Japanese policies require medical institutions to redefine their community roles and collaborate with various professions to develop a comprehensive care system. This transition is projected to last 10–15 years. In response to these circumstances, Nagata Hospital formulated and implemented a regional positioning strategy over a 3-year period, leading to improved management outcomes and increased external evaluation. The hospital’s shift from a physician-centered to a patient-centered treatment model facilitated a rapid response within a constrained timeframe. Earlier initiatives (the first transformation) institutionalized cross-professional dialogue and a mechanism for formulating and implementing a sequence of goals. This created a collaborative routine among professionals. The established routines were subsequently applied to the development and implementation of regional strategies. This enabled staff to more efficiently address new strategic goals and respond to the latent needs of communities. They adapted rapidly to new environmental changes by reusing established routines.