Structure and Design
Why did the Cleveland Clinic transition from a department-based to an institute-based model?
More natural collaboration across disciplines, like having both medical and surgical professionals work together on the same patient cases. It was a move away from isolated expertise toward patient-centered care.
Why might turf wars develop in traditional healthcare structures?
In the traditional model, departments were responsible for their own revenue and operations, which created competition rather than collaboration.
What should leaders do when a team member resists organizational change?
Effective leaders should start by understanding the source of the resistance and clearly communicate the vision behind the change. Support and guidance are important — but so is accountability.
What are the benefits of organizing teams around organ systems or diseases rather than medical specialties?
This approach mirrors how patients experience health challenges because their needs aren’t divided by medical specialty. Organizing teams by disease or organ system makes it easier for different types of providers to collaborate and offer better care.
What kinds of behaviors support or hinder successful collaboration in a team?
Supportive behaviors include active listening, openness to feedback, and a willingness to prioritize team goals over personal preferences. On the other hand, collaboration is hindered by territorial thinking, lack of communication, and resistance to shared accountability.
Why might a top-down change management approach work in some organizations and not others?
Top-down change can be effective when the organization has a clear hierarchy, strong leadership credibility, and aligned incentives. In flatter or more decentralized organizations, this same approach might create pushback.
When is it appropriate to change team structure vs. invest in improving an existing one?
Structural change makes sense when the current setup is actively blocking collaboration or creating inefficiencies. If the structure is functional and the issues are more behavioral or process-based, it's usually better to improve communication or leadership.
How can you ensure that collaboration happens beyond just co-location?
Physical proximity helps, but effective collaboration requires shared goals, mutual respect, and accountability. It also means having systems in place that encourage frequent communication and coordination, not just letting people operate in parallel.
What are some non-financial ways to reward effective teamwork?
Public praise, leadership opportunities, or including teamwork in performance evaluations are powerful methods. You can also offer professional development or let team members take the lead on key projects.