If we don't change direction soon, we'll end up where we're going.

Change management initiatives are a key focus of healthcare systems across the country. This commentary, written by a former health minister, looks at change from the perspective of senior decision-makers. The need to directly link change management activities to broader transformation necessary to improve outcomes and ensure sustainability of healthcare in Canada is discussed. Suggestions for elements of a national transformation agenda, key enablers required to ensure the best change initiatives are leveraged across healthcare systems, and questions that should be asked by leaders in the evaluation of change initiatives are proposed.