Our study has thus prompted us to propose a reversal of management logic in hospitals. The idea is to
overhaul an organization based on the ex-ante setting of rigid plans, with the determination of precise
objectives (whether in terms of activity, teaching or research), deadlines and predefined indicators. It is also
a question of reviewing the application of pure incentive and self-control logic (in the sense of Drucker) to
public hospitals. In this context, decentralization means not only giving greater autonomy to operational
staff, but also enabling department managers to meet in privileged forums for discussion and the forging of
bonds of trust, thus fostering the alignment of their individual strategies. In this way, the clusters can become
the very place where the hospital's objectives are set, and where shared projects emerge from departmental
needs.