Improving the public sector: can reengineering identify how to boost efficiency and effectiveness at a VA medical center?

Reengineering is a widespread management technique, but few evaluations of its application in health care, especially in public sector organizations, have been reported. We conducted a reengineering analysis to determine if the method could identify how to improve the efficiency and effectiveness of a VA medical center's primary care delivery system. We found that the reengineering method appears applicable in the institutional context of a public sector teaching hospital.