title: Improving the quality of health services organization structure by reengineering: circular design and clinical case impact in an academic medical center.
abstract: Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.
authors.affiliation: Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Lartin-Drake
authors.forename: C
authors.initials: C
authors.lastname: Curran
authors.forename: J
authors.initials: J
authors.lastname: Gillis-Donovan
authors.forename: N R
authors.initials: NR
authors.lastname: Kruger
authors.forename: J T
authors.initials: JT
authors.lastname: Ziegenfuss
authors.forename: J
authors.initials: J
authors.lastname: Ostrem
authors.forename: M
authors.initials: M
authors.lastname: Zanotti
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D017598:Efficiency, Organizational; D006754:Hospital Restructuring / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010414:Pennsylvania; D010564:Personnel, Hospital; D011367:Professional Staff Committees / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*