BOOK REVIEWS Book review Promoting Health through Organizational Change

Promoting Health is built on two major themes developed and reiterated in 19 chapters that are divided into three major parts. The first theme is that the changes needed to bring about health promotion should not only focus on the behavior of individual health care consumers, but also on the behavior of health care professionals and health care organizations. The second theme stresses the need to go beyond incremental change to the fundamental integration of public health and clinical services. Promoting Health is actually three books in one, each corresponding with the three major sections of the book. Part 1, entitled ‘Re-orienting Health Care Organizations’, is an overview of the present ‘health status’ of health systems in industrialized countries. Part 2 is a workbook and toolbox that helps the reader learn how to use the ‘Five Steps for Improving Organizations’. Finally, Part 3 is a state of the art summary of electronic technology in health care, entitled, ‘e-Health: The New Role of Information Technology’. The heart and strength of the book, Part 2, is well designed as a practical individual self-study tool or formal training guide for workshops, and as explained in the Preface, the historical origins of the book were actually in the realm of training. Concepts, case studies and worksheets lead the learner through ‘The Five-Step Process’, which consists of (1) building motivation for organizational improvement, (2) strengthening organizational capacities to change, (3) identifying strategic directions, (4) conducting critical functions analysis and (5) implementing improvements using ‘rapid cycle change’. The ultimate goal is not simply to identify and change a specific organizational problem, but to build within organizations the ability continually to ‘keep the