Carol White, the coordinator for the multidisciplinary mental health outpatient services of a 150-bed psychiatric hospital, feels frustrated because the hospital is very centralized. She believes that this keeps the hospitals therapists and nurse-managers from being as effective as they could if they had more authority. Therefore, she has worked out a plan to decentralize her department, giving the therapists and nurse-managers more control and new titles. She sent her new plan to Chief Executive Officer Joe Short and has just received this memo in return.

Dear Ms. White:

The Board of Directors and I met to review your plan and think it is a good one. In fact, we have been thinking along the same lines for quite some time now. Im sure you must have heard of our plans. Because we recently contracted with a physicians group to cover our crisis center, we believe this would be a good time to decentralize in other ways. We suggest that your new substance abuse coordinator report directly to the new Chief of Mental Health. In addition, we believe your new director of the suicide prevention center should report directly to the Chief of Mental Health. He then will report to me.

I am pleased that we are both moving in the same direction and have the same goals. We will be setting up meetings in the future to iron out the small details.