To pilot or not to pilot, that is the question. Choosing your first step in restructuring? Look before you leap!

To pilot, or not to pilot, that is the question! Don't allow yourself in your eagerness to restructure to fall victim to taking this decision too lightly. Sometimes establishing a pilot of a restructured environment is indeed the best way to go--particularly when the advantages of a pilot are the key hurdles to overcome toward broad acceptance and support for hospital-wide restructuring at your institution. However, implementing a pilot can also be a big step off of a short pier if the value of these advantages pale in comparison to the disadvantages. Sure, you may need to restructure one unit/area at a time for strategic or other reasons. And you always have the prerogative to pull the plug if things go south. But be aware of the important difference between the "first unit" of many and a "pilot" approach to restructuring. Like everything else associated with successful restructuring, understanding the crucial trade-offs behind the "to pilot, or not to pilot" decision can determine whether your restructuring initiative is off to a flying start, or a long way from starting to fly.