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.
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 radi
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