Reengineering the work of caregivers: role redefinition, team structures, and organizational redesign

Health care organizations are implementing new patient care delivery models with the expectation that operations reengineering will bring dramatic improvements in cost, quality, and patient satisfaction. Together with the fundamental redefinition of caregivers' work roles, the adoption of reengineering principles features the organization of work activities around team structures such that teams are considered the basic unit of work performance. This article draws from reengineering case studies to consider how hospitals are operationalizing team care concepts at the patient care unit level. Using a classification of caregiver work that distinguishes care production and care management tasks, evolving care team models are discussed through a conceptual framework that defines a continuum of team delivery strategies. The team models are illustrated by brief case examples.