After Restructuring: Empowerment Strategies at Work in America's Hospitals

Managing Change An in depth treatment of organizational change in hospitals. AfterRestructuring provides a mother-lode of insights and lessons thatwill be mined for years. A must read for all those committed toimproving hospital performance in a radically changing health caresystem. --Stephen M. Shortell, Blue Cross distinguished professor of healthpolicy and management professor of organization behavior, School ofPublic Health, University of California, Berkeley After Restructuring debunks the myths surrounding hospital changeand offers insightful and practical recommAndations for successfulrestructuring. This valuable book is based on the work of a team ofhealth services researchers headed up by Thomas Rundall, directorof the Center for Health Management Studies at the University ofCalifornia, Berkeley. The book reports the results of a three yearstudy of nine hospitals, an unaffiliated group of facilities inurban, rural, and suburban regions that received funding from TheRobert Wood Johnson Foundation and the Pew Charitable Trust torestructure patient care processes. The authors present a framework for understanding organizationalchange and define the principles that guide change facilitatorsthrough the five stages of change--readiness to change, awarenessof the need to change, identification and selection of changes,implementation, and institutionalization of changes. The standardsderived from the change experiences of these hospitals provideimportant best practice guidelines.

Table of Contents:
Part 1: Restructuring Hospitals to Improve Patient Care 1. The Changing American Hospital: New Approaches to PatientCare 2. Strengthening Hospital Nursing: A Program to Improve PatientCare 3. The Bounding of Empowerment: Managing Change with EmpoweredPersons Part 2: Strategies for Successful Restructuring 4. Studying for Successful Restructuring 5. Changes Implemented by SHN Hospitals 6. Principles of Successful Change Part 3: After Restructuring: Empowerment Strategies at Work 7. The Impact of Restructuring on Nursing and Patient Care 8. The Impact of Restructuring on Hospital Culture Part 4: The Cases 9. The Strategic Imperative: Abbott Northwestern Hospital 10. If It Ain't Broke, Fix It! Beth Israel Hospital 11. All Politics is Local: District of Columbia GeneralHospital 12. "You Can't Do Anything Unless You Change the Culture": HealthBond Consortium 13. Maintaining Mission Through Organizational Change: ProvidencePortland Medical Center 14. Building Networks to Improve Patient Care: The RuralConnection 15. Collaborating to Compete on Quality: University Hospitals ofCleveland 16. The Hospital As Academic Laboratory: University of UtahHospitals and Clinics 17. From a Knowing Organization to a Learning Organization:Vanderbilt University Hospital

About the Author :
THOMAS G. RUNDALL is the founding director of the Center for Health Management Studies at the University of California at Berkeley and professor and director of the Graduate Program in Health Services Management at the University of California at Berkeley. DAVID B. STARKWEATHER is professor emeritus of Health Services Management at the School of Public Health at the University of California at Berkeley. BARBARA R. NORRISH is a graduate of the doctoral program in Health Services and Policy Analysis at the University of California at Berkeley.

Review :
"An in-depth treatment of organizational change in hospitals. AfterRestructuring provides a mother lode of insights and lessons thatwill be mined for years. A must-read for all those committed toimproving hospital performance in a radically changing health caresystem." --Stephen M. Shortell, Blue Cross of CaliforniaDistinguished Professor of Health Policy and Management; professorof Organization Behavior, School of Public Health, University ofCalifornia, Berkeley "Unusual in its sensitivity to clinical and managerial agAndas,this book demonstrates how hospital re-engineering principles canempower caregivers to improve hospital performance. Anyone hopingto change hospitals, or expecting to be affected by hospitalchanges, should read this book." --Linda H. Aiken, director, Centerfor Health Services and Policy Research, University ofPennsylvania "I would recommAnd this pathbreaking book to any health careexecutive, manager, physician, nurse, and anyone who is working toimprove the performance of health care organizations." --Mary A.Pittman, president, Health Research and Educational Trust