The role of the organizational champion in achieving health system change

▸ We use ethnographic longitudinal case studies to study the role of the champion in implementing organizational change. ▸ We show that champions are highly effective in the first phase of adoption but less effective in later stages. ▸ Champions highly identified with their work and were threatened when asked to share their work with other stakeholders. ▸ Our findings caution against allowing change to become positioned within the remit of a few individuals. ▸ Whilst champions may initially be beneficial they can be detrimental to progress, in the later stages of implementation.