Implementation science includes the study and use of methods to promote the systematic uptake of and effective use of evidence-based interventions and other innovations to improve population health and well-being. In response, a variety of theories, models, and frameworks have been developed to describe the factors that influence implementation, guide implementation, and define and measure relevant outcomes. This chapter begins with a definition of implementation science and examination of its relevance to systems change. It explores the importance of operationalizing systems change “interventions” and continually assessing the context to inform decision-making. The chapter addresses the importance of fostering an enabling context, including the need for leadership from and continuous learning among diverse stakeholders. It ends with a reflection on the road ahead, including recommendations to expand the scope and pace of public health improvement.

Interpersonal leadership for systems change is an ability to create, foster, and sustain meaningful, authentic relationships whereby diverse perspectives can be shared, appreciated, and applied to generate new visions of the future. Engaging in a Creative Interchange process gives leaders both a philosophy and guide to facilitate relationships that influence systems change in four important ways. First, Authentic Interacting seeks to create environments and connections in ways that build trust. Second, Appreciative Understanding fosters an environment of listening and self-reflection. Third, Creative Integrating means finding connections and synergies between ideas in different ways. Finally, Expanding Capacity encourages leaders to embrace their bold, new thinking and take the first steps to implement while committing to continually revising and improving the change. This chapter provides an overview of Creative Interchange, a behavioral science process that leaders can use to effect systems change at the interpersonal level.

Public health change leadership is both challenging and crucial. Leaders in the field shoulder high levels of societal responsibility and often feel a moral imperative to protect the health of entire populations although leaders commonly work in the contexts of narrow decision-making authority, limited community understanding of public health, and constrained resources. Their leadership must balance this context with the constant need to be ready for change. This chapter explores change readiness concepts and several tools to consider for this purpose, many of which may already be in use in daily work. It can help to consider the organization’s readiness to undertake and implement change at the individual, organizational, and systems levels. The chapter describes the advantage of learning organizations in being ready for change, readiness tools such as change conversations and more formal readiness assessments, and finally offers some thoughts on leadership for readiness and resistance to change.

This chapter describes how systems change leaders can place the values of racial justice and power-sharing at the heart of practice, thereby shifting our own system in the process and supporting social movements to achieve systems change. It describes the following core principles and capabilities to implement this kind of approach: (1) How to develop a shared analysis and expand our mental models about how power imbalances, racism, and other forms of oppression define and structure the systems that drive health. (2) Attend to the work of ‘being’ together, and not just “doing” together, as a way of deepening the relationships necessary to disrupt these patterns at the interpersonal, team, organizational, and community levels. (3) Establish change processes that embody a model of sharing power and shifting who is represented in and leading transformation.

This chapter explores leadership at the systems level and public health’s role as Health Strategist for guiding community change to improve health. Community-level change results when those most impacted by social challenges have a say in designing and implementing solutions. The participation of intended beneficiaries and their families, neighbors, and trusted leaders can be an integral part of community health strategies to achieve better results. The chapter touches on the importance of building relationships and working within and across sectors on an ongoing basis and not just when a problem arises. It assists the reader to learn about community change frameworks and practices, and fundamental skills of successful systems change efforts at the community level. The chapter increases awareness of community change efforts that are achieving results in one state, and discusses systems change tools to apply in public health practice that address the root causes of inequitable health outcomes.

Organizational leadership, loosely defined as a management approach to encourage staff to follow a clear, compelling, and strategic vision, is one capacity that must be achieved if there is to be any success in systems change in building equitable organizations, and ultimately the work practitioners do in our organizations and communities to improve community health. Leading with a commitment to consistent communication and respectful dialogue when differences occur while working toward collaboration is fundamental to lasting systems change. This chapter describes a process to foster organizational change with a racial equity, access, diversity, and inclusion lens. It discusses the importance of a simultaneous power shift and dismantling of longstanding organizational practices and policies to elevate the voices of those who are most often ignored, undervalued, or silenced. The chapter applies leadership strategies to address systems change aligning with a public health perspective grounded in community building and collaboration.

Although certain individual personalities may be conducive to leading organizations and teams to accomplish their goals, there is evidence that leadership skills can be acquired through training and practice. Studying and analyzing the questions in this chapter will enrich competencies in the following topic areas: utilize critical analysis to prioritize and justify actions and allocation of resources; apply team-building skills, conflict management skills, negotiation skills, and organizational change management concepts and skills; and guide organizational decision-making and planning based on internal and external assessments. It also enrichs competencies to develop a mission, goals, values, and shared vision for an organization or the community in conjunction with key stakeholders; develop capacity-building strategies at the individual, organizational, or community level; and align organizational policies and procedures with regulatory and statutory requirements.

This chapter describes the fundamental steps of a good strategic planning process. The strategic planning process portrays six activities that happen in a specific order. They are mission, situational analysis, objectives, strategies, operating plans, and evaluation and control. The chapter discusses the importance of good leadership. Good leadership is a foundational requirement for an organization in any industry to be efficient and effective. Leadership is so important to the strategic planning process that a brief discussion is warranted. The chapter helps the reader to identify the sources of power. It discusses the five bases of power: legitimate power, expert power, referent power, coercive power, and reward power. The chapter then differentiates between leadership styles. The way in which a manager interacts with employees is often referred to as leadership style. Finally the chapter discusses the impact of quality improvement processes in strategic planning.