After Restructuring

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.