TAKING A STEP-BY-STEP approach toward your goals gives you the focus to stay on track and helps build credibility. In his book, The Heart of Change, Harvard business professor John Kotter observes that short-term wins accomplish four important purposes: 1) They enable leaders to test the validity of their visions and strategies; 2) they can be good for staff morale; 3) they prove that something tangible is being accomplished — when people see ideas go from paper to reality, it builds their faith in the process; 4) there is no better way to disarm critics than with a successful pilot effort.

Even if a visioning process allows you to see that your functions will be transformed in the future, you can't just stop doing what people expect of you. We've described this change process through this series, but nothing happens overnight. If you push too hard for your new initiative too quickly, your change will not last.

If you have a vision to improve the provision of CME using evidence-based methods, for example, it may be best to study the opportunities at hand and choose a willing and credible partner to pilot a planning process that examines other CME delivery methods. You can always scale up the effort following that, having learned from building the scale model.

So, what are the characteristics of a “short-term win”? Visibility is a key element. While the project may be small in size, it should be something that will be seen as tangible evidence of movement toward the goals you've defined. This win must also be related directly to your vision and strategy, and there should be no doubt that there was a win.

These short-term wins are like setting stones to cross a creek. Careful advance planning is required to know the territory. Each one needs to be set individually, but you need all of them to get across. You may have to reset one or another of them as you move forward since the topography of your situation may be different than you first thought, once you get a closer look at it. If the rewards on the other side are worth pursuing, you can tolerate setbacks and build momentum with each successive step.

Keeping leadership apprised of your progress and celebrating the setting of each milestone allows others — even your detractors — to see that there is a way across, and that careful effort is going to result in positive benefits over time.

We are now at the core of the process model being outlined in this column. We have set a stage, engaged key partners, mapped out a vision, and planned for progress. This is a key place for the leader to appreciate that a promise is only good on delivery. The leader needs to empower everyone involved in the process to carefully manage projects to a successful end while creating a pattern of win after win. That will lead to real transformation.

Robert E. Kristofco, MSW, is associate professor and director, Division of CME, University of Alabama School of Medicine, Birmingham, Ala.; Joseph S. Green, PhD, is associate clinical professor, Department of Community and Family Medicine and associate dean of CME, Duke Office of CME, Duke University Medical School, Durham, N.C.; James C. Leist, EdD, is interim director, Alliance Center for Learning and Change; and associate consulting professor, Department of Community and Family Medicine, Duke University Medical School.

Short-term Wins…

1. Test the validity of the change.

2. Boost morale.

3. Provide tangible accomplishments.

4. Disarm critics of change.