Reengineering a health care facility. Turning an organization on its head

How can you foster change in your organization? Accomplishing major organizational change is difficult and extremely risky. However, change is necessary if health facilities are to survive in a competitive managed care world. Thrust into this environment, military health facilities are finding they must improve access and quality, while reducing costs. Keller Army Community Hospital at West Point was reengineered to meet this challenge. The results? A nontraditional hospital structure and management philosophy. Pipeline hierarchical chains of command and traditional professional boundaries have been modified. The strategy and transition process, as well as the obstacles to change, are explored in this article. Three years into a multi-year process, expected obstacles to change have been experienced, and success is predicted.