Transforming Healthcare Organizations I（改变医疗组织我）.pdfVIP

Transforming Healthcare Organizations Brian Golden magine you are a member of a hospital’s execu- on the surface – other large, complex organizations, thoughtful tive team, having just left a meeting in which you analysis reveals that healthcare organizations are considerably I and other members discussed the possible intro- more than mere businesses. Peter Drucker (1993) tells us that duction of an ambitious Computerized Physician healthcare organizations are the most complex form of human Order Entry (CPOE) system. Around the conference table organization we have ever attempted to manage. This complexity you and others questioned whether CPOE would be the most derives from, among other things, the confluence of profes- effective way to realize your hospital’s commitment to patient sions (e.g., physicians, nurses, pharmacists and administrators) safety. Other issues that were raised included whether clinicians and other stakeholders (e.g., patients and government) often would support or resist the change, whether staff would have with seemingly incompatible interests, perspectives and time sufficient skills, where to begin, affordability and whether to horizons. Exacerbating the challenges for healthcare leaders is proceed incrementally or with a “big bang.” While there was the well-known need to satisfy what appears to be the insatiable much disagreement with respect to each of the issues, there was demand for healthcare – without unlimited financial support. near unanimity around two important decisions – CPOE would With these challenges in mind, this article attempts to lay be implemented and you would be the executive respons