Reengineering hospitals: evidence from the field

Current estimates suggest that over sixty percent of all U.S. hospitals are involved in reengineering initiatives. The level of investment is staggering; literally billions of dollars are being spent in the name of reengineering. Surprisingly little research has been reported, however, aimed at clarifying how this money is being spent (i.e., the content of reengineering) or identifying the management practices that facilitate or impede implementation. This paper summarizes extensive field research from fourteen hospitals across the country aimed at developing a clearer picture of reengineering. The research identifies seven components of hospital reengineering present in various configurations in the hospitals examined. Methods for facilitating reengineering are explored and eight major barriers recognized. Site specific examples are provided to illustrate how the facilitators and barriers work in practice.