Service integration in the reform era.

Fifty years of health care reform have centered around "fixing up" existing operational processes by examining the tasks attached to those processes. Today, restructuring seeks to identify the core processes of hospitals, such as patient care, and reorganize around those processes. Reorganization is painful, but also exhilarating. If hospitals are to use this exhilaration as a source of growth in a new economic climate, management must redefine itself and its relationship to staff.