Decision rights redesign in a hospital network
Latency measured with the Decision Velocity Index; verified under the Markham Verification Standard at month 11.
The situation
A regional hospital network of four hospitals and one merged administration had arrived at governance by accretion. It ran 31 standing committees, most of them created to solve a problem nobody could still name. Clinical quality was strong. Administrative decisions were not. A capital request took a median 61 days to decide, and operational questions routinely visited three committees before finding one that felt authorised enough to answer, or before whoever raised them gave up.
The culture was collegiate and consensus-minded, which everyone valued and nobody wanted destroyed. The brief was precise. Keep the consensus where it earns its cost, take it out of the decisions where it is only delay, and do not pretend those two categories are obvious from an org chart.
Impact in detail
Latency read from calendars and approval trails, not interviews; month-11 readings verified under MKM-F-003.