TY - JOUR AU - Kimani, James AB - 42 January–March 2009 Building capacity for a transformation initiative: System redesign at Denver Health Michael I. Harrison James Kimani Background: This article examines the development of transformation initiatives—deliberate attempts to achieve systemic changes and rapid performance improvements. Accounts of transformation initiatives often reveal little about past organizational and contextual conditions that contributed to success. Instead, these accounts concentrate on change barriers. Purpose: We seek to restore balance to this field by examining how antecedent system capacities contributed to a successful transformation initiative. Methodology: This article presents a case study of the first 2 years of a system redesign initiative at an integrated safety-net health system and provides a historical analysis of developments during the decade preceding the redesign. Findings: Beginning in the mid-1990s, Denver Health benefited from strong municipal support for its development and expansion. Gradually, it developed its financial and human resources, organizational structure, change strategy, change-management capabilities, information technology, and physical plant. These antecedent capacities all contributed to the implementation of the 2004 system redesign and helped Denver Health overcome several constraints. Implications: Transformation initiatives may build on existing features and resources, even as they overcome or depart from others. The Denver Health case study helps researchers TI - Building capacity for a transformation initiative System redesign at Denver Health JF - Health Care Management Review DO - 10.1097/01.HMR.0000342979.91931.d9 DA - 2009-01-01 UR - https://www.deepdyve.com/lp/wolters-kluwer-health/building-capacity-for-a-transformation-initiative-system-redesign-at-JdkjUdBsk0 SP - 42 EP - 53 VL - 34 IS - 1 DP - DeepDyve ER -