The basis for the organizational quantum condition comes from Elliott Jaques, MD, PhD (his PhD from Harvard in social relations). In his work at Glacier Metal following the Second World War, he discovered a time span depth-structure in management hierarchies that he went on to confirm in at least 100 organizations and 15 countries. (He also coined the phrase “midlife crisis.”) However, he missed the Midlevel in the depth-structure, the level that holds together and stabilizes hierarchies. In quantum fashion, it is the superposition of the employees across all the positions at the Midlevel that does the trick, and it takes an intervention by an experienced organizational analyst to properly staff this level. Without the intervention, a hierarchy remains unstable and the different levels continue to work at cross-purposes.
Unwittingly near the end of his life, Dr. Jaques came up with a model for how the Midlevel looks in healthcare. In a 1999 unpublished working paper, he proposed the model for a Medical Committee shown in the diagram to field issues on policy, practice, and quality. The Midlevel forms organically with the intervention, and the actual look and feel of the level would vary from hospital system to hospital system. As such, the Midlevel is uniquely positioned to coordinate and monitor the direct engagement of patients in their care, which again would vary across hospital systems. As Dr. Martin Makary, Professor of Surgery at John Hopkins University School of Medicine, wrote about and emphasized (https://soundcloud.com/bmjpodcasts/medical-errorthe-third-leading-cause-of-death-in-the-us) direct patient engagement promises to reduce avoidable medical errors. Without the intervention and significant patient involvement, these preventable errors persist as the third leading cause of death in the U.S. after heart attack and cancer.