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After Restructuring examines nine hospital systems as they go through the process of restructuring and reports on the most effective strategies and practices for making organizational change within hospitals and other health care organizations.

The practical strategies presented in this much-needed book are based on solid qualitative research, case study methodology, and organizational theory. After Restructuring shows what actually happens in health care institutions that have restructured their clinical operations and offers valuable information on how to strategically plan and manage the effects of change on patient care, nursing, and the culture of the organization.

In clear and accessible terms, the book introduces a framework for understanding organizational transformation and defines the principles that guide health care change agents through the five stages of changereadiness to change, awareness of the need to change, identification and selection of changes, implementation, and institutionalization of changes. To aid organizations currently undertakingor considering this challenging process, the book is filled with specific, illustrative examples from the real life case studies.

The book is based on an extensive study conducted by a team of health services researchers led by Thomas Rundall, director of the Center for Health Management Studies at the University of California, Berkeley. The study surveyed nine hospital systems in urban, rural, and suburban regions that received Robert Wood Johnson Foundation grants and Pew Charitable Trust funding to restructure their patient processes. The standardsderived from the experiences of these hospitals lay the foundation for important best practices guidelines.
At the very heart of the authors transformational process is the introduction of the innovative concept bounding of empowerment--the strategy of focusing the work of empowered employees on activities that improve organizational performance. The authors explain how implementing this successful strategy can raise a hospitals overall level of effectiveness. The book also identifies specific strategies used by staff members to transform a hospitals hierarchical culture to become a cohesive and effective group culture. In addition, the book reveals how to implement the appropriate organizational changes that will address the unique needs of an individual hospital or health care institution.

Improving Patient Care Through Effective Managed Change

Is your health care organization undertakingor consideringrestructuring?
This book puts you on the front lines as it examines nine hospital systems as they attempt to redesign operations, reduce costs, and enhance patient care. Step by step, After Restructuring maps the best strategies used by these health care executives as they successfully restructured their institutions. After Restructuring shows how you can apply these same winning principles to successfully transform your institution.

"An in-depth treatment of organizational change in hospitals. After Restructuring provides a mother lode of insights and lessons that will be mined for years. A must read for all those committed to improving hospital performance in a radically changing health care system."--Stephen M. Shortell, Blue Cross of California DistinguishedProfessor of Health Policy and Management, professor of Organization Behavior, School of Public Health, University of California, Berkeley

"Unusual in its sensitivity to clinical and managerial agendas, this book demonstrates how hospital re-engineering principles can empower caregivers to improve hospital performance. Anyone hoping to change hospitals, or expecting to be affected by hospital changes, should read this book."Linda H. Aiken, director, Center for Health Services and Policy Research, University of Pennsylvania

"I would recommend this pathbreaking book to any health care executive, manager, physician, nurse, and anyone who is working to improve the performance of health care organizations."Mary A. Pittman, president, Health Research and Educational Trust