Background:
The Puert Rico Health Department Institute of Laboratories suffered a major transformation on July, 2005 when for the first time in its history, an Anatomical, Clinical and Forensic Pathologist was appointed as its full time director.

Objective:
The objectives of this transformation answered to the newly appointed Secretary of Health point of view for health, and expected immediate changes in the Health Department's policies that would answer to the real necessities of Puerto Rico's population, far away from a very politicized, obsolete structure in order to provide quality laboratory services fast, following the needs of the surveillance and disease detection and treatment programs (mainly funded by the Federal Government). Transforming the Health Department in an proactive and up to date health care agency changing the perception that the laboratory services are bad!

Method:
Identification of actual working processes. Change institutional cultute. Communication thru meetings. Understand processes evaluation tools. Knowledge of Quality Assurance exercises. Internal public relation strategies.

Result:
In approximately 3 months and one week of hard work and commitment, the Institute of Laboratories transformed its Laboratory information system from an "enemy" to a tool used to improve services.

Conclusion:
Goal setting, hard work, commitment, organization, discipline, communication and understanding; served as the means of change making a process that was almost a year old (LIS installation), work in 5 weeks, improving surveillance and disease detection and treatment programs more agile.

Implications:
Surveillance and disease detection and treatment programs thrived on this new way that the laboratory was reporting results, actively participating in goals setting and acknowledging the priotities are ultimately program based.