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Verdiana Morando (Università Bocconi); Valeria Domenica Tozzi (SDA Bocconi School of Management)
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20 pages
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Field research


This case was written with the support of a Case Writing Scholarship awarded by The Case Centre. The case study displays the development of fast-track surgery in the field of vascular surgery, as a new field of application, from the early experience of a multi-disciplinary team and demonstrates the challenges of rising the start-up innovation and settled it down within the highly complex and multi-level governance of hospital settings. The clue of the fast-track track innovation relies on the knowledge management and work organisation within the surgery unit: thus, the challenges to put it forward are not financial resources (as for technologies or therapies) or new competencies but a radical reengineering of working processes and tasks to accomplish. The case hinges on a discussion of the fast-track development through a dialogue between the surgeon leader and the hospital general director. The experience is analysed in depth providing original data and evidences to support the understanding of the successful results achieved in care outcomes and cost savings compared to the matters of implementation. For instance: the personnel turnover, the costs of training and the barriers posed by the operation management system of hospitals and the quality evaluation of the Regional Authority, based on episode-base reimbursement (DRG) and length of stay, which turned to be unable to track and grasp the fast-track’s improvements. This case has been featured on our website, click to view the article.


Knowledge management; Knowledge leadership; Knowledge transfer; Innovation adoption; Innovation and change; Leader-driven change; Learning and organisational process; Public sector innovation; Change management processes; Change management, resistance, cultural change; Change management; Human resource management (HR); Healthcare management and policy; Healthcare innovation; Hospital management; Team building and team learning

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