Patient-centered process of work redesign. Arizona hospital reengineers with no outside help.

A few years ago, Carondelet St. Joseph's Hospital in Tucson, AZ, realized that care delivery reflected a mechanistic, boundary-filled system rather than a process centered around patient care. To change this, St. Joseph's planned a work redesign process that a multidisciplinary team (under the guidance of nursing leadership) implemented and evaluated. The Steering Committee for Patient Centered Care (an interdisciplinary group) established five teams to plan and implement the redesign effort. The teams were responsible for quantification, quality, public relations and communication, education and human resources, and the pilot project. Four key factors helped get the redesign effort up and running: Support from the top. The involvement of all key disciplines. The timely movement from envisioning to implementation. Communication of tangible measurements of the change process. Patient-centered care continues to be refined and improved at St. Joseph's.