ABSTRACT
This chapter discusses some design choices that might be evaluated by hospitals in search of possible answers: analysed functional modified structures based on workgroups and product managers, divisional structures and matrix structures with internal quasi-market mechanism. Hospitals' traditional functional design is now struggling to respond to emerging organisational needs in the medical field. Medical, paediatrics and obstetrics/gynaecology specialties, were more likely to emphasise the clinical and professional aspects of their role. In fact, functional designs are most appropriate when an organisation operates in a relatively simple and stable environment. Clinical pathways should combine evidence-based medicine (EBM) with a cost-conscious approach, in order to provide the highest clinical quality with a sound rational utilisation of resource. Hospital units' aggregation of divisions or departments makes sense when grouped specialties horizontal overlap each other in services delivered or integrate vertically along a production process.
