This paper is an evaluation of an attempt to apply managerial tools and techniques initially developed for industry in the health care sector. In 1999, Sunderby hospital was opened and the result of extensive organisational development became subject to an evaluation of whether goals in terms of process and patient orientation had been realised. The result indicates that a number of measures were taken in this direction but that they do not, in any fundamental way, challenge boundaries that need to be challenged in a process oriented organisation. For that, the new organisation is reminiscent of a traditional health care organisation, based on clinical departments and characterised by vertical as well as horizontal boundaries. Additionally, many of the projects initiated, clearly focus on the patient and the flow of patients, but can be regarded as free standing 'islands' as the concept of patient and process orientation is not fully supported and implemented in the organisation.