approaches from current life sciences industry leaders, specifically from the medical device,
pharmaceutical, and biotechnology sectors, to answer the following two research questions:
1. How do executive leaders approach organizational change within the life sciences
sector?
2. What are the industry’s best practices for ensuring success with organizational
change?
Overview of Design
This field study used a qualitative approach to secure insights, successes, and failures of
organizational change from the perspective of lived experiences from leadership executives
within the life sciences industry. The research questions guided the data collection and the
research methodology. The qualitative research of this study sought to unveil meaning disclosed
by researched participants (Creswell & Creswell, 2018). Sixteen semi-structured interviews
offered questions with the flexibility to explore answers provided by participants and there was
no predetermined order or wording to questions asked of the leaders. The free flowing and fluid
questions aimed to elicit responses from the executive leaders included questions focused on
behaviors, experiences, values, opinions, feelings, and knowledge (Merriam & Tisdell, 2016).
39

Through these interviews, the study extracted approaches and best practices employed within the
dynamic contexts of the life sciences industry's current landscape. These insights, drawn from
the participants' professional journeys, serve as a wellspring of inspiration and a guiding
roadmap for fellow leaders within and outside of the industry to take cognizance of and emulate.
Sample and Population
In qualitative studies, sampling maximizes insights and discovery while obtaining
relevant data about the study's central themes (Merriam & Tisdell, 2016). Patton (2015) required
the interview sample to consist of adequate participants to allow reasonable coverage and
saturation of topics of interest. This study collected qualitative data to understand current best
practices and approaches used by leaders in the life science sector. The parties targeted for
interviews were executives, ranging from C-suite executives and vice presidents within life
sciences who have led organizational change initiatives. The targeted leaders developed their
perceptions of organizational change based on their lived experiences. The interview participants
span from leadership roles with both Fortune 500 companies and start-up organizations, ensuring
a diverse range of perspectives on the successes and failures of organizational change initiatives.
The sample of participants emerged from my professional network.
Interview Sampling Criteria
Interview participants include the following criteria:
Criterion 1. Employment at a life science company includes medical device,
pharmaceutical, and biotechnology companies.
Criterion 2. The interviewee must hold an executive leadership position.
Criterion 3. The leader must have experience leading organizational change.
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Instrumentation
The research design employed in this study was qualitative, aimed to understand meaning
and context. The methodology utilized thematic coding to interpret the narrative data collected
(Creswell & Creswell, 2018). The instrumentation used was the inductive evaluation of
purposeful interviews. Interviews allowed participants a limitless platform to express
experiences, feelings, reflections, and intentions (Merriam & Tisdell, 2016). This semi-structured
approach afforded interview flexibility to explore insights provided by interviewees. A total of
16 executive leaders were interview for the study.
The study conducted interviews until achievement of saturation or redundancy of
responses. The saturation point occurs when the researcher begins encountering repetitive
responses to the interview questions from participants, signifying no novel information is
imminent. Merriam and Tisdell (2016) explained to reach the point of saturation, the researcher
must simultaneously engage in data analysis during the data collection process to recognize
redundancies. Finally, I asked the participants if they were willing to participate in a follow-up
interview, if necessary, for further clarification or expansion on the responses they had provided
during the initial interview. While all participants agreed, it was unnecessary for the study
findings.
The research design of this study was a qualitative approach to understand the meaning
and context from the leadership’s perspective. The method created thematic coding and
interpretation of the data collected narratively (Creswell & Creswell, 2018). Interviews consisted
of 15 semi-structured open-ended questions to gather participants' experiences with leading
organizational change. The semi-structured approach allowed for freedom to probe participants'
responses to clarify unclear, partial, or ambiguous answers, which allowed for the provision of
41

greater insights (Merriam & Tisdell, 2016). Probes utilized gained greater depth and richness in
the responses provided by the executive leaders of interest (Patton, 2002). The strategic
methodological approach of using open ended questions gathered information by allowing
participants to answer freely in their own words while also aiming to minimize any
predetermined or premeditated responses (Patton 2002). Semi-structured interviews granted the
ability to focus on topics related to the research questions; however, they offered the flexibility to
gain additional insights and interest expressed by the participants. The inductive approach
permitted emerging perceptions and allowed the researcher the freedom to pursue, challenge and
refine insights, themes, and tentative conclusions in subsequent interviews. Peer doctoral
students, the chair, and committee members reviewed interview questions, and two pilot
interviews were conducted to ensure the appropriateness and accuracy of the language of each
question.
Interview questions utilized the organizational change framework designed by Kotter
(2012). Eight of the questions correlated to the eight steps in the conceptual framework discussed
in Chapter Two to determine which are most prominent in current life science organizations and
which are not. These eight questions served to understand if all steps are necessary for major
organizational change and if the change required sequential completion for success. Follow-up
questions extracted and further delved into information related to research questions.
Data Collection
Before conducting the interviews, I obtained informed consent to verify participants'
voluntary participation and advise them of security and confidentiality (Merriam & Tisdell,
2016). Upon establishing verbal affirmation of informed consent, I described the study and
explained interview procedures and questions derived from a pre-written script (see Appendix
42

B). Interviews were conducted in person or via Zoom, depending on the participant's
geographical location and preference.
I gave participants the option to be video recorded with the option to decline at any time.
Each interview lasted approximately 1 hour, and to ensure accuracy in the representation of the
data collected for analysis, recorded interviews were transcribed the video and audio-recorded
interviews. To facilitate coding and data analysis, pseudonyms were provided to protect the
identities and maintain the anonymity of participants (Merriam & Tisdell, 2016).
Access and recruitment were based on my pre-existing professional network. Email,
phone, and LinkedIn was utilized to request participation. I used my USC email address to
contact participants within my professional network. All requests were pre-scripted message to
request voluntary participation. In addition, I requested the participants to contemplate specific
occurrences when they lead organizational change (both successful and unsuccessful) prior to the
interview as questions were focused on these experiences.
Data Analysis
According to Flick (2014), data analysis is interpreting and categorizing verbal and visual
materials to make meaning and conclusions from the information. Merriam and Tisdell (2016)
referred to this sense-making process as consolidating, reducing, and interpreting what people
have said and what the researcher has seen and read. Data analysis is the process of identifying
themes and categories in the data to produce answers to the research questions (Merriam &
Tisdell, 2016). The analysis is the process of searching for recurring patterns in the data.
Creswell and Creswell (2018) described the data-collecting process as follows: organization and
preparation of the data for analysis, reviewing data, and begin coding the data. Coding is a
process of chunking the information into categories with the terminology used by participants
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referred to as in vivo terms. The final step was to generate descriptions of themes and present the
themes as findings.
Interviews were transcribed using the audio transcription feature in the software platform
within Zoom. I reviewed each transcript immediately post-interview to ensure accuracy. Post-
interview transcripts included contextual and non-verbal cues from the executive leaders
interviewed. To achieve anonymity, all identifiable information of participants was removed.
Using the conceptual framework, the research identified and aggregated into empirical a priori
(before) or posterior (after) data codes (Sang & Sitko, 2014). From the codes, I conducted an
analysis to identify themes related to the framework to address the research questions.
Credibility and Trustworthiness
In this qualitative study, I ensured validity and reliability of the findings. Qualitative
validity defined accuracy, while qualitative reliability entailed employing an approach consistent
with other researchers in the field across numerous studies. (Tracy, 2013). Creswell and Creswell
(2018) defined the use of multiple strategies for validity, triangulation by converging the
multiple perspectives of the executive leaders interviewed to establish themes, and the use of
member checking. A process of member checking was used to decipher the accuracy of data
collected by giving the interviewees the final transcriptions and themes to validate the
correctness of the data captured.
Another strategy was the utilization of detailed robust descriptions of the of the setting
and themes to increase the richness and accuracy of the findings (Tracy, 2013). I maintained
awareness of how my reflexivity may have shaped the interpretation of the findings and offered
contradictory evidence when present. Other strategies outlined by Creswell and Creswell (2018)
are the use of other individuals such as peer debriefing or an external auditor to review the study
44

in its entirety to provide objective assessment of the validity of the study. To ensure consistency
and stability of reliability, I procured sound documentation of the steps taken such as certifying
there are minimal mistakes during transcription by checking each transcript and comparing and
cross-checking codes (Creswell & Creswell, 2018).
Ethics
This research supports medical device, pharmaceutical, and biotechnology industry
leaders with navigating organizational change. Answers were confidential and anonymous. As
per Glesne (2011), the ethical code encompasses several key aspects. First, research subjects
must be equipped with the necessary information to make an informed decision regarding their
participation. Furthermore, it is imperative that the benefits of the study surpass any potential
risks involved. Lastly, the responsibility of conducting the research should be entrusted solely to
qualified investigators. In addition, I provided participants the option to decline questions or
withdraw at any time. Voluntary participation provides informed content, confidential
researcher-researched relationship, and the right to privacy. All measures were upheld to avoid
any ethical dilemmas or breaches of confidentiality. Furthermore, the study was submitted to
USC’s Institutional Review Board (IRB) to ensure the adherence to all ethical principles. The
study followed all IRB rules, guidelines, and processes, protecting the rights and welfare of the
participants who consented to participate.
Researcher Reflexivity
Researcher reflexivity is an examination of one’s judgements, beliefs, positionality,
biases, values, and personal background such as gender, race, ethnicity, socio-economic status,
history, and culture, all which influence and shape the interpretation of the study (Creswell &
Creswell, 2018). Reflecting upon Morgan's (2014) diagram of intersecting axes of privilege,
45

domination, and oppression, my positionality resides in the top half of the illustration,
encompassing characteristics such as being able-bodied, credentialed, heterosexual, and upper-
middle-class. Conversely, characteristics in the bottom half of the sphere; are female and first-
generation south-east Asian American. Having an awareness of my background highlights the
potential shaping of the interpretation of the data, theming, and findings to support my position
to create advantageous or disadvantageous conclusions (Merriam & Tisdell, 2016). Positionality
is important to note due to the underrepresentation of women and minorities in C-suite and
executive leadership positions within the life sciences industry (Bismark et al., 2015; Dunne et
al., 2021; Kalaitzi et al., 2017; Ortmeyer et al., 2021; Pryor, 2019).
With 17 years of sales and sales training experience, I have developed and deployed
effective commercial learning and development strategies for medical device organizations such
as Intuitive Surgical, NuVasive, Thermo Fisher Scientific, and PROCEPT. Additionally, I have
provided consultancy services to the largest healthcare consulting firm advising biopharma
companies on how to commercialize their potential new molecules pending the Food and Drug
Administration approval to market. Currently I hold the position as the head of sales training and
professional education for the robotic surgery company, PROCEPT Bio-Robotics.
Interest in studying organizational change initiatives' approaches and best practices stem
from this background. The interest emerged from working for multiple organizations that have
failed to bring about lasting change, whether culture, competitive changes, or adaptation to
mergers and acquisitions. Often, it requires leadership's competency and ability to execute to
ensure changes are effective and permanent. The problem of practice assumes critical
significance due to its direct impact on the survival and transformation of organizations, as well
as their ability to remain relevant and competitive within the rapidly evolving medical industries
46

(Conceição & Altman, 2011). The inability of organizations to establish enduring and efficient
changes poses a substantial threat to their long-term viability.
Research reflexivity plays a crucial role in acknowledging and analyzing personal
background, beliefs, and biases that influence the interpretation of the study. Understanding
one’s positionality, as illustrated in Morgan’s diagram, unveils how characteristics and privilege
influences data interpretation. This awareness is particularly important when studying topics like
organizational change, given its significant impact on an organization's survival and
competitiveness. With a background rich in sales and training experience within the medical
device industry, the interest in studying effective approaches to organizational change emerges
from firsthand experiences of witnessing failed change initiatives. The gravity of this matter lies
in the repercussions on organizational transformation and sustainability, secondarily to the
imperative need for preserving and elevating human well-being. Recognizing one's positionality
becomes imperative in addressing the underrepresentation of women and minorities in leadership
positions within the life sciences industry, with the objective of ushering in more comprehensive
and triumphant organizational changes.
Summary
Chapter Three provides the research methods adopted in this study. A qualitative
methodology uncovered the successes and failures of organizational change from executive
leadership within the life sciences industry. The investigation involved thematic coding and
narrative interpretation of the collected data. Sixteen executive leaders were interview until
saturation of responses were achieved. The semi-structured purposeful interviews were utilized
as the primary data collection instrument, which allowed participants to respond freely their
experience, intentions, reflections, and feelings.
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This chapter also described my reflexivity which encompassed my background, biases,
and positionality and how these factors could influence the data interpretation. It also outlined
measures taken to uphold ethics involved to maintain the credibility and trustworthiness of this
study. My extensive sales, training, and consultancy experience informed the interest to pursue
studying organizational change and the focus on the challenges of bringing about lasting and
effective transformations. This problem of practice holds critical importance for both the survival
and competitiveness of life sciences organizations, but more importantly bears substantial
implications on the health and wellbeing on humankind. The next chapter presents findings
extracted from the data analysis to answer the predefined research questions.
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Chapter Four: Results or Findings
This study aimed to examine the best practices and approaches to organizational change
from the perspective of current executives within the life sciences sector, an industry whose
actions and outcomes directly affect the well-being of patients' lives. The framework used
Examining using the framework of Kotter's (2012) eight steps for change provided guidelines for
the investigation with the following steps:
• establishing a sense of urgency
• creating a guiding coalition
• developing a vision and strategy
• communication of the change vision
• empowering broad-based action
• generating short-term wins
• consolidating gains and more change
• anchoring new approaches in the culture
The subsequent study's research inquiries were shaped by the guidance of Kotter's eight steps:
1. How do executive leaders approach change within the life sciences sector?
2. What are the industry's best practices for ensuring success with organizational
change?
Participants
This study used qualitative methods to collect data from 16 executive leaders across the
life science industries to gain perspectives on organizational change through lived experiences.
Lived experiences of conducting organizational change included but not limited to the following:
corporate growth from a small startup to commercializing into a larger public organization,
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acquisition, closing a company, losing product patents, product launches, employed as a figure
head to conduct new change, territory realignments, mergers, and layoff. The study applied a
semi-structured format involving 15 open-ended questions. Hour-long interview sessions were
conducted either in person or via Zoom. Participants were briefed about the discussion's purpose,
their voluntary participation, confidentiality measures, and the utilization of pseudonyms.
Participants were also informed of their right to choose not to answer any questions.
Additionally, all participants willingly consented to the recording of interviews to ensure the
accuracy of the collected data and opted out of reviewing the transcripts upon completion.
Leadership positions of the participants ranged from chief positions (executive, financial,
commercial, administrative, people) and vice president positions, all within the life sciences
space. Of the 16 leaders, seven (44%) identified as female, and nine (56%) identified as male.
The participant pool does not represent the known gender imbalance within the industry.
However, this study sought a balanced perspective on best practices and approaches from both
men and women leaders across the industry. Sectors varied from pharmaceuticals, medical
devices, and biotechnology, and the size of the organizations ranged from startups (11-50
employees) to Fortune 500 organizations (125,000+ employees). Table 2 provides demographic
information regarding each leader.
Data Analysis
A systematic qualitative data analysis process identified categorical themes. The
conceptual framework guided interview questions, and prior to the interviews, Kotter's eight
steps for major change established priori codes for the study. Within the priori codes, subthemes
materialized from the data collected. Outside of the eight Kotter themes, two posteriori codes
emerged from study participants of the art of investigation and the human factor explained in
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further detail in this chapter. Interview transcripts underwent review and a coding system to
categorize, and label collected data into a code book which classified into priori and posteriori
themes.
Research questions purposefully explored life science leaders' approach (RQ1) and their
best practices (RQ2) for successful change. A best practice and an approach are not synonymous.
The researcher defined a best practice as a standard or set of guidelines known to produce
optimal outcomes. An executive leader can proficiently employ an approach for organizational
change without it attaining the status of a universally acknowledged best practice within the life
sciences industry. Each theme answers research questions by synthesizing best practices and
approaches gleaned from the executive leader participants. Chapter Four follows Kotter's eight
steps for major change, describes emergent posteriori study codes, and concludes with
synthesizing the study's results and findings.
Creating a Sense of Urgency
A sense of urgency is the initial step to moving an organization from its current state to
the desired state of change (Kotter, 2012). Over 50% of the study’s leaders contended that
instilling a sense of urgency is leading by example. "You really got to walk the talk and
demonstrate it," commented Pierre. While Willow noted "People's sense of urgency is their own
right on a continuum." Willow acknowledged that a person's sense of urgency differs from
person to person, and a leader's role in building the sense of urgency for a major change initiative
within an organization is to model behaviors, and to find the personal appeal of a shared purpose.
A sense of urgency allows the leader to establish common ground and encourages alignment with
change.

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Table 2
Leader Demographics
Pseudonym Position Gender Industry
Number of
employees
Interview
format
Aprilia President Female Biotechnology 125000+ Zoom
Billie President and CEO Female Medical device 11-50 Zoom
Charlie VP Female Biotechnology 125000+ Zoom
Elliot President and COO Male Medical device 51-200 Zoom
Gray EVP Male Medical device 51-200 Zoom
Harper CPO Female Medical device 201-500 In person
Indigo CEO Female Pharmaceutical 11-50 Zoom
Jack CCO Male Medical device 201-500 In person
Kai CEO Male Medical device 201-500 In person
Leo EVP and CAO Male Biotechnology 201-500 Zoom
Micah CEO Male Biotechnology 11-50 Zoom
Oliver CEO Male Medical device 51-200 Zoom
Pierre CFO Male Medical device 201-500 In person
Piper VP Female Medical device 1001-5000 Zoom
Wesley SVP Male Pharmaceutical 201-500 Zoom
Willow CPO Female Medical device 501-1000 Zoom

Additionally, leaders emphasize the importance to clarifying initiative specifics for their
stakeholders. Oliver agreed with Kotter's first step and stressed the significance of beginning the
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journey "right." Once there is agreement at the start of the change journey, Oliver creates
excitement by conveying the following, "Why does this journey even matter? Why is it
important? What good things are going to result from us taking this journey?" He dedicated time
to address these fundamental questions, targeted to provide a more profound understanding of
the change implications. He remains focused on the excitement, growth, and sense of
achievement of making a difference in the world, knowing they impact patient lives.
After obtaining buy-in from the team, Oliver begins breaking down the plan of specific
palatable steps going forward. He highlights the importance on writing down “the plan” to
maintain team focus. According to Oliver, the leader's role is to keep the team focused on the
plan and stay diligent in bringing people back to the plan because he noted that organizations
tend to drift from it. He, along with other leaders in the study, divulged that conducting regular
cadence meetings for updates aided in maintaining a sense of urgency.
Executive leaders also stressed providing the reason for the change heightens
understanding and a sense of urgency. Piper starts with "the why." She begins with understanding
where her employees are first and creating a story of the why, the need, and the vision of where
the organization needs to go. As a leader, she explained her role is to continue to tell the story
“six times a day," if necessary, "until people get it." According to Piper, the leader's role is to
constantly share the need and the vision to pace progress. Like Oliver, Piper also spoke to having
a plan and having people engaged in building the plan by defining what it will take to build the
change plan framework, which allows her employees the autonomy to "run with it." She also
defined the leader's role as breaking down barriers to keep engagement. She stated that employee
sense of urgency is in their "ownership … it's a lot more of a rich process and work product at
the end of the day." The leaders unanimously concurred that a shared purpose, the "why,"
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personal allegiance, a robust plan, and consistent communication constitute the essential
ingredients for sustaining a sense of urgency in the context of significant organizational change.
The leaders agreed their role of instilling a sense of urgency to ignite effective
organizational change was pivotal. Their role included exemplifying urgency through modeling,
addressing fundamental questions, articulating the reasons for the change, establishing
understanding, and gaining alignment. Sustaining momentum relied on the commitment to a
robust intentional plan, consistent communication, a profound why, and active engagement to
initiate and maintain the urgency during times of transformative change.
Creating a Guiding Coalition
The second step in Kotter's eight steps of major change model is constructing a group of
influential individuals who are powerful enough to lead the change (Kotter, 2012). The author
stated that regardless of title or which division these individuals were rooted in the organization,
they must work collectively as a team. Within this step, two distinct subthemes emerged in the
study. The first subtheme involved the selection of individuals possessing diverse expertise and
perspectives, including those who wielded organizational influence. The second subtheme
revolved around the crucial aspect of trust.
Differing Perspectives and Organizational Influence
The interview participants revealed the selection of the guided coalition is a strategic
process. Ninety-three percent of leaders interviewed utilized specific and relevant skills as the
main criteria for selecting members of the change group. The criteria included an individual’s
influence and power of persuasion, irrespective of their rank or leadership position. Indicting the
importance of selecting the appropriate team Wesley remarked “The right team of people to
make decisions and execute the change.” Micah further emphasized the individuals who
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comprised the change coalition varied across change endeavors and advised to tailor the team
based on skills required to implement the specific type of change.
Among the executives, eight of the 16 leaders placed value diversity of perspectives,
seeking members who offered distinct points of view and obtained influence within the
organization. Aprilia leans on a team with diverse perspectives from the broader organization.
She noted, "going to people that are always just completely like-minded generally is going to
give me blind spots." Aprilia depends on stakeholders with the right competency and skills,
subject matter experts, to identify knowledge beyond her current scope. She stated she sought out
“Individuals who can help you and can take your vision and translate it into the actual set of
steps to get there." Aprilia explained it is a combination of subject experts and "people who are
good at moving and at change." Willow defined these influential individuals as "people who pull
from their own magnetism." She added that she identified her guiding coalition as visible peers
with a clear remit to go out into the organization, coach, and hold their people accountable.
The leaders consistently sought members who exhibited influence, regardless of formal
titles or authority. Indigo remarked that forming a solid team involves identifying who can
convince others and having clarity in communication. Elliot stated:
The team is everything … Forget the org charts! …They might be buried a level down. If
you just sit back and ask who's the team? Who are the people you believe in that can do
this right? …Those people you really trust and believe in. Are they in the right place to
have an impact? Are they capable? We need to really support this person, and they're the
ones to lead it.
Leaders like Jack chose individuals who had experienced previously navigated successful
change. He commented he finds individuals who know "what great looks like" and have
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experience in achieving successful outcomes. Micah also selected people who will provide a
perspective on the change that will help figure out the steps, messaging, and implementation
strategies. His best practice is formulating the guided coalition and getting the group involved
early, at the very beginning. Oliver agreed and highlighted profiling individuals based on their
strengths, areas that come naturally to people versus non-strengths. He asserted having
individuals play to their strengths results in a higher-performing coalition.
Oliver adopted a dual-team structure, distinguishing between a strategic team, and an
execution team. He admitted the strategic team often held allure, he recognized the need for
execution focused members who turn strategic planning into action and can complete the tasks.
Oliver seconded the significance of task completion. He felt the prime determinant of success
was the team's ability to execute the change plan. He stated, "it's not necessarily the quality of
the plan or the brilliance of the strategy; it's about the ability to say you're going to do something
and do something. I've seen more good plans fail through poor execution." As a result of a
coalition of strategic and execution-focused members has "accelerated his business beyond all
expectations," noted Oliver. This discipline of having the "right players in the right positions
with the right culture" has provided his team with the clarity of responsibilities and gave him the
ability as the leader to better plan. Pierre also identified individuals who execute. His criteria are
people in the organization who he called "doers." He characterized these individuals as those
who willingly undertake tasks even if unfamiliar. He stated he looked for people “who can just
figure it out.”
Leaders highlighted that the selection of the change team might include individuals that
are external to the company. Aprilia named her external support as consultants. She explained the
consultants provided an outside perspective and formulated objective expert solutions. Whether
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the guided coalition consists of external or internal individuals, the team must cultivate trust and
work together to have the potency to drive the change.
Trust
The second sub-theme that emerged from the executives was the unequivocal
requirement of trust. The network of change agents must be a communal group based on trust
and a shared objective (Karasvirta & Teerikangas, 2002). Within the selected guided coalition
requires a foundation of trust between members. Trust allows the guided coalition to collaborate
to achieve desired endpoints for major organizational change. Elliot described individuals who
exhibit passionate accountability to themselves and, more importantly, to others. He emphasized
the vulnerability required for collective change execution. Elliot’s member selection process
includes finding the right people he can trust. He described qualities of “the right people” as
character, capacity, energy, and experience. He ascertained, "people who believe the beliefs.
…Who are the people that are in the boat with you and that you can count on because you can't
do it yourself. The ones are going to have to have to take it forward." Jack determined equally
important to have mutual trust between team members and the leader. He advocated that team
members need to feel that they can speak freely and in his change coalition he works to ensure
his team believes that "he has their backs."
Confidentiality is another facet of trust. Wesley acknowledged the importance of a group
where there is trust because many change initiatives are confidential. He advised using
pseudonyms for confidential change initiatives, exemplified by labeling a reduction of the sales
force as "project apple" rather than "project layoff," until details have been established and a
clear path forward is outlined. Wesley noted that specific aspects needed to be "hammered out"
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to ensure minimal organizational disruption. Indigo concurred with discretion and premature
disclosure of the change with stakeholders that could lead to resistance.
The selection must include champions of the change. Indigo recommended that the group
of champions should be small (five to 10 people). Individuals, who will still be champions,
should the charge or initiates developed by the broader guided coalition team contradict their
original proposals. The guided coalition must comprise individuals who will steadfastly maintain
their belief in and trust towards the rest of the team members, thereby refraining from any
actions that may undermine the implementation stage.
Lastly, the role of the leader is to attract talent from the guided coalition through effective
salesmanship. The leaders must ensure the team believes in the mission and vision. Elliot shared,
"they need to be exposed to the passion you have in what you are doing." The leader must
identify who is capable and who aligns with the culture. "In the end, if you find you have
recruited the wrong individuals for your coalition, move quickly and reshuffle the deck." asserted
Elliot. He also stated that the leader must obtain salesmanship to persuade individuals to join the
guided coalition and to sell the change vision.
Formulating the selection process for the guided coalition involves considerations that
directly impact the success of the change initiative. The executives’ revealed that crafting a
committee of change agents who can provide diverse perspectives, organizational influence, and
evoke and exude trust are paramount in assembling an effective change team. The leader’s
salesmanship in not only championing the change but curating the coalition becomes evident.
Aligning this selected few with the organizations culture, mission, and vision cannot be
overlooked. The amalgamation of these components creates a comprehensive approach that
promotes, innovation, and pursuit of successful transformation. Through the lens of the executive
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interviewees’ the process of choosing the guided coalition is a strategic and deliberate
undertaking, which serves as a vital catalyst for achieving change.
The Vision
The leader's true north and guiding star for organizational change is their formulated
vision. Each participant in the study stressed the significance of the vision and referred to it as
the pillar that offers direction and purpose for the organization. Wesley explained that the vision
conveys why the change is happening but also envisions the company’s destination after the
change. The study findings show that the vision must be clear, concise, achievable, and time
bound.
The leaders collectively shared that the purpose of the vision must possess attributes of
aspiration, clarity, and simplicity. Kai highlighted leaders need to “truly believe in the vision you
define for the organization. Where do you want to go? What do you want to do? How are you
going to do it? … You define your values, and you rally the team around it, and you come up
with your metric analytics." Jack added the ownness on the stakeholder, "it is getting everyone
collectively believing that if I do my part that we can, that we will win, and we can have an
impact in total." He offered an analogy to the electoral process, "It like getting people to believe
your vote matters."
Executives emphasized that the purpose of the vision is to define the organization's focus.
Kai noted the vision must be both aspirational and clear to give the organization proper direction.
Sixty percent highlighted that the vision should be simple and straightforward. Willow confirmed
that the vision should be "so crisp and clear that nobody asked what the priorities are, that people
really understand what is going on in the business, and they know what their part is in that."
Willow related the simplification of organizational change initiatives to an "egg" analogy:
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It's kind of like going to cooking school, and they spend an entire semester on eggs. And
you're like, 'Why are you spending an entire semester on eggs?' Because eggs are perfect!
They can transform into all different things, and there's nothing to take away. They are
only just an egg. You can add, but you can't take anything away. They're simple and
perfect in their current state.
Willow furthered simplification was not exclusive to the vision but also the process for the
change initiative. She referred to this best practice as a reduction exercises, simplifying 15-step
processes into five steps. She stated, "organizations are often very good at addition; they are not
great at subtraction."
Elliot urged executives to define, “what is the actual thing that you are trying to
accomplish?” He stated a focused vision is paramount and defines “what you believe you can
accomplish.” The methodology he used to create vision is the concept of investigation and stated
it may take several months but there is a process to validating the hypothesis believed is
necessary for change. He defined investigation as, “get your feet in the lab, talk to your own
people, spend time and really see it and once it clicks for yourself, then you can lead others.”
Indigo also spoke to investigation, “What happens is, it's often top down that it should always go
from bottom up. Identify where that inefficiencies are, whether it is personal inefficiencies,
process, and efficiencies. You have to approach change with surgical precision.”
The study participants validated the seven attributes defined by the literature in Chapter
Two of a compelling vision; brevity, clarity, abstractness, challenge, future orientation, stability,
and desirability or the ability to inspire (Baum et al., 1998; Haque et al., 2020; Kantabutra &
Avery, 2010; Mahmood & Rehman, 2016). Greater than 50% expressed that if the organization's
actions do not align with the vision, the change will not come to fruition. Indigo advised to only
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embark on a change initiative if it aligns with the vision. She stated, "that means you're killing
the organization. You may not kill it today. You're slowly depriving oxygen for that organization.
When in doubt, have the vision statement of the company on top of the change." Unanimously,
all study participants affirmed that their capacity to inspire others, along with their clarity of
vision and ability to communicate concisely, played instrumental roles in driving successful
organizational change within their respective entities.
The vision serves as guiding star offering direction, aspiration, and clarity in the
orchestration successful organizational change. The study participants provided valuable
guidance for others seeks to navigate the complex landscape of change. Best practices highlight
visions must be well defined, compelling, and meticulous in steering the course to a desire future
trajectory.
Communicating the Change Vision
Of the eight steps defined by Kotter for major organizational change, the communication
of the vision was the resounding topic of every interview conducted for this study. Each is
passionate about their multilayer methodologies, the frequency, and a well-organized and
thought-out rollout plan. "There's got to be a seminal moment where you have a kickoff. Where
the burning platform for the change is introduced, disseminated by the person who's the most
influential symbolic leader of the change," stated Leo. The subsequent phase encompasses a
comprehensive communication planning process, various multilayered methodologies for
dissemination of the message, and the recommended frequency from the study participants.
Communication Plan
Leaders recommended the implementation of meticulous planning concerning the
communication rollout. Wesley emphasized the necessity of formulating a comprehensive
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communication plan. He drew from his experience learned and witnessing other executive
leaders who successfully lead change within large pharmaceutical organizations through
implemented well-organized and thought-out communication plans. Wesley described drilling
down to intricate details for planning the communication of a pending downsizing of a
pharmaceutical organization of over 37,000. The communication plan identified who, what, and
when communications are dissemination and by whom. Leaders received explicit instructions on
the exact messaging and forums to broadcast and were given specific dates and times for
communication. The plan also anticipated questions and mapped the answers to provide. He
stated that the plan identified individuals to prepare, "you should call these employees ahead of
time just to grease the skids. Everything was so meticulously planned out almost to the point
where you'd say, 'Oh, my God! This is overdone, but it’s not! … Communication is paramount."
In addition, it is advisable to address the sequencing of communication, starting with top-
down communication, considering the distinction between group communication and individual
communication. The communication should exhibit consistency, mainly when multiple
individuals are involved in conveying the message. Wesley emphasized the necessity of
uniformity, stating, "they must articulate it with identical phrasing and meticulousness."
Micah also emphasized the significance of a well-thought-out plan and its proper
execution to achieve desired outcomes. He furthered thoughtfulness in the plan, including
anticipating questions from different person's perspectives because senior executives can be
blinded by their own viewpoints if they do not proactively think about the questions and how
they will impact their employees. The planning approach provides intel and empower leaders to
understand navigate the change journey with insight and sensitivity, the personas they will
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encounter, and their role in effectively embarking on the organizational change. Willow
cautioned:
Planning is worth it. However, the analysis paralysis of planning, sometimes you have a
moment in the business, and you just got to meet it. You can do planning all day long, but
you cannot tinker forever. You must take concepts and put form to them.
Preparation for the change empowered leaders to anticipate reactions and equipped each with an
arsenal to combat initial resistance and the readiness to adapt when necessary.
Multilayered Methods
According to the study executives, varying communication methods are situation
dependent when choosing communication methods, ranging from broad forms of
communication, such as monthly town halls, to small groups, to one-on-one conversations with
critical individuals. The multilayers of different approaches to communicating the vision is
intended to cascade the new messaging to every level of the organization. Eighty-six percent of
the leaders mentioned their preference for communicating face-to-face. Even amongst the recent
challenges of the COVID-19 pandemic, executive advised for employees to have cameras were
on to create greater connectivity. Jack asserted that face-to-face allows leaders to make eye
contact, see and use unspoken body language, and have visibility to emotions not captured over
the phone.
Willow presented an illustrative instance of a highly impactful leadership
communications she has witnessed throughout the course of her career. She referred to the
method as “drip communication.” It involved a massive merger between two prominent
pharmaceutical companies affecting over 85,000 employees resulting in the closure of one of the
company's corporate offices, layoffs of 1500 people, and the fusion of two distinct cultures. She
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described the CEO as a big man with furrowed brows "which always made him look angry," who
committed to writing an email to the new combined organization every Friday. She admitted the
CEO lacked people skills, but "his emails were fantastic!" Each email outlined insights of the
week, what he learned, and what they needed to know about anticipating the closure of the
corporate site. Willow commented, the CEO encountered intervals where he did not have new
pertinent information to report; he explained, "hey guys, there is no news this week, I have
nothing to say, but I committed to communicating with you every Friday. So, here's the email."
The result of the drip communication was highly influential in reforming the organization during
tumultuous change. It resolved the organization's psychological anxiety around uncertainty.
Billie referred to her version of drip communication as her “weekend note.” She
referenced her five-minute read, where she would open with something personal in her life,
shared a patient story, reminded the organization of the vision and its objectives, explained her
whereabouts during the week, and ended with a relevant quote (from a patient, an employee, or
impending holiday). According to Billie, the result of the consistent communication updates built
trust and strengthened credibility. Billie reported that it gave her organization insight into her as a
person and kept everyone aligned on the change vision, its objectives, and each person's role in
the change initiative.
Willow added a supplementary best practice to highly effective communication approach
drip communication aforementioned as “executive spotlights.” She defined an executive
spotlight as a subset of organizational executives who frequently communicate the vision. The
spotlight would highlight what leaders cared about, what they believed in, and what principles
they felt were most important to put into practice. Per Willow, this type of communication
mitigated questions the front-line manager, such as, "I wish I knew what was in my leader's
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mind, what's running through their head." This method permitted accessibility to leaders,
humanized them, kept people informed to take ownership, and allowed for decentralized
decision-making.
Frequency
Once planned, the multilayer approach requires frequency of communication to keep the
change initiative at the forefront of behaviors and activities. All of the executive leaders
conducted monthly communications by means of town hall meetings when they assembled to
exchange vision and vital information pertinent to the change. The cadence of these
communications depended on the specific audience and geographic location during the change.
Oliver communicates in person every two weeks with this leadership team. Additionally, he
conducts a bi-yearly, three day retreat for his leaders to come together and discuss the ongoing
strategy of how to activate the vision on a day-to-day basis.
The most frequent cadence conveyed from the interviews is constant, ensuring a
consistent flow of the vision messaging throughout the designated period. Due to the ongoing
need for reminders of the change among employees, Jack and Charlie indicated a persistent
frequency. They recognized consistent reminders were crucial to reinforce the vision and ensure
the new path forward remained at the forefront of employees’ minds.
Jack utilized every opportunity with all stakeholders he encountered and stated, "I remind
them all the time. It's constant, an everyday activity. Whenever I have free time, I work on the
phones.” He referred to this method of communication as the “water cooler conversation." His
approach encompasses a proactive undertaking to establish personal interactions with many
individuals across the organization’s global landscape. The direct personal engagement is meant
to foster meaningful connections to build rapport and network on a global scale aimed to further
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the vision communication. He highlighted, "if I can have an impact on those people, they'll talk
to three or four other people, so that belief in what we are doing goes much broader." Other
leaders in the study also used the water cooler conversation and one on one connections to
communicate the change. Similar to Jack, the impact of this individualized communication
resulted in a ripple effect of organization adoption of the change.
Regardless of the methodology or cadence of the communication, the leaders reinforced
the importance of reciprocal communication, affording employees an opportunity for a two-way
conversation rather than a monologue. Elliot stressed that the art of listening to the employees’
express concerns, opposition, questions, and feedback alleviates anxiety and fosters greater
acceptance. He commented that proactively asking questions and hearing the organization
provided insight into how leaders can support their employees during the change. Pierre advised
executives to "get out and mingle with field-based personnel. Go spend and week with each one.
You learn a lot when you are on the ground with folks." Oliver's question-and-answer forum also
created an open and transparent relationship with his employees. He admitted he is "not always
right and does not have a monopoly." He encouraged employees who disagreed with the
opportunity to "speak up" and provided an open platform for a transparent discussion. Oliver
informed it is more time-consuming having two conversations upfront; however, it gains greater
alignment and less resistance allowing his change initiatives to forge forward faster. Two-way
communication proved to reduce opposition and further resistance and increased buy-in,
alignment, and connectivity toward the change initiative. Charlie summarized, "Listen. Learn.
Understand. Adjust."
The vision, per the leaders, provides transparency in lieu of the communication plan,
layers, frequency, and bi-communicative opportunities. The majority of the leaders commented
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that the purpose of the communication was to be fully transparent and to keep their organizations
informed. Wesley coincided, "people don't want to be surprised; they want to understand what is
happening and why it is happening; even if it is a bad thing, they feel like part of the process, and
they know what is coming." He added that it is imperative to be transparent so employees do not
feel deceived and can plan for the future. Oliver agreed and offered his best practice in being
transparent is carving out the last 30 minutes of his monthly town hall for his employees for a
question-and-answer session where his employees are "encouraged to ask absolutely anything
personal and professional." He explained, "transparency is very powerful because I believe that
it's a foundation of building trust, and without trust, it's harder to be a leader."
The study participants validated Kotter's fourth step while supplementing best practices.
The interview with the leaders resoundingly called for a multilayer approach, strategic cadence,
and meticulous planning. The executive participants shared desire for authenticity and
transparency in their preferences for favoring face-to-face interactions, promotion of open two
way conversations, drip communications, and executive spotlights. The leaders validated
Kotter’s fourth step through deliberate planning skillful execution, and ongoing adaptation while
enriching this stage with actionable insights and tangible effective practices.
Empowering Broad-Based Action
After communicating the change vision, the next step in Kotter's eight-step model for
major change is to empower the employees to take action. According to Kotter (2012), leaders
can influence the empowerment for action through behaviors such as removing barriers,
alternating the current status quo structures, and systems that may inhibit the change, providing
training for employees to learn new skills, and encouraging new behaviors and actions from their
employees. Across the study, all leaders acknowledge the importance of training and bringing in
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cross-functional partners when appropriate to ensure employees are adequately prepared and
supported to take independent actions.
During this sixth stage of empowering broad-based action, the leaders addressed those
resistant to the change initiative. A thematic code that arose from participant responses was the
identification of resistors and the methods used to quell or overcome their opposition. The
executive leaders experienced, if not addressed, the resisters become toxic, poisonous entities
who sabotage and suffocate the momentum and success of the organization's major change
initiative.
Confronting Resistance
With change comes resistance, and although most of the organization will adopt the new
change initiative, inevitability there will be employees who will resist and hang on to the
organization of the past. The study participants offered a few solutions. The first is to proactively
seek to understand the root cause of resistance. According to the leaders, offering coaching or
finding the individual a better fit within the organization can be viable options. However, if the
employee cannot align with the organizational change, each participant in the study stated that it
is better for the person and the company to part ways and separate.
Seeking to Understand
Unanimously, the executive participants stated the first action when encountering an
employee who does not align with the change initiative is to understand. Leo stressed that leaders
must "listen." Oliver defined possible reasons for the opposition as the individuals are "too
committed to the old way, feel a sense of ownership to an old strategy, or maybe they don't
understand and believe that we are going in the right direction." Wesley pointed out that the
reasons behind the resistance may be something a leader can help, support, advise, or motivate.
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According to Wesley, the leader should start positively and consider the position or "fit" first.
Coach the employee by helping them through it by being transparent with expectations. He
offered using verbiage such as, "I'm hearing you, and this is how it is affecting your peers, your
team, the organization, and the customers. Hoping they will respond to this." Leo advised trying
to understand where the angst is coming from and uncover the underlying motivation for
resistance. He expressed that he viewed resistance as a manifestation of insecurity. He further
shared, "I want to go, understand, and pick away at what's going on there and then turn someone
who is a resistor into a champion."
Similarly, Micah offered to sit down with that person, discuss why the change is
happening, understand where the individual is coming from, and acknowledge the concerns. He
commented that his reasoning is to uncover something he may have overlooked while
implementing the change and to ensure he is not making a poor decision. There are opportunities
for the leader to modify the change slightly to appease the hesitant employee. However, if he
cannot get through, he said it is time for a "come to Jesus" and to be straightforward with the
employee. The language he suggested that he has used effectively is, "I hear you and understand
what your concerns are. I've tried to address those, but at the end of the day, this is what we are
doing, and I need you to get on board." Best practice among the study participants concluded to
assume good intentions, seek to identify the underlying reasons and gaps, and offer clarity and
support. If misalignment, defiant behaviors, and resistance persist, the study's leaders collectively
arrived at the unanimous determination to proceed with employee separation.
Respectful Separation
If the leaders are unable to overcome resistance despite efforts to bridge the gap, they
unanimously agree that swift action is necessary for the greater good of the organization, as
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resistant employees become detrimental to the team. "Negative people are toxic and will kill
your culture," noted Jack. Elliot experienced resistant entity will manifest on the team and
frustrate their peers. Oliver remarked, "even if they are high performers that have bad behaviors,
get rid of them quickly because they will infect the whole organization." Willow commented:
We will separate with a good employee. … Do we still have a match between us, and if
we don't, then you'd find a way to separate, and you try to do it as respectfully and as
dignified a way as you can, but that's hard.
Leo stated, "it's time for them to step aside. Move away, get out of the way. So, get out of the
way, meaning you put them somewhere else in the organization or get out of the organization."
According to the study participants, resistors at the leadership level are even more
detrimental to the change effort. Oliver concurred, "any lack of alignment at the top of an
organization is ultra visible to the rest of the organization. Resistance becomes a problem when it
festers deep inside an organization." Billie attributed failures in her past change processes was
due to her hesitation to remove an individual who became her "derailer" and, ultimately, who
worked against her. Leaders unanimously moved derailers aside to achieve change.
Leaders differentiate a derailer from an employee who provides initial opposition to
opinions and feedback. Fifty percent of the study participants expressed opposing opinions,
allowed them to consider if the change initiative they were on was the right path, and made them
consider alternatives and blind spots in the change direction as they humbly admitted they are
not always right. Oliver and Billie stated they have disagreements and encourage this
conversation privately, but the leadership team needs to maintain 100% alignment with the
organization publicly. Billie summarized her approach with opposing opinions from her team:
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You can yell, scream, attack each other, debate, do anything you want, and disagree. But,
once I, the leader, make the decision. When we walk out of the door, we file in a straight
line, and we all support it, irrespective of what we thought, because you had your opinion
heard, and the decision was made. … If you're not with me, then you need to leave.
The study leaders swiftly terminate resistant employees while striving to do so with the
utmost respect, showing empathy and support. They assist in finding alternative employment,
provide references, and enable the employees to part ways amicably, extracting the poisonous
force for the organization's greater good. If not dealt with, the toxicity will suffocate, be the
demise of the change initiative or, at a minimum, slow the adoption and progression of the
organization to the desired change state. These employees are not conducive to a winning
organization performance necessary to survive the ever-changing global landscape (Kotter,
2012). Seventy-five percent of the leaders’ stated termination was unnecessary because
employees often self-select to leave the organization due to their misalignment with the change.
The leaders' optimal approach entailed initially presuming good intentions and
endeavoring to comprehend the perspective of the resistant individual while demonstrating
empathy, support, and offering assistance. They attempted to negotiate to establish terms of
alignment, aimed to facilitate the individual's comprehension of the new direction for the change.
However, if there continued to be a mismatch between the cynic and the change initiative,
leaders eliminated the individual while attempting to maintain a respectful separation.
Another type of employee surfaced during interviews, the neutral employee, merits
consideration. A neutral employee is defined as one who is no longer resistant however is not
supportive of the change initiative. Additionally, 88% of the executives did not believe neutral
was sufficient. Jack viewed neutral as "a starting point. If you can get too neutral, then there is
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progress." Elliot stated, "ultimately, they have to be supporting each other and supporting the
mission, and I don't think you can be just neutral in anything."
Empowering broad-based action is Kotter’s stage to foster alignment and mitigate
opposition. When met with opposition, the leaders sought to understand employee perspectives,
address resistance, and navigate the delicate balance between fostering a supportive environment
and separating from a resistor of necessary. The executives concluded that separation was the
best path for the employee and the organization if alignment with the new direction was
unattainable. Each used a blended focused utilizing a people-centered approach, leveraged
transparency and respect, while demonstrating a commitment toward the success of the change.
Generating Short-Term Wins
During the progression of adoption of the change initiative, the sixth stage of Kotter's
model generates short-term wins. The short-term wins are threefold: they must be visible to a
wide range of employees throughout the organization, unambiguous, and related to the change
effort (Kotter, 2012). The short-term wins provide the organization with evidence that the change
is worth the cost, rewards change agents, and fosters positive morale. Quick wins are indicators
of early success, validate the ideas implemented by the guided coalition, overcome the efforts of
the resisters and cynics, and build significant momentum.
Employee recognition emerged as a unanimous point among the leaders for driving
change. Forty-three percent of the leaders reported that recognition facilitated trust-building with
the change effort and the leaders themselves. Similar to Kotter, the leaders noted that the
recognition needs to be a proclamation. "The leader's role is to make the small wins visible,"
stated Piper. Generating small victories allowed the organization to see progress and validate that
the change effort was working. Micah seconded public recognition of individuals by
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acknowledging individuals who achieved a "clear cut goal or has gone above and beyond.
Recognition in front of peers is important. It keeps people motivated." Conversely, Aprilia
commented lack of recognition of behaviors and actions; employees started to perceive their
efforts as insignificant. The president views recognition as "investments in people." Leo
explained, "you want to reward people who are busting their bump." He noted that it motivates
employees' performance to continue to execute. Although recognition inspires continued
performance, he cautions that the recognition must be "genuine and sincere." Disingenuous
recognition results in a loss of trust in the leader and demoralization of the organization. He
stated, "they will look at you like you are a farce." Aprilia also warned, "don't recognize things
that are insignificant." A notable, 67% of the study population indicated that small wins must be
intentional.
Leo, and 72% of the participants, defined the markers as keeping performance indicators
(KPIs) linked to the project plan. His recommendation for setting the KPIs included accuracy,
timeliness, operational definitions, and alignment with the overall cadence of the change
initiative. Leo highlighted, accuracy in defining the timing feeds the overall momentum of the
change. Gray ascertained, "Progression towards milestones may indicate you may need to re-
evaluate the process." Over 50% of the leaders found that the milestones allow for course
correction and indicated that the change is working. Milestones allowed the change team to
assess, and course correct.
The leaders in the study validated Kotter's sixth step to build momentum toward the
desired change. It is essential to clearly define, measure, time, and make the small wins visible.
The wins are indicators of success, signaling to supporters and cynics that the change is
occurring and is working, propelling progression forward. In addition, broadcasting small wins
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increases morale, employee loyalty, and builds trust. The winning milestones reward behaviors
and demonstrate to the organization that the cost, hard work, and sacrifices are worthwhile.
Consolidating Gains and Producing More Change
While the small wins are early signs of sparking change, the seventh stage is sustaining
the energy of the momentum over time. Motivation inevitably begins to wane, and employees
may become fatigued. During this stage of the change, the cynics and resisters begin to re-
emerge. Willows states, "the worst thing you can do is not acknowledge it." Willow recognized
that motivation would decline; however, leaders must address it head-on. She explained, "you
must call it out. Are you still in this or not? Because it's totally okay to not be. But I need
somebody who is." She advised leaders to act, rather than avoiding the issue, as avoidance could
erode the leader's effectiveness and influence.
Wesley's approach when he felt his organization had hit a "trough" was to go into "high
touch mode." He advocated, "try to be in constant contact with people. You got to stay close to
them until the whole thing is done." Leo approaches this stage of change "like any other project
management." He outlined having a specific cadence, reporting out of project status, check-ins,
and design reviews. Leo stressed the importance of cadence in staff meetings, customer
meetings, customer insights, product reviews, and talent reviews. The timing may be weekly,
monthly, or quarterly. He said, "you've got to get in a rhythm for the change. That's how you get
momentum going, and that's how you actually effectuate change."
Enlisting broader assistance is part of Kotter's seventh step for major change. CEO Micah
promotes transparency and candor when he is able. The guided coalition of change agents may
be privy to more than others in the organization; however, during this stage, the call to action
permeates outside of the group of change agents. Micah stated, "maybe they don't know the
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whole piece. But here's one piece of what I'm trying to solve and get them involved. People feel
that it's not just a decision handed down to them. They have some ownership of it." He advocated
for the empowerment of a larger number of employees to become involved in the process, thus
becoming part of the solution which subsequently generated further change.
The study leaders established metrics and analytics to evaluate organizational health and
frequently measured the delta in behaviors. This approach enabled the leaders to maintain an
inquisitive and adaptive stance. Billie commented that she focused on understanding the
dynamics of the organization at its current stage. "I get to understand the good, the bad, the ugly.
What drives them? And what doesn't? What frustrates them." Indigo highlighted, "you have to
have a constant post-survey. Just like how we do post-market surveillance on a device or on a
drug. Understand what is happening. Even the small changes needs are noted." Fifty percent of
the leaders advised leaders to continue being inquisitive and agile to keep the organization
moving toward the change initiative outcome.
In the study, the leaders strategically established deliberate indicators of success. They
accomplished this by identifying the desired end-stage behaviors of the change and retroactively
outlined essential milestones along the change journey. Seventy-five percent of the study
participants opined "measurable" markers for gauging success. Piper's organization used
centralized scorecards. She called this approach "game-changing because it gives us something
to shoot for, and when we are off, we have red on our scorecard, and nobody likes to see that."
The scorecards also allowed her teams to have the proper dialogues, keep the change initiative
alive, and define what to celebrate.
A period of lull or trough is an unavoidable occurrence in any change initiative and
Kotter’s seventh stage to consolidate gains and produce more change involves upholding
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momentum as the change progresses. Strategies utilized by leaders included open
acknowledgment of challenges, consistent communication, and involving a broader group of
employees. Various leaders emphasized the importance of maintaining curiosity, adaptability, and
clear metrics. How leaders inspire and rally the organization holds great significance. Their
commitment to defining key indicators of success and steadfast attention on the change’s goals is
essential. Interviewees affirmed Kotter’s stage indicating the key to this stage lies in proactive
leadership, continuous assessment, and persistence to drive change closer to the end state of
success.
Culture
The culminating step in the major change model is integrating the new change into the
organization’s culture (Kotter, 2012). Culture, with its imperceptible yet potent influence,
functions as an agent of indoctrination, manifests through the actions of numerous individuals
within the organization, transpiring without conscious intent. The author intentionally placed
culture at the end of the change journey as the final step rather than at its inception, finding in his
extensive career most adaptations of shared values and norms occur at the end of the
transformation process.
An indicator of change success is that it becomes anchored in the organization's culture
(Kotter, 2012). Notably, Kotter stated the foundation of the old culture is often compatible with
the new vision. Therefore, the task is to integrate the new practices onto the existing culture
while eradicating the inconsistent elements.
Organizational culture is significant because of its power to influence human behavior
(Kotter, 2012). Although Kotter referred to culture as an invisible force, the executive leaders in
this study highlighted there are visible indicators of new practices being grafted into the culture
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as signs of transformative success. Harper remarked that altered behaviors are emblematic of
successful adoption of the change initiative into the organization’s culture. In fact, over 50% of
the leaders spoke to visible behaviors and new practices as indicators of change to the company
culture. Elliot accentuated that culture manifests in employee behaviors, asserting that true
culture is discernable through observation rather than written slogans on walls. He stated "you
can write whatever you want on the wall, but culture is how the team behaves. It is what you
observe.". Willow commented:
You really get concrete about it so that if the fifth grader walked in the door and saw
behavior, they could say if it was the behavior, you were looking for or not. It's that
unambiguous.
Willow added that language acquisition serves as a tangible indicator of culture transformation.
Language acquisition, in the context of culture change, pertains to the evolution through which
there is an adoption and incorporation of new terminologies, phrases, communication styles, and
expressions by individuals and or groups within an organization as a reflection of the desired
culture shift. The linguistic transformation is an outward manifestation of the employees’ internal
mindsets. She furthered that language acquisition signifies successful adoption of organizational
change.
Forty-three percent of the leaders expressed that the managers and people leaders are
responsible for permeating the change into the culture. Jack highlighted, "if you're a people
leader, you are responsible for culture. Everybody's got a role in culture, but your responsibility
is enhanced, and it's your job to ensure our culture is where we want it to be." More than 50% of
the leaders indicated that after the adoption of the change initiative, it ceased to be a change
initiative and became what Wesley referred to as a "new organization."
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Because of the culture’s influence and power, Kotter cautioned that new transformation
approaches would regress if not firmly anchored into the culture. Such regression might unravel
incrementally, evading notice until the cumulative effect undermines the progress achieved
through the various stages of change. Thus, culture is Kotter's last step because he believed, as
did the participants in the study, that reshaping norms and sharing values materializes at the
conclusion of the transformation odyssey, not at the beginning.
The journey of organizational change is incomplete without the assimilation of the new
order into the company’s culture. The influence of culture, with its blend of subtle and tangible
influences, validates the triumph of the implementation of change. The interviewed executive’s
guidance on culture, in conjunction with Kotter’s framework, function as a guiding compass for
organizations as they navigate the tumultuous journey of transformative change.
Posteriori Codes
Outside of Kotter's well defined eight steps of major change, the qualitative data analysis
uncovered two themes that garnered significant weight in the realm of successful change
management. The first was the concept of investigation prior to embarking on implementing any
major change initiative. The majority of the executive attributed their organizational change
successes to “doing their homework” stated Elliott. Preceding change efforts, the leaders took
time and energy to comprehend the present state of the organization. Although admittedly time-
consuming, the investigation allowed for faster adoption for the change to occur. The second
theme was the consideration of the human factor. During the interviews, leaders often
emphasized the imperative for leadership to embrace the vantage point of their employees,
exercising caution, and demonstrating genuine care for those directly impacted by the change.
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The following delves into the two posteriori codes surfaced within the scope of this
investigation.
The Art of Investigation
During the interviews, each of the executives revealed Kotter's eight steps, thereby
providing further validation for the efficacy of the change process in achieving successful major
transformation within the life sciences sector. Fifty-six percent of the study executives asserted
the magnitude of investigation when embarking on transformative change. According to the
leaders, the best practice for change success was a product of being inquisitive, asking thoughtful
questions, and listening carefully. Investigation prior to initiating change, applicable to all of the
leaders regardless of the organization's size or stage of maturity.
The leaders utilized questioning and active listening to glean diverse inputs and
perspectives from employees connected to the issues at hand. Aprilia admitted instances where
leaders are disconnected from the day-to-day activities, issues, and perspectives, such as at the
factory level, laboratories, operating rooms, or field commercial territories. Micah stated that
asking questions allowed leaders grasp ground level realities which informed change decisions.
The discovery process minimizes blind spots and aids in comprehending how the organization
functions. Charlie’s strategy when joining a new company is to listen, learn, and understand the
organization's history and pointed out ineffectiveness of leaders who conduct change by "coming
in with a big, heavy hammer and an agenda."
In situations where leaders joined a new organization, 100% of the executives dedicated
time to assimilating information regarding the business context, the environment, prior business
decisions, leadership, and the prevailing organizational culture. The investigation stage is a
precursor to any decisions. Oliver referred to this phase as a "do no harm" stage. He coined the
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term and urged leaders to be very patient for a period and absorb as much information about the
business as possible. To comprehend the current environment, previous business decisions,
leadership approaches, and the prevailing organizational culture prior to implementing change,
leaders entering a new organization are advised to withhold judgment for a minimum of three
months. Jack expressed that this discovery process aims to understand the existing landscape,
acquaint oneself with individuals, their respective strengths, and contributions to the broader
organization, and seek their perspectives on opportunities and challenges. He and other
interviewees were recruited into the new organization to effect positive change, as the preceding
approach had proven ineffective. This practice armed leaders with valuable information to
formulate their change plan of action moving forward.
Billie, a seasoned CEO, with a track record of successfully changing the trajectory of
multiple medical device companies, stated that before starting her first day, she requests
documents, strategic and technical plans, board minutes, monthly reports, and market overviews.
After joining, she begins conversations with all of the senior leaders by engaging in one-on-one
meetings to understand and get to know the dynamics of the team, priorities, and problems. Then
she connects with all the different levels of the organization. She stated, "I'm going to spend the
time and energy to dig deep enough to see what the problems are. Once the problems are
identified, I'm able to build operational plans and strategies and execute them flawlessly to get
things moving." Billie and the other participants were recruited into the new organization to
implement change. However, the best practices gathered from the interviews revealed a common
thread: taking the time to learn about the organization before executing any changes. In addition
to the information they acquired, this approach enabled the leaders to earn respect, credibility,
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and trust. As a result, these relationships transformed into alliances, provided support when the
change was implemented, and reduced resistance.
The investigation provided leaders with a broader perspective to effective approaches to
navigating the landscape of organizational change. Questioning and active listening to
understand employees affected or closest to the issues benefited the leaders as they uncovered
blind spots, gave an understanding of the present status quo, and fosters seeds of respect and
trust. Through the art of investigation leaders were better positions to make informed decisions
which successfully guides their organizations through the transformations.
The Human Factor
The second posterior code from the study participants was consideration and care for
their employees during organizational change. Greater than 50% of the leaders stressed the
importance of their people. Wesley advised maintaining respect for people remembering there is
a human aspect to change. He stated it is about "how you do things, how you communicate, and
how your treat people … to do your best to make sure they land on their feet." He added, "It's
recognizing that people are delicate; you have to really be thoughtful about how people receive
information and what's going to be on their mind and to try to anticipate how they're going to
take it."
Willow accentuated the need to take on the change through the lens of the employee. She
commented, "what does it feel like to be an employee with this change? The leader needs to walk
in the shoes of the employees who are facing that change and understand it deeply from the
person who is affected." The leader's genuine care allowed for greater adoption of the change and
more effective decision-making for the organizational change.
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Although, not an explicit step called out by Kotter, investigation analysis and genuine
consideration for the human element were best practices pivotal to achieve successful
organizational change amongst the life sciences leaders in this study. The heartfelt attention of
employee well-being and in-depth inquiry made the executives more adept at maneuvering
through the intricacies of organizational change. These outlined best practices promoted
smoother adoption and enhanced decision making, contributing to the overall success of major
organizational change in the life sciences sector.
Findings Summary
This research study centered around the examination of best practices and approaches, as
viewed through the viewpoints, and lived experiences of executive leaders within the life
sciences industry. Although the researcher had disguised the study's interview questions that
were based upon Kotter's eight steps to major organizational change, the leaders all alluded to
each of the stages as industry best practices. When asked, after the conclusion of the interview,
about their familiarity with Kotter's model, revealing 68% of the participants were unaware of
the change model, validating that Kotter's steps serve as an effective method for successful
change. Although Kotter (2012) advocates for the necessity of following each step for successful
change, this study contradicts this notion. The leaders used many but not all of Kotter's steps to
achieve successful lasting organizational change irrespective of the gender or the division of the
life sciences industry the executive originated. Of the eight steps, step four, involving
communication of the vision garnered robust conversations and significant attention. Each leader
exhibited a multitude effective communication methodologies, techniques, and approaches,
along with a diverse range of examples illustrating successful communication strategies for
accomplishing change.
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In aggregate a best practice, the study's findings added a resounding prerequisite
requiring leaders to take prior to leading change. Preliminary investigation surfaces as an
essential precursor, occurring months prior to the initiation of change initiatives. Playing the new
card, putting boots on the ground floor, asking good questions, discovering, and listening allow
the leaders an understanding of the current state and organizational readiness for the impending
change. The discovery stage validated the leader's hypothesis for change and illuminated
alternate avenues to attain organizational change. The leaders conceded that the investigation
requires additional time and patience but noted that is value in yielding optimal change
outcomes. The majority of the executives expressed authentic focus and acknowledgement of the
human dimension through any change initiative as a standard best practice in their change
processes. In summary, the 16 leaders affirmed the effectiveness of Kotter's eight steps for major
change.
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Chapter Five: Discussion
The purpose of this study is to explore the perceptions of executive leadership within the
Life Sciences sector on approaches and best practices of organizational change through lived
experiences. Chapter Four presented the findings to address two research questions:
1. How do executive leaders approach organizational change within the life sciences
sector?
2. What are the industry’s best practices for ensuring success with organizational
change?
The study conducted open-ended semi-structured interviews in person or via Zoom with 16
executive leaders across the life sciences industry. The distribution of female and male leader
participants in the study is not representative of the disparity of gender at the executive level
within this sector. The executives shared lived experiences of organizational change success and
failures and provided their best practices and approaches proven effective.
Findings
The literature has made clear that 70% of change initiative fail (Wanser & Luckel, 2021),
and the outcomes of this study substantiated and Kotter's eight steps and provided alternative
approaches and best practices from executive leaders within the life sciences industry. Effective
leadership to address organizational change in an industry directly tied to the lives and health of
patients across the globe add an even greater expectation for successful change efforts from these
organizations. While a significant responsibility, it is imperative to comprehend the preset
leadership approaches for navigating change (Figueroa et al., 2019). In addition to validating
Kotter's change model, through successful and failed organizational changes, the executives
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interviewed provided new insights into best practices that transcend the scope of Kotter's eight
steps.
Finding One: Validation of Kotter's Eight Steps Are Best Practices
Regardless of the executive participants familiarity with Kotter’s change model, the
interviews gleaned executive experiences aligned with Kotter's eight steps, even if the leader was
not privy to the change framework. Each executive share instances of how they implemented the
different change steps. Collective the leaders offer illustratives for the various stages; however
individually, not all steps achieved their desired lasting change endpoint.
Leaders created a sense of urgency by providing "the why" and the benefits for
employees, fostering common ground and employees’ ownership of actions toward the change
cause. Each built a team of change agents, recognizing the collaborative effort for the change
initiative to come to fruition. Leaders describe how they created their vision for the change
highlighting the vision should be inspiring, time-bound, clear, and concise.
Communication was the cornerstone for change. In communicating the vision, many of
the leaders called out the best practice in the detailed planning process of the communication.
The communication plan was as crucial as the communication itself, outlining how, what, and
when to message the change to the organization. It determined the cadence, gave leaders
personas, and anticipated organizational questions. The leaders offered guidance on managing
resistance, emphasizing recognizing, and celebrating short-term wins, maintaining progress
markers, and intently listening to employees to make alterations if needed.
Lastly, the leaders recognized the culmination of change success when the focus shifted
from attaining progress milestones to the assimilation of change within the organizational
culture. The study findings answered the research question to understand best practices, validated
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Kotter's model, and showcased real experiences from current industry leaders on achieving
successful change.
Finding Two: Uncovered Varying Approaches to Achieve Change
Collectively the leaders aligned with Kotter's eight steps; however, the study accentuated
diverse pathways to accomplish each step, contingent on the organizational contexts and specific
circumstances. An example is communication. While the leaders recognize the importance, each
employed different methodologies for disseminating the messaging. Approaches encompassed
face-to-face, town halls, emails, and live meetings. The approach's preference was often
dependent on the leader's individual communication style. Although approaches varied, each
proved effective in communicating the change. These findings effectively addressed the research
query of understanding executive leadership's current approaches, by providing contemporary
strategies implemented to achieve proven organizational transformations.
Finding Three: Investigation and the Human Factor
Pivotal to change efforts, this study uncovered two vital steps that merit integration prior
to adopting the eight-step change model: deep investigation of the organization and
conscientious consideration to the human dimension. The first was taking a step back from the
change that needs to happen to learn organization and its readiness. The leaders in this study
spent considerable time researching and discovering before embarking on a change initiative.
They gathered financial statements, meeting minutes, and read press releases. They actively
engaged with their leadership teams, established cross-functional partners, and conversed with
those in close proximity to the product or clientele. Additionally, they physically immersed
themselves in field activities, laboratories, and operating rooms to spend time with customers.
Through these measures the executive participants gathered insights into the people, the culture,
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and the prevailing current state of the organization. Listening allowed the leaders to collect vital
information to devise change strategies that were in alignment with the organizational climate,
garnering supporters for the change cause, and mitigating initial resistance.
Augmented to the art of investigation, the second consequential discovery pertains to the
human factor. Within a known highly competitive, cutthroat industry aimed at exceeding the
bottom line and sustaining shareholders support, each leader profoundly considered their
employees and used this lens as a guiding force to influence decision-making. They consistently
placed emphasis on the well-being of their staff at the center of their change trajectories and
demonstrated genuine concern for employee sentiments regarding the impending change and
potential impacts. Employee centered focus prompted the executives to lead with transparency
and openness to keep the organization well-informed. Moreover, they invested one on one time
with employees to gain feedback, cultivating a platform for coping with change that was marked
with empathy and respect. By giving precedence to the human aspect, these executive leaders
created a conductive environment to manage the delicate dynamics of change, consequently
contributing to smoother transitions and enhanced change implementation.
Finding Four: Successful Change Irrespective of Leadership Gender
Although not directly correlated to the two research questions that fueled this study, the
fourth finding necessitates highlighting. The interview subjects were individuals in C-suite roles
and vice presidents within the life sciences sector, who have spearheaded organizational change
efforts. Among the 16 leaders participating in the study, seven (44%) self-identified as female. As
aforementioned the participant pool does not represent the known gender disparity present within
the life sciences industry. However, this study sought a balanced perspective on best practices
and approaches from both men and women executive leaders across the industry.
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The study found implementation of change success remained consistent irrespective of
the gender of the leadership. Gender was indecipherable in participant responses throughout the
study regarding how each leader executed change. Stereotypical passive methods, hesitancy, and
weaker approaches compared to men were absent in the actions describe by the female
interviewees. Women leaders were unapologetically themselves and executed transformational
change apart from a label of being a female executive. Each embraced their leadership positions
and led fearlessly. Gender did not serve as a hinderance. Respondents who identified as female
exhibited greater gumption and fortitude compared to their male executive counterparts.
The impact genderless leadership substantiates the undeniable potential for current and
aspiring female leaders in organizational change. This revelation challenges conventional gender
stereotypes and underlines the transcendent power of leadership competence and determination,
irrespective of gender. These insights pave way for informed considerations and deliberate
actions aimed at fostering a more equitable and effective landscape for change leadership.
Recommendations
Four recommendations address the findings for future consideration. The
recommendations draw upon previous literature. Such recommendations of paying for
performance, executive coaching during change, implementing an organizational change
division, and tailored communication offer suggestions to increase the adoption and achievement
of significant organizational change.
Recommendation 1: Pay for Performance to Spark and Accelerate Major Change
The executive leaders in this study directed their focus on changing employee behaviors,
instilling a sense of urgency that compelled employees to take ownership and actively contribute
to driving change. The first recommendation for life sciences organizations to consider to is
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financial incentives to drive behaviors. Monetary rewards have been widely employed by
numerous organizations as an effective means to motivate employees to enhance performance or
alter behaviors (Mattson et al., 2014). Although money may not be the sole motivational factor
for all employees, it is a driving factor that satisfies needs and allows people to demonstrate their
status (Robescu & Iancu, 2016). According to the authors, monetary incentives rank as the most
important motivator for employees. They posited organization should consider that short-term
incentives are more effective than long-term incentives.
Illustrative instances of financial incentives are option shares, increased basic salary, or
cash bonuses. Elliot et al. (2018) discussed the advantages of paying for performance and how
incentive intensity can significantly generate improved performance. Increased incentive
intensity correlates with higher intensity of employee motivation. According to the authors
behavioral measures of performance should be objective rather than subjective. To accelerate the
adoption and commitment of employees, the life sciences organization would benefit from
reviewing their current bonus structures and redirect allotted funds towards specific metrics to
drive behaviors positively towards the organization's change effort. For instance, many
organizations have existing corporate bonus based on the overall organizational performance
irrespective individual contribution. Modification of the bonus parameters, even if only adjusting
a portion of the corporate bonuses to align with metrics related to change adoption, would
effectively steer behaviors in a positive direction towards the change. These considerations
should span all divisions and levels, including the executive leadership bonuses, to propel
behaviors and motivations to support for the major change initiative.
The caveat for consideration is that robust incentives are drivers of strong motivation and
behavior changes but may inadvertently lead to unintended negative consequences (Elliot et al.,
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2018). Leaders must do their due diligence to assess the potential risks of these consequences.
Elliot et al. (2018) identified consequences such as creating aggressive competition within the
organization, extreme risk-taking, causing harm or undermining intrinsic motivation, and
unintentionally diverting attention from long-term performance, customer service, and quality
towards immediate change needs.
As a key recommendation, the integration of financial incentives within the life sciences
organization hold potential to stimulate desired behaviors to amplify the change process. The
delicate equilibrium essential for effectively leveraging incentive as a motivational catalyst
demands thorough evaluation to mitigate unintended negative consequences. By harmonizing
financial rewards with judicious decision-making organizations can adeptly maneuver the
complexity of change
Recommendation 2: Executive Coaching During Organizational Change
The study's findings demonstrate executive leaders personally require support and growth
while leading during times of change. The investment in executive leadership training and
development is the second recommendation course of action. Continuous learning allows leaders
to develop the needed skills and knowledge to navigate major organizational change (Bolman &
Deal, 2017). The authors’ stated training is often an afterthought resulting in costly, inefficient
processes, lost opportunities to competition, and demoralized employees. Opportunities such as
executive coaching and change management certification sessions serve as avenues for seasoned
executives to incorporate, aiming to yield improved personal and organizational change
outcomes.
The application of executive coaching aids executives in cultivating the psychological
and behavioral proficiencies needed to simultaneously pursue professional goals while
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navigating the uncertainties arising from change (Grant, 2014). The researcher highlighted that
participation in coaching for executives during organizational change increased goal
accomplishment improved solution-focused thinking, improved adaptability to change, increased
resilience and self-efficacy in leadership, as well as decreased anxiety, stress, and depression.
These positive impacts of executive coaching influences extended into other non-work-related
aspects such as family life.
This recommendation focuses on the well-being of the leaders and provides the
executives with personal growth and appropriate support to help navigate major change. The
practice of executive coaching is frequently adopted by corporations to aid leaders in achieving
organizational or professional objectives and to enhance their capacity to navigate change
(Goldsmith & Carter, 2009). Executive coaching aims to improve leadership skills, well-being,
personal, organizational effectiveness, and individual performance. According to Grant (2014),
executive coaching increases goal attainment, cognitive flexibility, solution-focused thinking,
change readiness, the leader's self-efficacy, mental health, resilience, and workplace satisfaction.
All meaningful during times of turbulent organizational change. In addition to executive
coaching, there are many change management programs and certifications leaders can attend to
stay up to date with techniques and discoveries to manage through major change.
The findings of this study illuminate the dynamic landscape of executive leadership
during organizational change. The experience of leaders, encompassing successes and the harsh
reality of failures, necessitates personal growth and support when navigating change. The
investment in training and executive coaching empowers leaders with essential skills and
resilience required to lead successful change. Such recommendations will undoubtedly
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contribute to fostering agile and effective leadership capable of guiding organizations through
change.
Recommendation 3: Organizational Change Department Implementation
The study’s findings elucidated the diverse strategies employed by executive leaders in
managing organizational change. Each interview participant acknowledged it takes more than
one person to achieve change. However, among the 16 executives interviewed, only one had a
dedicated team to conduct change management, the other executives dealt with organizational
change without such team. Departments within organizations with a specific focus on change are
more effective with the intended transformation compared to organizations without dedicated
departments. Change departments help the organization lay the foundation for successful change
(Sirkin et al., 2005). Human resources and other learning and development departments do not
necessarily have the expertise, skill, experience, focus, or bandwidth for ongoing major
organizational change initiatives. The third recommendation calls for the establishment of a
change team or department focused and solely dedicated to drive all major change. A group of
dedicated individuals, not a singular token individual with expertise in organizational change,
pegged responsible for driving all major changes. Implementation of such a division would
provide life sciences organizations with individuals with expertise, known and established
processes, more substantial sponsorship, and a focus on change readiness and resilience.
A dedicated change department offers specialized knowledge, expertise in managing
change, and a repository of best practices and tools. These dedicated and subject matter change
experts bring guidance, support, potency, and resources to leadership and employees to increase
overall adoption and effectiveness of change initiatives (Pearce et al., 2002). This division would
oversee the coordination and consistency of the change across all cross-functional teams and
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business units. Responsibilities of the change department would include the orchestration of
communication and other imperative processes of Kotter's eight steps. The change department
prioritizes, sequences, and allocates resources, ensuring alignment with the strategic objectives
of the change and factors organizational readiness and capacity (Pearce & Sims, 2002).
According to the researchers, a devoted department allows for centralized change leadership, and
sponsorship provides consistent oversight for major change efforts to enable cohesive strategy
aligned with overarching change goals. A team with the right blend of expertise, focused on
performance specific to change goals, responds to the demands and opportunities of the
organization, has a shared commitment, and is collectively accountable for the achievement of
change (Bolman & Deal, 2017). The authors asserted that this structure of teams could
significantly improve effectiveness by paying conscious attention to relationships,
communication, responsibility, and lines of authority. A dedicated department would require a
significant investment from life sciences organizations. However, the ever-changing global
environment and the commitment to patient care begs the investment worth effective and lasting
change.
Recommendation 4: Tailored Communication
Communication exudes transparency. A primary reason for failed organizational
transformation is the under communication of the vision by a factor of 10x, 100x, even 1000x
per Kotter (2012). Of the eight stages the interview participants divulge the most information on
best practices around the concept of personalized communication. The strategies within this
recommendation outlined approaches for leaders within and outside of the life sciences industry
to emulate for effective change transformation. According to the leaders the communication must
suit the individuals of the organization but also align with the leader’s unique style and strengths.
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A combination of well-established communication methodologies were utilized by the
executives to effectively convey the change within their respective organizations. Each leader
employed a blend of communication strategies to optimally disseminate the change with their
organizations (Gilley et al., 2008). The executive leaders stressed the importance of the
frequency and the practice of detailing the communication plan as a part of the planning process
prior to implementation (Ballaro et al., 2020). Communication approaches included town halls,
one on ones, team calls, leadership retreats, watercooler conversations, drip communication, the
guide coalition initiatives, visual aids, social media channels, texts, and feedback surveys. The
cadence and frequency of methods varied.
Leadership styles and individual preferences dictated communication. The formulaic
combination of appropriate approaches to achieve effectiveness were dependent upon the
change, organization readiness, culture, and leader’s personal style. The results of an
amalgamation of winning communication approaches were increased receptiveness, perceived,
leadership authenticity, transparency, and enhanced trust. The fluid combination of approaches
and flexibility of communicative execution ensured the message reached individuals across the
organization through the most engaging channels.
Effective communication remains a cornerstone in the realm of organizational change.
Leadership’s communication strategies embody diverse approaches unique to the needs of the
change endeavor, the organization’s culture, and the distinctive style of the leader. The approach
enhances receptiveness, transparency, adoption, and trust among employees. This final
recommendation along with the previously proposed span financial incentives, executive
training, and the investment in a dedicated department collectively serves as a holistic map, in
conjunction with Kotter’s eights stages, to navigate inevitable organizational change journeys
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ahead. The study findings offer valuable considerations and guidance to ensure transformation
efforts conclude with the ultimate positive and favorable results.
Limitation and Delimitations
Limitations are aspects of the study that the researcher cannot influence and must be
transparent about to preserve the validity and credibility of the research study (Maxwell, 2013).
The following were the limitations in this study. Qualitative study limitations included a lack of
adequate sample size and challenges generalizing findings. This field study utilized qualitative
interviews, introduces the potential for indirect information through the interviewees.
Participants' biases could have influenced their responses and the variability in the participant’s
ability to articulate their perspectives could vary (Creswell & Creswell, 2018). Using qualitative
methods risks delivering inaccurate data representations (Merriam & Tisdell, 2016). Another
limitation was the small sample size comprised of the 16 executive leaders in the life sciences
industry. A larger sample could result in added insights which would diversify the findings.
Delimitations are components of the study that the researcher selects to establish
boundaries in the study, which must be disclosed to maintain the study's veracity and credibility
(Maxwell, 2013). Delimitations included the diversity of multiple organizations within the life
sciences industry. The study included leadership from multiple life science’s organizations
enhancing the generalizability to the industry of interest. Another delimitation concerned the
participants in the study, all who possessed extensive experiences of organizational
implementation, contributing to the richness of perspective drawn upon.
Future Research
This study delved into current best practices and approaches of executive leaders within
the life sciences industry to achieve major organizational change. Subsequent research could
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enhance the depth of insights by narrowing its focus to specific segments within the life sciences
sector, such as pharmaceutical or medical device companies, rather than combining multiple
sectors as done in this study. Conversely, expanding beyond the life sciences industries would
yield an even broader perspective on change related best practices and approaches.
Additionally considering the known substantial gender disparity in executive leadership
within the life sciences industry, exists rationale for conducting additional research to explore the
implications of gender on the adoption of organizational change. Shedding potential light on
gender specific strategies executive leaders employ to conduct change and areas of improvement
for more inclusive and effective change efforts. Further examination of disparities between male
and female executives in terms of role, responsibility and experience while influencing and
instilling organizational change could offer insights into gender-biased discrepancies in
leadership styles, decision-making, and outcomes of change. Investigation of the profound
impact of diversity, equity, and inclusion (DEI) initiatives on organizational change efforts would
enhance the existing body of knowledge. Investigating how DEI influences change initiative and
how they can be integrated into leadership practices specifically within the life sciences sector
would provide valuable awareness in producing more diverse and inclusive effective change
strategies.
Additionally, this study predominantly concentrated on the leadership’s perspective.
Exploring the viewpoints of followers would not only benefit the organizational leaders but also
contribute to the broader field. Also being an executive leader for any organization is inherently
challenging, solitary, and at times isolating. Further research on support systems for executives
during change would benefit leaders to achieve the support to attain more decisive decision-
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making, better mental health, and greater self-efficacy for improved execution to address
whatever change initiatives that may arise.
Conclusions
Change is inevitable, and the severity of successfully navigating the ever-changing global
environment within the life sciences industry holds an even greater magnitude of significance as
failures have implications on patient life. The aim was to explore executive leadership
perceptions within the Life Sciences sector on approaches and best practices of organizational
change through lived experiences. The study utilized Kotter’s (2012) eight-step change
framework to examine current practices of executive leadership within the industry, including
pharmaceuticals, biotechnology, medical device, and others.
Founded on an extensive literature review, interviewing 16 executives, and coding, the
data collected validated Kotter’s eight steps for change as it gathered numerous examples of
implementation for successful transformation. The leaders provide how they approached creating
a sense of urgency, building a guided coalition, creating the vision, communicating the vision,
empowering broad-based action, generating small wins, consolidating gains, and weaving the
change into the culture, solidifying the achievement of a new organization.
Additionally, this study identified two contemporary best practices gleaned from the
recommendations from the executives enhancing Kotter’s change model, the art of investigation,
and consideration of the human factor. The revelations that emerged from the narration of
successes and setbacks, inclusive of the executives’ extensive tenures with life sciences have
been generously shared for the broader benefit. Their humility, capacity to inspire trust, and drive
to do the right thing for their employees and the organization serve as an exemplar for other
leaders.
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The findings and recommendations within this study have significant value and
implications for change agents within life sciences and other industries at large. Continued
hypervigilance to achieve successful organizational change is paramount, and leadership should
continue to seek out and share best practices and approaches irrespective of years of experience
or industry.
The alarming 70% failure rate for major organizational change should light a fire under
leaders and fuel behaviors for successful change. The significance of this study is the
contribution of actions executive leaders are currently executing today to ensure organizational
change success. Successful transformations allow life sciences organizations’ viability and
sustainability to flourish in today’s competitive global market, preserving these organizations
dedicated to improving patients’ lives worldwide. As Willow stated, “the patient is waiting.
They’re waiting. They’re waiting for us. And so, we have got to deliver.” A 30% success rate is
unequivocally intolerable in matters concerning the health and well-being of humanity.
Therefore, leaders should never settle. Collectively, they should relentlessly stive to avidly
explore the most effective avenues for lasting successful change, not merely for the
organization’s continuity but even more importantly for the safeguarding and advancement of
human life.

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Appendix A: Kotter’s Sources of Complacency

111

Appendix B: Interview Protocol and Questions
Research Questions:
1. How do organizational executives approach organizational change?
2. What are best practices for ensuring success with organizational change initiatives?
Respondent Type:
The parties targeted for interviews are chief executive officers (CEOs) and other
executive leaders, ranging from C-suite executives to executive vice presidents, across the Life
sciences’ industry. The leaders are from fortune 500 companies to start up organizations to
gather their experiences and best practices on organizational change initiative successes and
failures.
Introduction to the Interview:
Good morning/afternoon/good evening and thank you your time for this interview. My
name is Sam Presley, and I am a student at the University of Southern California. I am
conducting this interview as part of my research in pursuit of a doctoral degree.
Before we begin, I want you to know I will be taking notes throughout our conversation,
and these notes will be immediately removed from my digital notepad and stored in a password
protected folder on my desktop computer. Additionally, I would appreciate your permission to
record this interview via Zoom and my smartphone to allow me to come back to your responses
and ensure I capture your answers and input thoroughly and accurately. Do I have your
permission to record our conversation? Thank you.
Now that we are recording, I briefly want to discuss informed consent. I know your
participation is voluntary, but if you are uncomfortable with a question or the subject matter you
have the right to withdraw at any time. Additionally, all individuals and organizations will be
112

assigned a pseudonym in my study, and any especially identifying information will be omitted to
protect you.
The purpose of this study is to explore the perceptions of executive leadership within the
Life sciences sector on approaches and best practices of organizational change through your
lived experiences.
Interview Protocol
The interview protocol includes 15 primary questions. All participants are executive
leaders with experience with conducting major organizational change prior to interviews.
1. I have asked you prior to this interview to think about times when you have
conducted major change. Please describe your approach when embarking on a new
major organizational change initiative?
2. Describe how you motivate and create a sense of urgency?
3. Tell me about how you create your vision or strategy for the change?
4. What are the milestones that indicate your change initiative is succeeding? Were they
recognized? If so, then how?
5. Describe your process in creating the vision and strategy for the change.
6. How do you choose the key players to support the change initiative? (Building a
guiding coalition)
7. Describe how you typically communicate the change vision/initiative?
8. How do you empower followers/the organization to adopt?
9. What indicators notify you that you have adoption?
10. Once you have sparked adoption, what methods do you think are important to keep
the momentum going?
113

11. How do you measure if the change was successful?
12. Conversely, when you think about a change initiative that you did not feel was
successful are there any learnings, or words of advice to other leaders?
13. Any other best practices you would like to the share on creating major organizational
change?
14. What are your opinions on leaderships role for successful organizational change?
15. What experiences have molded your view of how to effectively implement
organizational change?
Conclusion to the Interview
That was my final interview question, and I have stopped recording this session.
I appreciate your time and appreciate your insights. Additionally, if something comes to
light during my research, may I contact you for a follow-on interview? Would that be
acceptable? Do you have any questions for me? Is there anything I can do for you?
Again, thank you for your time and I hope you enjoy the rest of your
morning/afternoon/evening.

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Asset Metadata

Creator Presley, Samantha (author)

Core Title Life sciences executive leadership’s perspective on organizational change

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2023-12

Publication Date 09/05/2023

Defense Date 07/18/2023

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag biotechnology,leadership,Life Sciences,medical devices,OAI-PMH Harvest,organizational change,organizational culture,pharmaceuticals

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Language English

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Advisor Datta, Monique (committee chair), Ott, Maria (committee member), Pritchard, Marcus (committee member)

Creator Email samantha.presley@yahoo.com,spresley@usc.edu

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