Tomás Romero Hospital

This teaching case presents a decision to implement a “strategy of value creation,” based on multi-disciplinary teams organized by acute health conditions, in a hospital organized by areas of specialization, in functional units. The case describes how a new management team of “Hospital Romero” has achieved several organizational changes, including greater and more productive communication between new and veteran staff, improved relations with the labor union, and support from community groups. However, the team encounters strong resistance to the implementation of an IPU (integrated practice unit), which is a multi-disciplinary team to provide integral attention throughout the treatment cycle related to the diabetic foot. The case puts the reader in the position of Dr. Juan Contreras, the Medical Subdirector of the Hospital, who must evaluate alternatives to overcome this resistance. This case is based upon semi-structured, in-depth interviews with hospital staff, participant observation, and the analysis of hospital reports and statistics. The names of some individuals and places have been changed at the request of the Hospital administration.