Following in her father’s footsteps, Dr. Pat was the owner and head veterinarian at North River Veterinary Hospital. Recently, the hospital had begun to look more like a zoo. Surgeries were being overbooked, patients with appointments were left waiting, and confusion seemed to be around every corner. Though Dr. Pat had commissioned the building of a new hospital in 1993, she wondered if she had given enough thought to the organization’s operational structure. How could she better organize her staff and work processes to address the confusion?