This book is for healthcare and physician executives, consultants, human resource professionals, students, and researchers who want to understand how change in the form of downsizing, restructuring, and reengineering affects those who manage large complex organizations. The method used in this book is a longitudinal case study that spans one year in the lives of twenty-three healthcare administrators faced with the need to downsize, restructure, and reengineer their hospital. The interviews were conducted at four-month intervals and, when taken together, tell the reader an intense story about General Hospital (all names are changed throughout the book) and how those who managed it experienced and dealt with change.
The story is an intimate one. The thoughts and feelings of those going through the change are shared with the reader. These are, it is worth noting, very likely similar to the thoughts and feelings of those in thousands of other organizations undergoing the same types of change. Downsizing, restructuring, and reengineering have become popular responses to the need for change. These management strategies have become the bread and butter of many consulting companies, and they seem to be liked by top management, perhaps because they rely upon traditional management tools such as redrawing organization charts, recasting job descriptions, redesigning work, and analyzing numbers to determine efficiency. Downsizing, restructuring, and reengineering are, in fact, so pervasive that this story is really about America in the 1980s and 1990s. These methods for managing change have profoundly touched the lives of a high percentage of American workers. Tens of millions of workers have lived through them with their family and friends. One is left to wonder why we are creating a workforce that feels expendable and what the long-term effects will be upon productivity.