All together now: The circular organization in a University Hospital. Part I. Planning and design

Abstract

During a period of significant change in health care, hospitals are being transformed. This article—part I—reports on one university hospital's experience with a project funded by a Robert Wood Johnson Foundation and Pew Charitable Trusts initiative. The article presents the history and conditions that led to a planning year during which participants defined external and internal conditions contributing to the needs for change. Along with the driving pressures, the article addresses the planning process and the basic design for organization change, Ackoff's idealized design and circular organization. This model had been used in industry, but not in a hospital. Key themes related to the design and start-up are offered. Part II addresses the implementation of the model, the process of change, supports and barriers, and progress to date.