A pragmatic look at hospital reengineering. Successful reengineering requires the right leadership.

The market turbulence of recent years has made healthcare leaders particularly open to the management tool called "reengineering." Unfortunately, many such efforts fail because they do not go beyond simple cost cutting to create processes that, by adding value to product, attract customers. A healthcare organization planning reengineering should: Find leaders who will educate themselves in reengineering tools and techniques, talk to both proponents and opponents of reengineering, consult those staff members who are most knowledgeable about the organization's processes, and skillfully communicate the organization's vision for the future. Determine its customers' needs by, first, learning who its customers actually are and, second, consulting with them. Reengineered processes should have the built-in data-collecting and reporting mechanisms that will help the organization meet customers' standards. Get the organizations' managers on board. Since satisfying customers' needs is the reason for reengineering, the organization must not let hidden agendas torpedo the effort. Redesign its processes. To accomplish this, the organization must allocate sufficient resources for the redesign effort, assign talented employees to it, and overcome such organizational limitations as "innumeracy" among its work force.