Change initiatives such as that taking place at Victoria Hospital are often met with enormous resistance from staff in many different specialties and at many different levels of the organization. The case in point - that of Victoria Hospital - reflects a real-world example of how a change initiative based on an assessment of needs and a decision to restructure the strategic focus of the organization can be managed. The initiative involved restructuring the case management process and team initiatives of the institution as well as improving the communication channels (flattening the hierarchy and establishing meaningful linkages between internal actors). Many care providers are establishing interdisciplinary teams that bring together the varied expertise of different actors in the care delivery system.
A five step process for the diffusion of this innovative strategy can be identified. The first step is acquiring knowledge regarding the needed change, followed
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