Restructuring of cardiovascular services at Children's Hospital, Boston, Massachusetts.

BACKGROUND: In recent years there has been growing concern about the turbulence and many uncertainties in the health care environment. The leaders of the Cardiovascular Departments at Children's Hospital in Boston recognized the need to position themselves more effectively for providing quality cardiovascular services in the future. METHODS: A transformational strategy for leadership and organization of cardiovascular services was designed by the physician and nursing leaders of the Cardiovascular Departments. The new Cardiovascular Program included changes in governance administration and clinical operations. RESULTS: A Governance Board was appointed to oversee the fiscal and clinical affairs of the unified Cardiovascular Program. The operating budget was reduced by 10% (2.1 million dollars) over a 2-year period. This goal was achieved with creative restructuring in three areas: (1) personnel, (2) supplies, and (3) ancillary usage. CONCLUSIONS: This organizational innovation is a model for collaborative practice. It is hoped that this new model will allow the faculty and staff to improve upon a tradition of excellence in clinical care and will help in retaining an environment and spirit conducive to the generation of new knowledge.