The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction. These will ultimately assess adaptation of structures within these new organizations. In this article, we share our insights based on experience gained over the past six years by surgical teams of the CAPIO group.