tag:blogger.com,1999:blog-32053362.post4777528175134516691..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Batalden updates MachiavelliPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-32053362.post-24304291515881049862008-04-19T17:43:00.000-04:002008-04-19T17:43:00.000-04:00In health care, there are two kinds of change:1. I...In health care, there are two kinds of change:<BR/><BR/>1. Internal cultural and procedural changes initiated by executives or employees. Very difficult because, why do it? These changes often require intense CEO commitment and leadership.<BR/><BR/>2. External change, such as the da Vinci, CT, MRI, DRGs, HMOs, EEOC and other technological, market and regulatory forces. Easier. The superior outside authority says do it or lose business or do it or go to jail. CEOs can be less involved, if they are involved at all, I'm thinking.<BR/><BR/>I'm bemused by the call for "change" in the presidential campaign. Rostenkowski, Waxman, et al, found out what "change" meant to Medicare beneficiaries back in the late 1980s. It wasn't pretty.<BR/><BR/>Great blog. I've blogrolled you.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-62228863537316474362008-04-19T10:41:00.000-04:002008-04-19T10:41:00.000-04:00"Every system is perfectly designed to get the res..."Every system is perfectly designed to get the results it gets." -PBWongMLhttps://www.blogger.com/profile/15507550914792992303noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-83295935758460172272008-04-19T08:21:00.000-04:002008-04-19T08:21:00.000-04:00There are uncountable examples of cultural change ...There are uncountable examples of cultural change where painful demands for adaptation broke the functioning of the system (e.g. colonization). This happens when the rewards of adaptation cannot be realized (e.g. decreased rather than increased access to resources), and the interactions that humans lived by fail. <BR/><BR/>But the rewards of this change to individuals and organizations are substantial, and attractive. Have the risks to slow adaptors really shifted? Can they do business as usual?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-83693615792910006862008-04-18T05:31:00.000-04:002008-04-18T05:31:00.000-04:00Really there is nothing more difficult to take in ...Really there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the <A HREF="http://www.themedica.com" REL="nofollow">introduction </A>of a new order of things.Sandhyahttps://www.blogger.com/profile/07845369576162836722noreply@blogger.com