FOUR

Transforming a Medical Center into a Level 2 Culture

At this point in our analysis it seems appropriate to consider an entire organization moving toward Level 2 relationships in all interactions among staff, up and down the hierarchy, across occupational boundaries, and, most important of all, with patients and their families. Can an entire health care organization evolve and sustain what would amount to a Level 2 culture?

We know that health care is moving in this direction around tasks that require a high degree of coordination (Gittell, 2016). We know that many hospitals have adopted various versions of reexamining their work processes through different kinds of reengineering models, and we know that there are broad calls for the “coproduction” ...

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