The radiology department at a Danish regional university hospital implemented integrated RIS/PACS. In the process, it became clear that some aspects of the changes had been ignored and that the impact on the organization would be substantial. With that in mind this study was planned, and an interdisciplinary working group was appointed and tasked with implementing activities to improve the organizational environment and atmosphere in the department. One activity aimed at formulating a vision/activity plan by using café seminars to involve all employees. The plan for implementation included 35 activities to support the realization of the vision. Bottom-up organizational development does work – provided that responsibility for the process is delegated.