The Hidden Cost of Being a Champion of Change

The more a champion holds things together, the less visible the case for investing in change becomes, until the champion can no longer hold it together.  

A change champion in healthcare quality improvement is an influential clinician or staff member who promotes and supports new initiatives, often acting as an informal leader among peers (Punia et al, 2026). They help drive change by engaging colleagues, offering mentorship, overcoming resistance and ensuring new practices fit into everyday clinical work. By connecting teams and securing necessary resources, they play a key role in turning improvement ideas into practical, sustainable outcomes. 

Being designated a champion is rightly seen as an achievement and an honour that’s deserved. Champions tend to be among the most committed, experienced and values-driven people in the organisation. This is exactly what makes them good at turning policy into everyday practice (Miech et al, 2018) but carrying the champion role often comes at a cost.

What makes you effective also makes you vulnerable

A recent paper in Implementation Science Communications examined how organisations sustain change over the long term, and described what its authors call a "champion paradox" (Stark and Page, 2026). The study itself looked at education programmes rather than healthcare, but the mechanism it describes will feel familiar to many clinical leaders.

A service that only works because people are overextending themselves isn't a success story.

The qualities that drive champions to make things better can result in a vicious cycle: the more a champion holds things together, the less visible the case for investing in systems becomes, until the champion can no longer hold it together.  

Three patterns tend to emerge:

• The champion becomes the informal safety net for gaps in the system, not only striving for change but becoming the temporary “sticking plaster”.

• Without the authority, staffing or resources that are needed to bridge these systemic gaps, the pressure builds on the champion.  That means extra hours, extra vigilance and extra emotional labour, often invisible and becoming normalised.

• The gap between what good looks like and what can actually be delivered creates moral distress (Maunder et al, 2023).

  
  

A familiar story

Factors that make champions effective, such as credibility, clinical expertise, strong relationships and personal investment, are the very ones that put them at risk of burnout (Bonawitz et al, 2020).  This isn't about one person's resilience running out. It's a familiar story. You know, the one about a programme that was never given the infrastructure to run without its champions. It's a story that demands a different ending.

The qualities that make you a champion are exactly the qualities your organisation should be protecting

Consider a scenario many senior clinicians will recognise. A palliative care consultant champions the rollout of a new advance care planning process across their trust. It's a genuine success:  earlier conversations, better-documented preferences, families reporting they feel more supported. Two years on, the consultant is still the only person training new staff on the process, still the person colleagues call when a conversation goes badly, still quietly checking documentation has happened because the system doesn't prompt for it. All of this has been absorbed into an already full clinical workload, because the alternative is watching standards slip. They're exhausted, disillusioned and unable to sustain the positive impact, not because it doesn't matter to them, but because they are the infrastructure that makes it work.

Reframing the champion

None of this means champions should be removed, or that the people doing this work aren't valued. It means the role needs to be redefined from a long-term carrier of the work to a transition lead, focused on distributing knowledge, training others, and embedding processes so quality doesn't depend on any one person's presence (Miech et al., 2018).

The story about individual resilience running out demands a different ending

If you recognise this situation, in yourself or others, the answer isn't more resilience training (even though this is usually the first thing to be offered). It does not mean having to grit your teeth or power through another change initiative, innovation call or service redesign. It means not only calling attention to the existence of “the bridge” (that means you, Dr Champion, or Nurse Champion, Pharmacist Champion…) but screaming out loud that it is about to collapse under the weight of a load it was never meant to carry permanently.  

If this is you

Here are some ways you can harness your powers as a champion for yourself and your fellow champions.

1. Deliberately and intentionally implement a succession plan from the beginning. State clearly when your tenure will end and start thinking about what your legacy will be for the person who will follow you.

2. Explicitly document the expertise that is accrued over the life course of the project and pass it on, rather than it being implicitly held by one person.  

3. Document unambiguously that your role is to work with others to distribute knowledge, build capability and embed processes that reduce reliance on any one person. Make these areas the framework for meetings and reports and regularly check your team’s performance against these areas. If need be, remind everyone when your tenure will end (circle back to point 1 if necessary)

4. Remind yourself that you are enough. I’m afraid to tell you that champions do not have super powers. Do not be beguiled by silver-tongued managers suggesting otherwise.

5. Be clear to yourself and anyone else who needs to hear it, that the goal was never to build a system that depends on champions. It's too risky. The goal is to build systems that don’t need champions at all. 

6. Finally, find structured spaces for connection and reflection with others.  At times, being a champion can be a lonely place. Nothing is better at reminding you why you answered the call to improve than being with other people. Listen to each other with an open heart and an open mind. This is where you’ll find your why.

   
   

Need more support?

You may have read this and recognised that you’re the bridge that’s about to collapse and fear what could happen if it does. Perhaps you’ve already approached your organisation’s support services or maybe you can’t drop the champion persona when it’s in-house? 

I’ve been that champion. I know how it feels. I found a path through it that kept me true to my purpose and helped me regain my health and happiness. Book a free, completely confidential call with me to start you on your own path to more balance and fulfilment in doing what you do best.