Milestone 18 Summary

Description: Practice has developed a vision and plan for transformation that includes specific clinical outcomes and utilization aims that are aligned with national TCPI aims and that are shared broadly within the practice.

What does success look like?


1 2


Practice has not yet begun developing its transformation vision and detailed plan. . Practice is beginning to develop a vision and plan that addresses goals of transformation but aims are not yet set. Practice has developed a plan that addresses goals of transformation with specific aims but has not yet detailed how the aims will be addressed. Practice has developed and shared a vision and detailed plan that addresses goals of transformation with specific clinical outcomes and utilization aims along with the detail on how each of the aims will be addressed.

Note: numbers are PAT scores

Tools and Resources


What might this look like in practice?


Vision for Change exercise: the goal of this exercise is to help guide your practice through establishing your vision for change and writing your “change vision”. This exercise will also help identify your practice’s culture around change.

Time Needed: 45 minutes

Deliverable: Development of a “Change Vision” statement

Resources before you begin: Kotter International and Simon Sinek Ted Talk

DIRECTIONS: Answer the questions in Part 1 to help your write your ‘change vision’ in Part 2.

PART 1: With a small group of senior leaders, brainstorm answers to the following questions.

Recommended activity: Walking through each question individually, have each team member right every answer and quality that comes to mind on an individual sticky note. At the end of 2-5 minutes, designate a team leader to help group answers into “like” groups (this is called an affinity exercise). Using these team-generated categorize, finalize your answers to the questions below by writing full statements.

  1. In an ideal world, what does your practice look like 5 years from now?
  2. What is your practice ‘transforming’ towards?
  3. What do you want your practice to achieve?
  4. What kinds of processes, technologies, outcomes will you have?1

PART 2: Using the answers from your brainstorming session above, put your change vision onto paper.

Recommended activity: Have 1-2 senior leaders write the initial draft of the change vision. Disseminate the change vision both in writing and through a 5-minute ‘elevator pitch’ to receive feedback from other practice team members and staff. Revise the change document into a clear, concise description of the desired future state of your practice.

A change vision is a statement of what your practice looks like in the future. This vision tells others where you are headed and what the rewards of upcoming change look like -it needs to speak to employees in a way that encourages them to follow senior leadership down a path of change. 2 The final statement should be easy to understand, intellectually sound, and easily communicated in about 1 minute.1   Most importantly, the vision should ignite action.


  1. John Kotter. How to Create a Powerful Vision for Change. Forbes. June 7, 2011. Available at
  2. Robert Tanner. Leading Change (Step 3) — Develop a Change Vision and Strategy. Business Consulting Solutions LLC. 2016. Available at