Abstract
A survey of hospital chief executive officers found financial challenges to be the most important issue facing their organizations (American College of Healthcare Executives 2007). However, researchers (Griffith et al. 2006; Langabeer 2008) have found that hospitals have been unsuccessful in significantly improving or changing their financial performance. In the present case study, the author reports how hospital leaders achieved cost reductions while maintaining quality patient care in the complex and messy reality of their organization. The author (serving as a consultant to leadership and using an action research methodology) examined the process of leading change in a hospital organization and the associated reactions of individual organizational members to change interventions. The author tried to link current theory and practice while identifying those factors most crucial to leading this financial change initiative, the major challenges faced, and what seemed most effective in addressing those challenges. The author also examined 4 phases of the change process: realizing the need to change, planning the change, implementing the change, and sustaining the change.