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Chapter 6 Organizational Redesign: Effect on Lnstitutiond and Consumer Outcomes CONTENTS Methods Findings Studies of First-Order Redesign Studies of Second-Order Redesign Studies of Third-Order Redesign Discussion Condusion Organizational redesign is most noticeable in hospitals, where innovative models are being developed to move the organizations from a product-focused to a market-focused orientation (Shortell, Momson, & Friedman, 1992). Hos- pitals are introducing a variety of caredelivery models, most of which wn- centrate resources around patients with similar needs. Developers of the models have reported reductions in costs of staffing (Jones & Bullaml, 1993) and in time spent in duplication of services (Cassidy, 1992). These reports are anec- dotal, however, and few studies of their long-term effects have been conducted. To determine the state of the science concerning the effect of organiza- tional redesign on institutional and consumer outcomes, a comprehensive review of published literature was conducted forthe years 1985 through 1994. Forpur- poses of the review, cmwner was defined as health care worker, patient, fam- ily, or member of the community. Health care workers are included because RESEARCH ON NURSING CARE DELIVERY they constitute internal consumers of the organization, whereas patients, families, and community members constitute external consumers of services. Studies
Annual Review of Nursing Research – Springer Publishing
Published: Jan 1, 1996
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