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Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

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This paper describes strategies to enhance organizational capacity through a large-scale role redesign initiative. Innovation for change strategies were used as the framework to guide the change. Project management processes were used. Assessment of need was based on characteristics of the patient population, service access, staff preferences and opportunities for enhancement identified through patient feedback. Twenty-one roles were reviewed, ten new roles created, seven revised and four consolidated. Transition support and sustainability processes and structures were implemented.