title: The "5Rs of Reorganization": A Case Report on Service Delivery Reorganization within a Pediatric Rehabilitation Organization.
abstract: OBJECTIVE
  Pediatric rehabilitation centers constantly reorganize services to accommodate changes in funding, client needs, evidence-based practices, accountability requirements, theoretical models, and values. However, there are few service delivery models or descriptions of how organizations plan for change to guide organizations through this complex task.
  
  
  METHODS
  This case report presents the "5Rs of Reorganization," a novel process for planning service delivery reorganization projects in pediatric rehabilitation centers. The 5Rs include: 1. Recognize the need for change, 2. Reallocate resources for project management, 3. Review the reality of clients, service delivery, and the community, 4. Reconstruct reality, and 5. Report results.
  
  
  RESULTS
  The implementation and outcomes of the "5Rs of Reorganization" process are described for one pediatric rehabilitation center to illustrate how use of this process led to effective service delivery reorganization planning. The resulting multi-component customized service delivery plan reflects high levels of stakeholder involvement.
  
  
  CONCLUSIONS
  Principles of project management can be applied to support service delivery reorganization planning within pediatric rehabilitation centers using the "5Rs of Reorganization." Strong communication throughout the planning phase is key to developing and sharing a plan for service delivery reorganization. Communication can be supported through use of the 5R process.
authors.affiliation: a 1 CanChild Centre for Childhood Disability Research, McMaster University , Hamilton, Ontario, Canada.|b 2 School of Rehabilitation Science, McMaster University , Hamilton, Ontario, Canada.|c 3 KidsAbility Centre for Child Development , Waterloo, Ontario, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Phoenix
authors.affiliation: a 1 CanChild Centre for Childhood Disability Research, McMaster University , Hamilton, Ontario, Canada.|b 2 School of Rehabilitation Science, McMaster University , Hamilton, Ontario, Canada.|d 4 Department of Pediatrics, McMaster University , Hamilton, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenbaum
authors.affiliation: c 3 KidsAbility Centre for Child Development , Waterloo, Ontario, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Watson
authors.affiliation: a 1 CanChild Centre for Childhood Disability Research, McMaster University , Hamilton, Ontario, Canada.|e 5 School of Rehabilitation, Sherbrooke University , Sherbrooke, Québec, Canada.|f 6 Centre de Recherche du CHUS , Sherbrooke, Québec, Canada.
authors.forename: Chantal
authors.initials: C
authors.lastname: Camden
mesh_terms: D002648:Child; D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration; D019988:Children with Disabilities / Q000534:rehabilitation*; D006754:Hospital Restructuring / Q000379:methods*; D006801:Humans; D010372:Pediatrics / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration*
keywords: pediatric; project management; rehabilitation; service reorganization