Real reform begins within: An organizational approach to health care reform

Jean Louis Denis, Pierre Gerlier Forest

Research output: Contribution to journalArticle

Abstract

Health care systems are under pressure to control their increasing costs, to better adapt to evolving demands, to improve the quality and safety of care, and ultimately to ameliorate the health of their populations. This article looks at a battery of organizational options aimed at transforming health care systems and argues that more attention must be paid to reforming the delivery mechanisms that are so crucial for health care systems' overall performance. To support improvement, policies can rely on organizational assets in two ways. First, reforms can promote the creation of new organizational forms; second, they can employ organizational levers (e.g., capacity development, team- based organizations, evidence- informed practices) to achieve specific policy goals. In both cases organizational assets are mobilized with a view to creating complete health care organizations - that is to say, organizations that have the capacity to function as high- performing systems. The challenges confronting the development of more complete health care organizations are significant. Real health care system reforms may likewise require implementing ecologies of complex innovation at the clinical, organizational, and policy levels. Policies play a determining role in shaping these new spaces for action so that day- to- day practices may change.

Original languageEnglish (US)
Pages (from-to)633-646
Number of pages14
JournalJournal of Health Politics, Policy and Law
Volume37
Issue number4
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Health Care Reform
Delivery of Health Care
Organizations
Organizational Policy
Quality of Health Care
Ecology
Safety
Pressure
Costs and Cost Analysis
Health
Population

ASJC Scopus subject areas

  • Health Policy

Cite this

Real reform begins within : An organizational approach to health care reform. / Denis, Jean Louis; Forest, Pierre Gerlier.

In: Journal of Health Politics, Policy and Law, Vol. 37, No. 4, 08.2012, p. 633-646.

Research output: Contribution to journalArticle

Denis, Jean Louis ; Forest, Pierre Gerlier. / Real reform begins within : An organizational approach to health care reform. In: Journal of Health Politics, Policy and Law. 2012 ; Vol. 37, No. 4. pp. 633-646.
@article{a77a2f80bc344b558fc70929c81831ac,
title = "Real reform begins within: An organizational approach to health care reform",
abstract = "Health care systems are under pressure to control their increasing costs, to better adapt to evolving demands, to improve the quality and safety of care, and ultimately to ameliorate the health of their populations. This article looks at a battery of organizational options aimed at transforming health care systems and argues that more attention must be paid to reforming the delivery mechanisms that are so crucial for health care systems' overall performance. To support improvement, policies can rely on organizational assets in two ways. First, reforms can promote the creation of new organizational forms; second, they can employ organizational levers (e.g., capacity development, team- based organizations, evidence- informed practices) to achieve specific policy goals. In both cases organizational assets are mobilized with a view to creating complete health care organizations - that is to say, organizations that have the capacity to function as high- performing systems. The challenges confronting the development of more complete health care organizations are significant. Real health care system reforms may likewise require implementing ecologies of complex innovation at the clinical, organizational, and policy levels. Policies play a determining role in shaping these new spaces for action so that day- to- day practices may change.",
author = "Denis, {Jean Louis} and Forest, {Pierre Gerlier}",
year = "2012",
month = "8",
doi = "10.1215/03616878-1597457",
language = "English (US)",
volume = "37",
pages = "633--646",
journal = "Journal of Health Politics, Policy and Law",
issn = "0361-6878",
publisher = "Duke University Press",
number = "4",

}

TY - JOUR

T1 - Real reform begins within

T2 - An organizational approach to health care reform

AU - Denis, Jean Louis

AU - Forest, Pierre Gerlier

PY - 2012/8

Y1 - 2012/8

N2 - Health care systems are under pressure to control their increasing costs, to better adapt to evolving demands, to improve the quality and safety of care, and ultimately to ameliorate the health of their populations. This article looks at a battery of organizational options aimed at transforming health care systems and argues that more attention must be paid to reforming the delivery mechanisms that are so crucial for health care systems' overall performance. To support improvement, policies can rely on organizational assets in two ways. First, reforms can promote the creation of new organizational forms; second, they can employ organizational levers (e.g., capacity development, team- based organizations, evidence- informed practices) to achieve specific policy goals. In both cases organizational assets are mobilized with a view to creating complete health care organizations - that is to say, organizations that have the capacity to function as high- performing systems. The challenges confronting the development of more complete health care organizations are significant. Real health care system reforms may likewise require implementing ecologies of complex innovation at the clinical, organizational, and policy levels. Policies play a determining role in shaping these new spaces for action so that day- to- day practices may change.

AB - Health care systems are under pressure to control their increasing costs, to better adapt to evolving demands, to improve the quality and safety of care, and ultimately to ameliorate the health of their populations. This article looks at a battery of organizational options aimed at transforming health care systems and argues that more attention must be paid to reforming the delivery mechanisms that are so crucial for health care systems' overall performance. To support improvement, policies can rely on organizational assets in two ways. First, reforms can promote the creation of new organizational forms; second, they can employ organizational levers (e.g., capacity development, team- based organizations, evidence- informed practices) to achieve specific policy goals. In both cases organizational assets are mobilized with a view to creating complete health care organizations - that is to say, organizations that have the capacity to function as high- performing systems. The challenges confronting the development of more complete health care organizations are significant. Real health care system reforms may likewise require implementing ecologies of complex innovation at the clinical, organizational, and policy levels. Policies play a determining role in shaping these new spaces for action so that day- to- day practices may change.

UR - http://www.scopus.com/inward/record.url?scp=84864515053&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864515053&partnerID=8YFLogxK

U2 - 10.1215/03616878-1597457

DO - 10.1215/03616878-1597457

M3 - Article

C2 - 22466053

AN - SCOPUS:84864515053

VL - 37

SP - 633

EP - 646

JO - Journal of Health Politics, Policy and Law

JF - Journal of Health Politics, Policy and Law

SN - 0361-6878

IS - 4

ER -