{'fraction_non_alphanumeric': 0.02040816326530612, 'fraction_numerical': 0.0, 'mean_word_length': 4.755102040816326, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Leading change in health care: the challenge of anxiety.

PURPOSE
The purpose of this paper is to identify the centrality of anxiety in health care, especially in the context of leading change. It identifies the importance of emotional labour for clinical professionals and the resultant development of defensive routines. The idea of containment is central to addressing anxiety.


DESIGN/METHODOLOGY/APPROACH
The approach involves identification of anxiety as a key factor in leading change in health care, but one which is often ignored.


FINDINGS
Anxiety is the elephant in the room vis-a-vis leading change in health care. To address the use of defensive routines, a range of activities can act as "containers" for anxiety and help with leading change.


PRACTICAL IMPLICATIONS
To lead change in health care implies addressing the existence and importance of anxiety and the emotional labour which health-care professionals undertake.


ORIGINALITY/VALUE
The existence of anxiety and the profound impact it has on leading change in health care has typically been under-estimated or avoided. The paper aims to remedy this.