title: Strategic positioning: a case study in governance and management.
abstract: This case describes the experience of the Detroit Medical Center (DMC) in restructuring its governance and management. It provides a background on the DMC, examines the driving forces that led to modification of its structure, identifies key principles in guiding the change, and describes the strategies and specific steps taken in managing structural change. Finally, the critical lessons learned about leadership style, communication, agenda development, and relations with the board, medical staff, and management are discussed. This case study will help reduce the learning curve for any large, complex organization undertaking board and management restructuring to better meet its mission. At the time of DMC's restructuring there were no models to guide the effort. This case study attempts to reduce the gap in research on the management of structural change.
authors.affiliation: George Washington University, Washington, DC, USA. bhorak@gwu.edu
authors.forename: B J
authors.initials: BJ
authors.lastname: Horak
authors.forename: D J
authors.initials: DJ
authors.lastname: Campbell
authors.forename: J A
authors.initials: JA
authors.lastname: Flaks
mesh_terms: D003258:Consumer Behavior; D017046:Cost Savings; D004465:Economic Competition; D017598:Efficiency, Organizational; D006075:Governing Board / Q000458:organization & administration*; D006297:Health Services Accessibility; D006754:Hospital Restructuring / Q000458:organization & administration*; D006786:Hospitals, Urban / Q000191:economics / Q000458:organization & administration*; D008329:Managed Care Programs / Q000458:organization & administration; D008824:Michigan; D019982:Organizational Case Studies; D015279:Organizational Culture; D009936:Organizational Innovation; D009937:Organizational Objectives; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning; D010563:Personnel Turnover