Transition to 21st Century Healthcare: A Guide for Leaders and Quality Professionals, 1st Edition (Hardback) book cover

Transition to 21st Century Healthcare

A Guide for Leaders and Quality Professionals, 1st Edition

By Scott Goodwin

Productivity Press

208 pages | 12 B/W Illus.

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Hardback: 9781498726870
pub: 2015-04-28
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This book explains why the fundamental structures of 20th century American healthcare have failed to keep up with American industry in terms of quality and cost. It describes how this has led to the introduction of industrial mass production concepts in American healthcare, such as Lean and Six Sigma, and how the resulting industrialization breaks down the 20th century model and opens the way for a new vision of healthcare.

Exploring the links between healthcare history, quality history, and the current state of healthcare, the book will help healthcare leaders and quality professionals recognize, understand, and respond to the changes currently under way in American healthcare. It provides clear guidance on the role of industrialized quality in breaking down 20th century assumptions and building the foundation for 21st century healthcare.

As readers grasp the transformative effects of the macro-level changes resulting from industrialization, the book provides simple assessment tools to assist leaders and quality professionals in evaluating organizational development. It describes ten transitions that arise out of industrialization that healthcare organizations need to traverse and provides the tools to assess the transitions that indicate whether an organization is progressing towards the 21st century American healthcare model.

The book explains that the rate of transition to the 21st century healthcare model is based on the level of acceptance and implementation of industrialized quality. It concludes by sharing insights into the future of American healthcare and the importance of creating a vision to assist in the transition to this future.

Helping healthcare leaders and quality professionals understand the need to use the transitions to create clear visions of the future and use these visions to guide and motivate their organizations, the book provides the tools, understanding, and roadmap you need to successfully transition your organization toward the 21st century American healthcare model.

Table of Contents


A Brief History of American Healthcare


The Stethoscope and the AMA

The Medical Record

The Money

Healthcare Quality History


Quality from within Healthcare

Quality from outside Healthcare

Quality-Driven Healthcare


Deconstructing 20th Century Healthcare

Lean and Six Sigma and Industrialized Healthcare

Industrialized Healthcare and Organizational Transitions


Organizational Transitions

Organizational Structure Transition: Hierarchy to Complex System

Organizational Relationship Transition: Transactional to Emergent

Leadership Transition: Control to Trust

Innovation Transition: Centralized to Adaptive

Process Transitions

Production Method Transition: Craftsman to Multidisciplinary Teams

Delivery System Transition: Hospital to Continuum of Care

Information System Transition: Isolation to Network

Financial Transition: Fee-for-Service Financing to Consumer Health Financing

Cultural Transitions

Professional Transition: Autonomy to Integration

Metaphor Transition: Scientific Machine to Complex Adaptive System

The Transition Scorecard and Transition Progress Scale

A Vision of 21st Century Healthcare


Generative Metaphors of the 21st Century

The 21st Century Circle of Care

What Does It All Mean to You?



About the Author

Scott Goodwin has 20 years’ experience as a healthcare quality professional that includes positions as hospital-based quality vice president and chief quality officer, quality consultant for multiple hospitals, and currently as vice president/chief quality officer. In 2013, he completed his doctorate in leadership studies at Franklin Pierce University. Since 2013 he has been an adjunct professor at New England College in Henniker, New Hampshire, where he designs and teaches a course in Quality and Lean, in addition to courses in organizational ethics, health informatics, and supply chain. He also designed and taught a course at Bay State College, Boston, Massachusetts.

In 2014 he received the innovator’s award from the New Hampshire Foundation for Healthy Communities, which celebrates extraordinary ingenuity, creativity, and skill in improving health and healthcare access, delivery, or quality. Mr. Goodwin’s work as chair of the New Hampshire Health Care Quality Assurance Commission brought him into legislative session to assist elected officials and policy makers in discussions about the complex world of measuring health care quality. And he has worked to support the efforts of quality professionals across New Hampshire to improve delivery of care to patients in hospitals and ambulatory surgical centers.

Joining with quality professionals across the state, Goodwin has supported innovative and cost-saving approaches to improving care that include reducing infections, improving surgical safety, and promoting organizational cultures that support high quality.

Mr. Goodwin was selected to present at the National Association for Healthcare Quality 2014 conference in Nashville, Tennessee, on the topic, "What’s in a Name: The Importance of Metaphors in Quality Improvement."

Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Industries / Service Industries
MEDICAL / Administration