Reengineering in Healthcare Sample Paper

People have been keen to understand how reengineering facilitates low costs and increased quality of health services, or whether it is just as another management practice whose benefits are blown out of proportion. This paper explores the current developments of reengineering in the healthcare practice and academia. It also examines the core elements of reengineering in healthcare practice and management. Finally, the paper identifies change as a challenge and limitation encountered by healthcare practitioners in implementing reengineering.

The Concept of Reengineering

Nurfadhilah et al. (2021) defined reengineering as a radical approach to bringing change, causing the obliteration of processes that are considered standard practice across the healthcare sector. Ford Motors, one of the pioneer organizations of reengineering applied reengineering by eliminating most of the usual functions of its accounts payable department (Vilasdechanon & Sopadang, 2018). In the process, according to Srinivas et al. (2021), the company changed how it interacted with its business partners such as suppliers by eliminating the need for an invoice payable. As a result, the company reaped success that was attributable to a change in its accounting customary roles in procurement and receiving departments.

From Ford Motors’ story, healthcare business process reengineering can be considered a radical change and redesign of critical organizational processes and systems to support and deliver care to patients so that the hospital organization can achieve dramatic improvements in its organizational performance within a specified time (Hassan, 2017). According to Vaez-Alaei et al. (2018), healthcare organizations that implement reengineering evaluate what they are supposed to do, their organizational objectives, and how those objectives facilitate and guide their internal processes.

Reengineering in healthcare must be conducted within seven main principles: first, the organization must organize its reengineering process around health outcomes and not just based on a single task (Arinahaq & Achadi, 2019). Secondly, the management must have those who use the processes’ output to perform the process. Also, the information processing work must be subsumed within the real work that produces the information (Hassan, 2017).

The fourth principle of BPR is that the organization must be considered any of its geographically dispersed resources as they are centralized through information sharing and effective telecommunication networks. It is a principle of BPR that all parallel activities must be linked instead of a sequential integration of their results. The penultimate principle of BPR is that decision points must be placed within the sections where the work is performed, accompanied by proper control over the process.  Lastly, in PBR, the information must be captured once and at the source.

BPR is often confused with other quality acronyms such as continuous quality improvement. However, in healthcare, these two concepts are different in a range of ways including the nature of change they bring, how employees participate in them and their implementation timelines. First, according to Nurfadhilah et al. (2021), the nature of change in BPR is fundamental while that in CQI is incremental. A hospital may decide to evaluate its booking process for elective surgical services and remove redundant steps and improve the quality of services. In BPR, one may then consider eliminating the entire process because less than 10% of admissions use the elective admission booking process.

Secondly, as Alaei et al. (2018) argued, BPR is implemented on a top-down approach within the organizational hierarchy while CQI occurs on a bottom-up approach. For example, in CQI, during staff recruitment in the laboratory, the staff in charge of laboratory recruitment identifies any duplicated handling of specimens and recommends a change in procedure to the laboratory department manager to eliminate those duplications. However, in BPR, a top-down approach will need to be involved because the senior managers are responsible for those processes and are therefore in the best position to make such radical changes.

Lastly, BPR’s term of implementation is longer than that of CQI because the former has a pervasive organizational impact (Antokhin et al., 2021). Typically, it takes longer to prepare the organization for the radical changes involved in reengineering.

Teamwork

In healthcare, the reengineering team is responsible for analyzing, redesigning and implementing the proposed changes. According to Nurfadhilah et al. (2021), a reengineering team may consist of 6 to 12 individuals selected from across the organization to represent each department. Nurfadhilah et al. (2021) insist that these individuals must bust have adequate knowledge in their respective functional departments and must be available to spend a significant amount of time on reengineering. The team must be a true representation of the organization with enough resources at their disposal to successfully achieve the reengineering objectives.

Current Process Analysis

With the help of reengineering experts, the reengineering team analyses the current business processes from beginning to end to identify all the users, departments and functional linkages (Antokhin et al., 2021). Further, according to Srinivas et al. (2021), the team must also audit the quantity of physical, information and human resources available. The team will then collet the various aspects of the performance of the current process for example waiting time and patient satisfaction.

On the other hand, Alaei et al. (2018) recommend that large processes such as materials distribution must be separated into subprocesses and assigned to the reengineering team members based on their respective expertise. This will yield a systematic review of the processes, which is at the core of BPR. For instance, the analysis will ascertain if the steps are out of sequence, whether there are unnecessary bureaucracies, whether various steps in the process such as form filling are required, whether some of the steps can be combined, or whether the sequential steps can be changed and done in parallel.

The analysis of the current process, being the core process of BPR, should unravel the elapsed time, incremental costs dependencies and bottlenecks within the process of healthcare delivery and use process design tools such as process activity network diagrams or Program Evaluation and Review Technique (PERT) to visualize how the processes should flow.

Redesign

Upon analyzing the current processes and identifying the faults, the reengineering team will brainstorm on how to redesign the process to eliminate those faults. According to Srinivas et al. (2021), the team should first the steps that do not add value to the customer and eliminate them, then streamline, consolidate or automate the remaining processes. But a significant challenge with the redesign process is that it challenges the existing organizational rules and principles and therefore the reengineering team might meet some resistance (Hassan, 2017). As such, the reengineering team must maintain their focus on improving efficiency and constantly challenging existing methods with new and innovative approaches.

Conclusion

Whereas BPR depends on many traditional management approaches, its cope within the healthcare sector is different. It establishes high expectations for service quality improvements. Therefore, the health organization’s ability to achieve those expectations determines reengineering’s success. Typically, the basic approach to reengineering is to disregard the organization’s traditional culture and replace it with a new customer-oriented culture of customer service delivery.

References

  • Antokhin, Y., Sokolova, I., & Suprun, A. (2021, April). Business Process Reengineering for Health Care Management and Medical Insurance: The Case of Russia. In Computer Science On-line Conference (pp. 510-521). Springer, Cham.
  • Arinahaq, A., & Achadi, A. (2019). Factors Associated with Business Process in Hospital: A Systematic Review. In 6th International Conference on Public Health 2019 (pp. 270-278). Sebelas Maret University. https://doi.org/10.26911/the6thicph-FP.04.07
  • Hassan, M. M. (2017). An application of business process management to health care facilities. The Health Care Manager, 36(2), 147-163. doi: 10.1097/HCM.0000000000000149
  • Nurfadhilah, N., Sidin, A. I., & Kadir, A. R. (2021). Key Success Factors in Implementing Business Process Re-Engineering (BPR) in Hospitals: Integrative Review. Journal of Asian Multicultural Research for Medical and Health Science Study, 2(3), 60-72. https://doi.org/10.47616/jamrmhss.v2i3.163
  • Srinivas, S., Nazareth, R. P., & Shoriat Ullah, M. (2021). Modeling and analysis of business process reengineering strategies for improving emergency department efficiency. Simulation, 97(1), 3-18. https://doi.org/10.1177/0037549720957722
  • Vilasdechanon, S., & Sopadang, A. (2018, April). Business process reengineering for the saline management in hospitals. In 2018 5th International Conference on Industrial Engineering and Applications (ICIEA) (pp. 84-88). IEEE. DOI: 10.1109/IEA.2018.8387075
  • Vaez-Alaei, M., Baboli, A., & Tavakkoli-Moghaddam, R. (2018, December). A new approach to integrate resilience engineering and business process reengineering design. In 2018 IEEE International Conference on Industrial Engineering and Engineering Management (IEEM) (pp. 778-782). IEEE. DOI: 10.1109/IEEM.2018.8607662