sp; I've learned over and over again that the people with the decision-making authority over resources need to be behind a change effort to ensure its success.  In my opinion, time spent early on bringing to light and addressing sponsors'  predictable and understandable questions and anxieties, saves anguish and frustration later.  In this case, the physic' concerns included:

• what kind of resources will be needed to carry on this project?  Specifically, staff time.
• how can we fit this in to already over-flowing schedules
• what influence do I as a physician have over decisions made by the teams that impact me?

Wise and experienced practitioners that they are, their is no question in their mind of the need for transforming the health care system.  They see evidence of this need every day.

Staff also have their set of anxieties:

• why are we doing this? 
• how do I add work to my already full plate?
• how is this different from changes in the past when I got my hopes up only to be disappointed?
• will I have the resources to be successful?
• will I have the new skills I need?
• will this mean I'll loose my job?
• how will I continue to meet the demands of my job while making changes (I'm reminded of Dr. Berdi Safford's analogy of changing clothes while jogging)

Of course, everyone wants to know what the new world will look like.  Hopefully as we clarify roles, goals, decision-making processes and authority, agreements and communication processes, we'll ensure that the journey is a constructive, creative and positive adventure for everyone.