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Reengineering Health CareThe Complexities of Organizational Transformation$
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Terry McNulty and Ewan Ferlie

Print publication date: 2004

Print ISBN-13: 9780199269075

Published to Oxford Scholarship Online: October 2011

DOI: 10.1093/acprof:oso/9780199269075.001.0001

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Process Redesign and Changing Contexts of Health Care

Process Redesign and Changing Contexts of Health Care

(p.45) 3 Process Redesign and Changing Contexts of Health Care
Reengineering Health Care

Terry McNulty

Ewan Ferlie

Oxford University Press

Although individuals from agencies may have the best ideas for the betterment of the organization, agency-led approaches should be reinforced by the notions that organizations are contextually embedded entities, exhibit structures that reproduce themselves and are highly resistant to change. An analysis of this organizational context has to be looked at in three perspectives while also analysing the players in these particular perspectives. First is the macro or outer context that discusses the broad social, economic, competitive, and technological framework in which organizations operate. The meso-context looks into the dynamics within a specific sector or population of organizations; this specific case looks at the hospital as an organization or the general health care sector. The micro-context looks into the local sites of these organizations and considers the general management, the clinical directorates, the NHS Trust status, the conditions and pressures from the quasi-market and other such pressures.

Keywords:   agencies, clinical directorates, health care sector, social framework, organizational context

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