The challenges are organizational not just clinical

Contemporary hospitals fall far short in applying both state-of-the art clinical knowledge and management practices of known effectiveness. Organization and management practices in hospitals are shaped by four factors: their conflicting missions, a distinctive and largely professional workforce, demanding external environments, and a complex day-to-day task environment. This article identifies two critical organizing challenges that hospitals face: organizational learning and implementing effective high involvement management practices. It discusses how findings from organizational research, including articles in this special issue, identify solutions to the problems underlying these challenges. Copyright © 2006 John Wiley & Sons, Ltd.

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