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Accelerating environmental turbulence in the health care industry has led to a significant interest in strategic management and work redesign. This paper examines different types of generic hospital strategies and alternative approaches to work redesign, and proposes a contingency framework consisting of these two important organizational elements for improved hospital effectiveness.

The digital transformation calls for new thinking about sociotechnical systems design (STSD) because it has enabled new kinds of work systems to proliferate. We identify a new class of sociotechnical system, called the Platform-STS (P-STS), which complements the existing Industrial- and Knowledge-STSs. The P-STS has distinctive characteristics compared to the other classes because it reaches directly into ecosystems and is, therefore, “distributed,” and because it is governed through market mechanisms rather than hierarchy or clan mechanisms. We introduce a new design principle, redundancy of connectivity, to ground design thinking about the P-STS. We demonstrate why fundamental STSD principles need to be reconfigured, suggest how they might do so, and conclude that socioecological designs and interventions may need to supplant sociotechnical ones.

The field of organization design is changing rapidly, reflecting contributions from managers and diverse organizational consultants. One of the most recent developments is in the design of non‐routine systems. Explores non‐routine systems design from a socio‐technical systems (STS) perspective. Includes a brief discussion of non‐routine systems and an examination of alternative methods for diagnosing and redesigning organizations composed of knowledge workers. The results of two STS case studies provide new learnings and point to special design principles for non‐routine systems. Concludes with implications for both managers and STS consultants interested in management of knowledge workers.

Business process re‐engineering (BPR) is certainly one of the latest buzzwords and is the subject of great interest and also great controversy. Organizations need to shake themselves out of complacency to close competitive gaps and achieve superior performance standards ‐ the reason why many have embarked on huge BPR projects. In view of the high risks associated with radical change, there are, however, many problems associated with BPR. For some BPR is going off the rails before it is properly understood, and many BPR exercises are not delivering the goods. Sometimes, organizations are expecting “quick fixes”, thus displaying their lack of understanding of a complex system. It is unreasonable to expect quick results when so much change is involved, especially when these business processes involve not only machines, but also people. Many believe, such as Mumford, that the management of change is the largest task in re‐engineering. Many people perceive re‐engineering as a threat to both their methods and their jobs. Owing to this recognition, many authors concentrate on the need to take account of the human side of re‐engineering, in particular the management of organizational change.

The Summer 1972 issue of Personnel Review contained an article by Enid Mumford setting out a framework for analysing job satisfaction. This article presented a theoretical and practical approach for evaluating and measuring job satisfaction, together with a definition which equated job satisfaction with the fit between what an employee was seeking from work and what he was receiving or, in other words, the fit between job needs and expectations and the requirements of the job. This analytical framework has since been used extensively in industrial and commercial organizations as a means for assisting the design of the human part of computer systems. The method has been used in the following way.

The purpose of this paper is to elicit the determinants of information technology (IT) professional work change and investigates the impact of such changes on IT professionals. Specifically, this paper investigates the effect of work redesign on two personal outcomes: self‐perceived psychological empowerment and organizational commitment.

An empirical study is conducted in the field of high‐tech industrial organizations in Taiwan. Data collected from 40 technological companies, located in the Taipei and Hsinchu Science Parks (n=428), are analyzed using structural equation modeling.

The results confirm that both work redesign and empowerment generate positive and direct influence on employees' commitment. Specially, the effect of work redesign is amplified on employee commitment through the implementation of employee empowerment.

The conceptual structural equation model provides useful information for managers to improve employees' commitment towards their work and the organizations through the proper employee empowerment policies.

As technology continues to change at a rapid pace, IT professionals are required to adapt to new tasks and enhanced roles. The paper demonstrates how work redesign indirectly but positively influences employees' work commitment and illustrates the mediate effect of employee empowerment on employee commitment.

For me, the human side of work is the most important aspect in any consideration of jobs and organizations. Hospital organizations, for example, are made up of people, their jobs are, of course, done by people, and the results of that work are for people — whether they be direct recipients such as patients, or customers; or whether they be the indirect recipients such as the community, or the employees themselves. The dilemma is highlighted by asking, why do we so often separate the effects of work on the humans involved in its production, from the effects on humans as recipients of its end result? I will posit that if work is consciously designed as a meaningful activity for the people involved in its production, then chances are good that its product will also better suit its human users. That is, there is a systemic relationship between the quality of working life and the quality of the product of that work. In so saying however we must likewise acknowledge the importance of the technical requirements of the work — for having meaning to the people involved is not enough. Work that is meaningfully arranged, both for the humans involved in its execution and for its technical requirements, typically results in a higher quality product and, not infrequently, in greater productivity as well. In our experience results are frequently accompanied by lowered absenteeism and turnover and greater feelings of satisfaction with the work activity. Work system design, or socio‐technical system design, is a powerful approach to this human side of work — work that is meaningful in both that human sense, as well as the technical sense.

Purpose – This chapter argues that health care is best conceptualized as a complex adaptive system. Sustainable health care depends on harnessing the complexity of the system by building aligned purpose, flexible pathways to connect people, knowledge and resources, and the capacity for self-organization.

Design/methodology/approach – The case study of the Southern California Region of Kaiser Permanente is based on three years of interviews and archival data collection examining the system's transformational change that began in 2004 and has been aimed at building a sustainable health care system with the guiding principles of value and prevention. The case focuses primarily on the medical care delivery system designed by the Southern California Permanente Medical Group, the capabilities that have been built into the system to continually improve the quality of care and the outcomes of the system, and the results that have been achieved.

Findings – During the period from 2004 to 2011, the region improved significantly in slowing cost acceleration by significantly improving medical care. The implementation of an electronic medical records system and its integration with other clinical information technology systems have enabled: (1) truly integrated, well defined, and easily navigated care delivery systems that are based on evidence; (2) upstream focus on prevention, disease control, patient education, and population health; and (3) management accountability and organizational improvement systems based on transparency of data and feedback. Physician leadership and partnering with the region's administrative and hospital leadership have been critical change enablers.

Originality/value – Embracing the complexity of the system has led to the crafting of pathways and linkages that enable patients to move through the system to flexibly and efficiently connect to the knowledge and resources required to optimize their health. This requires continual self-organization based on well-defined roles and connections. Previous health care improvement approaches have stressed initiatives and organizational changes that may further fragment the health care system.

Achieving more from less is a preoccupation of many organizations in the turbulent 1990s. Midst the maelstrom of apparently mutually exclusive organizational objectives, managers respond to what may turn out to be the siren call of business process re‐engineering. Rapid assimilation of business process re‐engineering into managerial practice in the 1990s is arresting. However, a number of articles on the subject have been based on hyperbole rather than evidence. Considers and examines theoretical antecedents of business process re‐engineering within the context of this decade’s challenges. Uses empirical evidence to provide evidence‐based critical success factors for business process re‐engineering programmes. Discusses indications for future research in business process re‐engineering. Places emphasis on the need to bridge the lacuna between business process re‐engineering theory and evidence‐based practice.

Presents findings from a study undertaken to identify some of the conversational issues in the production of knowledge in cross‐functional work redesign groups. Illustrates what may be key sources of miscommunication based in differing conversational relevance. Postulates that the recognition of relevance and, by extension, the recognition of a valid contribution, is influenced by the manner of discourse or speech style. Feels that the language behaviours as disclosed in the analysis can be inhibiting to the work of cross‐functional teams responsible for a variety of organizational change processes, including IS development and workflow redesign.