Reengineering Health Care

This book explores three interlinked themes: the models and nature of organizational change; the implementation of Business Process Reengineering (BPR); and the management of contemporary public sector organizations. The authors describe and evaluate a BPR programme in a major NHS teaching hospital - its successes and its shortcomings. Organizations are being urged to experiment with new structures and processes. A 'process perspective' on organizing is emerging as a major challenge to 'functional' principles of organizing established during the last century. Business process reengineering is one exemplar of process thinking that has received great attention amongst organizational theorists and practitioners. This in-depth account of business process reengineering within a major NHS hospital is an important contribution to the very limited stock of empirical knowledge about new organizational forms, especially in the public sector. The book combines empirical data gathered through an intensive, comparative case study method with strategic choice and neo-institutional theories to analyse the changing context of public organizations, importation of models of organizing from private to public organizations, and dynamics of public sector transformation. The outcomes of the change programme add to our more general organizational knowledge about (a) the impact of corporate change programmes, particularly in professionalized and public sector settings, (b) impediments and enablers of lateral organizing structures and processes, and (c) contradictions within the New Public Management between functional and process principles for organizing.