Reeingineering Health Care: The Complexities of Organizational Transformation

This book explores three interlinked themes: the models and nature of organizational change; the implementation of Business Process Reengineering (BPR); and the management of contemporary public sector organizations. The authors describe and evaluate a BPR programme in a major NHS teaching hospital - its successes and its shortcomings.
This work examines the experience of a major teaching hospital in adopting a change programme based on the principles of Business Process Reengineering (BPR). Empirical data were gathered through an intensive comparative case design, which is outlined. The outcomes of the change programme were much more nuanced than had originally been hoped, with little evidence of a wholescale organizational transformation. There was also found to be strong variability within the hospital in terms of the degree of change secured This particular empirical study adds to the more general literature on the variable impact of corporate change programmes, particularly within highly professionalized and public sector organizations. In terms of the generic change literature, we consider why it was that change outcomes were partial rather than transformational in nature. The ability of the medical profession in particular to continue to shape the change process is highlighted. It is also argued that BPR is but one example of a number of attempts to move towards more lateral forms of organizing.