Workplace Reengineering, Reorganization, and Redesign From Nursing Management: Principles and Practice

Patricia Stanfill Edens, RN, MS, MBA, FACHE

September 13, 2005

In This Article


Editor's Note: Manyfactors influence the way healthcare is delivered, including changes in reimbursement, shortages or excesses in staffing, the economy, and politics. This book chapter except from Nursing Management -- Principles and Practice, edited by Mary Magee Gullatte, RN, MN, ANP, AOCN, FAAMA, examines some of the factors that influence the way we practice and provide care to our patients.

"He who upsets a thing must know how to rearrange it." African proverb

Workplace reengineering, reorganization, and redesign are responses to internal and external factors exerting influences on the organization in this dynamic healthcare environment. The most aggressive application in the workplace is reengineering. Hammer and Champy (1994), the founders and leading proponents of reengineering, defined the process as the fundamental rethinking and radical redesign of process to achieve dramatic improvements in critical, contemporary measures of performance, such as cost, quality, service, and speed. Reengineering is the design of a completely new process, whereas variations on reengineering can deliver enhancement or improvement in an existing process or a response to an external stressor. Reorganization and redesign are less aggressive in scope than reengineering and may involve reconfiguring an existing structure or process similar to what may be involved in total quality management rather than starting from scratch. The manager operating in the current healthcare environment can expect to face a need for workplace reengineering, reorganization, and redesign in the future and must be prepared both professionally and personally for its impacts.