Growing organizational capacity through a systems approach: one health network's experience.
BACKGROUND
Hospitals are reporting unexpected surges in demand for services. Lehigh Valley Hospital challenged its clinical and administrative staff to increase capacity by at least 4% per year using an interdepartmental, systemwide initiative, Growing Organizational Capacity (GOC).


METHODS
Following a systemwide leadership retreat that yielded more than 1,000 ideas, the initiative's principal sponsor convened a cross-functional improvement team. During a two-year period, 17 projects were implemented. Using a complex systems approach, improvement ideas "emerged" from microsystems at the points of care. Through rigorous reporting and testing of process adaptations, need, data, and people drove innovation.


RESULTS
Hundreds of multilevel clinical and administrative staff redesigned processes and roles to increase organizational capacity. Admissions rose by 6.1%, 5.5 %, 8.7%, 5.0%, and 3.8% in fiscal years 2003 through 2007, respectively. Process enhancements cost approximately $1 million, while increased revenues attributable to increased capacity totaled $2.5 million.


CONCLUSIONS
Multiple, coordinated, and concurrent projects created a greater impact than that possible with a single project. GOC and its success, best explained in the context of complex adaptive systems and microsystem theories, are transferrable to throughput issues that challenge efficiency and effectiveness in other health care systems.
MacKenzie
Richard
R
Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania, USA. Richard.Mackenzie@lvh.com
Capuano
Terry
T
Durishin
Linda Drexinger
LD
Stern
Glen
G
Burke
James B
JB
D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D017598:Efficiency, Organizational; D008332:Management Quality Circles / Q000458:organization & administration; D019982:Organizational Case Studies; D010414:Pennsylvania; D013597:Systems Analysis