Healthcare organizations periodically restructure to meet the evolving needs of patients, changes in regulations, and financial pressures. Restructuring can induce organizational stress, disrupt workflows, and compromise quality if not managed properly. For this reason, adaptive leadership is required to guide reconstruction efforts while balancing human, financial, organizational, and quality-related factors. Despite the prevalence of restructuring in healthcare, there is limited writing on evidence-based strategies to improve care and sustain organizational change over a continuum. Fostering unity of purpose, appreciation of existing expertise, and clear communication are key components of successful restructuring within the healthcare industry. This commentary explores best practices as it relates to the scope of organizational restructuring.

Referrals to specialty care are prolific, yet they are also associated with inefficiencies and clinician frustration. The literature suggests that structured referral templates improve the clarity and completeness of information exchange between multidisciplinary providers. This evidence-based practice project aimed to optimize multidisciplinary communication at a free specialty care clinic. Primary outcomes included specialty clinic provider and staff satisfaction, as well as primary care clinic intervention adherence. Specialty-specific referral templates were implemented for 5 specialties at the free clinic. The templates were piloted at 5 primary care referral sites and refined using the plan-do-study-act model. Templates improved satisfaction with overall referral processes, and 100% of survey respondents reported satisfaction with the finalized templates. Template adoption by referral sites was realistic and achievable, and referring primary care providers also expressed satisfaction with the templates. Specialty-specific referral templates are a no-to-low-cost intervention to improve information exchange between primary and specialty care providers.