Anyone who chooses to be a change agent or improvement leader in healthcare doesn\u2019t choose an easy life. There are so many forces opposing the changes we want to see; a system that rewards people for \u201ckeeping the trains running\u201d rather than radical change, those with the power and\/or a vested interest in keeping the status quo, colleagues and leaders who are sceptical, apathetic or scared of change.\u00a0 Many times in my career in improvement, I have felt isolated, vulnerable and misunderstood. People have treated me like some kind of oddball when I have craved to be taken seriously and appreciated for my efforts as a leader of change. Yet big change only happens in healthcare organisations because of heretics and radicals; the courageous, passionate people who are willing to take responsibility for change, who support their organisation in its mission but also challenge the status quo.<\/p>\n As Martin Luther King described it: \u2018\u2018The saving of our world . . . will come, not through the complacent adjustment of the conforming majority, but through the creative maladjustment of a nonconforming minority\u2019\u2019. <\/i><\/p>\n The hope of healthcare rests with the non-conformists, the radicals, the heretics and mavericks in our midst.<\/span><\/p>\n So who are the radicals in healthcare organisations? Research by Debra Meyerson <\/a>\u00a0shows that the most effective radicals are those who have learnt to oppose and conform at the same time. Or, as she puts it, \u201cthey are able to rock the boat and yet stay in it\u201d. These are change leaders who stand up to challenge the status quo when they see there could be a better way. They develop the ability to walk the fine line between difference and fit, inside and outside. These leaders are driven by their own convictions and values which makes them credible and authentic to others in their organisations. Most importantly of all, they take action as individuals that ignite broader collective action that leads to big change. These leaders already exist in every healthcare organisation, in many different roles and multiple levels. They aren\u2019t typically the Chief Executives or senior clinical leaders yet the impact of their change activities are often just as significant. We saw so many examples of this on NHS Change Day 2013.<\/a> Many organisation-wide change efforts that led to tangible improvements for large numbers of patients were initiated by grass roots front line leaders.<\/p>\n Rebel<\/b><\/p>\n<\/td>\n Troublemaker<\/b><\/b><\/p>\n<\/td>\n<\/tr>\n create<\/p>\n<\/td>\n complain<\/p>\n<\/td>\n<\/tr>\n mission-focused<\/p>\n<\/td>\n me-focused<\/p>\n<\/td>\n<\/tr>\n passion<\/p>\n<\/td>\n anger<\/p>\n<\/td>\n<\/tr>\n optimist<\/p>\n<\/td>\n pessimist<\/p>\n<\/td>\n<\/tr>\n energy-generating<\/p>\n<\/td>\n energy-sapping<\/p>\n<\/td>\n<\/tr>\n attract<\/p>\n<\/td>\n alienate<\/p>\n<\/td>\n<\/tr>\n possibilities<\/p>\n<\/td>\n problems<\/p>\n<\/td>\n<\/tr>\n together<\/p>\n<\/td>\n alone<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n![\"OLYMPUS](\"https:\/\/blogs.bmj.com\/quality\/files\/2013\/07\/100400_H-Bevan-Small.jpg\")
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