The TRUST Leadership Framework for clinical innovation and effective change

As health care systems pursue effective change and implement innovation, leaders are increasingly responsible for leading implementation efforts while preserving trust, safety, and outcomes. Despite significant investment in advanced technologies and data tools, change initiatives and technology implementations often fail due to inadequate attention to organizational readiness, relational dynamics, and ethical stewardship. The authors examine best practices and frameworks that ground clinical innovation in professional practice and operational workflows. Building on established ethical principles and leadership theory, the authors introduce the TRUST Leadership Framework, a model designed to support effective and sustainable change. Grounded in 5 pillars, the framework positions trust as both a prerequisite for and an outcome of successful change.