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1 - Rare Opportunity

Transparent Implementation of Organizational Change

Published online by Cambridge University Press:  30 November 2025

David L. Weimer
Affiliation:
University of Wisconsin–Madison
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Summary

Organ transplantation offers patients greater longevity and quality of life. The allocation of scarce deceased-donor organs involves high stakes for patients, transplant centers, and Medicare. The US Congress delegated authority for the development of allocation rules to the Organ Procurement and Transplantation Network (OPTN), which engages stakeholders in the process. In 2018, the OPTN committed to replacing categorical allocation rules with continuous distribution, a new framework that sought to eliminate inefficiencies and inequities at categorical boundaries. The transparency of the OPTN provides an opportunity to observe this attempt to implement a consequential planned organizational change. The process reveals the extent to which the stakeholder rulemaking of the OPTN, an example of constructed collaboration, can implement radical as well as incremental change. More generally, it offers insight into the roles of expertise and values in high-stakes and complex organizational decision-making.

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  • Rare Opportunity
  • David L. Weimer, University of Wisconsin–Madison
  • Book: Negotiating Values
  • Online publication: 30 November 2025
  • Chapter DOI: https://doi.org/10.1017/9781009687744.002
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  • Rare Opportunity
  • David L. Weimer, University of Wisconsin–Madison
  • Book: Negotiating Values
  • Online publication: 30 November 2025
  • Chapter DOI: https://doi.org/10.1017/9781009687744.002
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Rare Opportunity
  • David L. Weimer, University of Wisconsin–Madison
  • Book: Negotiating Values
  • Online publication: 30 November 2025
  • Chapter DOI: https://doi.org/10.1017/9781009687744.002
Available formats
×