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American Journal of Medical Quality
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Improving the Quality of Health Services Organization Structure by Reengineering: Circular Design and Clinical Case Impact in an Academic Medical Center

Joan M. Lartin-Drake

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Christine Curran

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Joanne Gillis-Donovan

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Nancy R. Kruger

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

James T. Ziegenfuss, Jr

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Jill Ostrem

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Marie Zanotti

Pennsylvania State University's Milton S. Hershey Medical Center, Harrisburg, Pennsylvania

Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization de sign concept were the driving principles and methods. This report presents the needs for and initial obstruc tions to change, planning and project design work, a description of the change process, and illustrative ac complishments to date— two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.

American Journal of Medical Quality, Vol. 11, No. 3, 151-158 (1996)
DOI: 10.1177/0885713X9601100307
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