The change process and a clinical evaluation unit at University of Massachusetts Medical Center

In the late 1980s, the University of Massachusetts (UMass) began its evolution toward the creation of a clinical evaluation unit (CEU). This article presents an overview of the history leading up to the formation of our clinical evaluation program and some of the projects developed to measure and improve clinical outcomes and reduce costs. Our experience in establishing the UMass CEU reflects an attempt to change clinical practice through effecting organizational change.