Combining the Viable System Model and Kotter’s 8 Steps for Multidepartment Integration in Hospitals

Integration between different departments is a major challenge for hospitals. It is considered as a key step towards greater efficiency. Yet research in industrial engineering does not provide satisfactory answers to this issue. Multi-departments issues are under-investigated and the implementation of recommendations is scarce. In this article, we focus on the first phases of a change program aiming at the better integration of a hospital sub-system. We propose an original methodological combination: Stafford Beer's Viable System Model, an organizational cybernetics model, is coupled with John Kotter's 8 steps for leading change, a change management method. We implement this approach in an action-research project in a French hospital's outpatient chemotherapy sub-system. The method allows us to diagnose structural issues in the system, to build a change program and to launch its implementation effectively. The first elements of an integrated vision are already present in the hospital.