Hospital reengineering: an evolving management innovation: history, current status and future direction.

This article summarizes six years of research on reengineering in hospitals and is the result of two national surveys and eighteen site visits to hospitals that engaged in reengineering in the 1990s. The research shows that actual hospital reengineering differs substantially from that which was initially proposed by early promoters of reengineering. However, this evolved reengineering continues to be implemented by the majority of hospitals in the United States. The authors illustrate how extensive reductions of managers and changes of nursing models have been in the past six years. Data comparing financial and cost competitiveness changes are also shown. The authors then explore the continued experiences of two early proponents of reengineering and find that their competitive outcomes to be in contrast with their early statements. Finally, the authors suggest a number of reasons that may impact on the success or failure of reengineering.