title: Transformation of the cardiovascular program. Leadership and organization.
abstract: The development of this organizational innovation continues to provide many challenges and opportunities for all involved. The authors emphasize that although cost containment is perhaps the most noticeable effect thus far, it is not the central goal of this endeavor. Obviously, it is important to be conscious of reducing costs in this very competitive health-care environment where quality of care is in danger of being substituted for lower-priced care. The challenge before all of us is to maintain excellence and efficiency less expensively within a collegial and risk-willing environment, as external forces seem to be countercurrent to these efforts. We hope that this new model for providing cardiovascular services within the institution will allow us to continue to improve our tradition of excellence in clinical care and will help us in retaining an environment and spirit conducive to the generation of new knowledge. The more long-lasting result achieved to date is the level of creativity and commitment demonstrated by all staff toward our common vision. The other articles in this issue of Nursing Clinics exemplify the collaborative spirit of our CVP and offer some initial evidence about the early effects of these changes.
authors.affiliation: Department of Cardiovascular Nursing/Patient Services, Children's Hospital, Boston, Massachusetts, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Hickey
authors.forename: A R
authors.initials: AR
authors.lastname: Castaneda
mesh_terms: D006348:Cardiac Surgical Procedures / Q000191:economics / Q000458:organization & administration*; D003659:Decision Making, Organizational; D006776:Hospitals, Pediatric; D006801:Humans; D007857:Leadership; D016294:Models, Nursing; D009936:Organizational Innovation; D010348:Patient Care Team / Q000191:economics / Q000458:organization & administration*; D010372:Pediatrics / Q000191:economics / Q000458:organization & administration*; D016730:Program Development