Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery

Amazon.com Review of "Reengineering Healthcare: A Manifesto for Radically Rethinking Health Care Delivery. Jim Champy, J.D., and Harry Greenspun, M.D. FT Press, Upper Saddle River, NY. 2010.Eric W. PalfreymanJuly, 2010.In the present cultural climate--with its emphasis on political absolutism--it would be easy to hand off responsibility for healthcare change to the government. To its credit, Reengineering Healthcare does not do this. In the beginning, it specifically places the action on those who can most directly and positively influence it:"Reengineering must be done, and it must be done by clinicians. No angel of government, even under the auspices of `national health care reform,' can reduce the cost and improve the quality of health care without the work and leadership of clinicians. It's time for all clinicians--physicians, nurses, technicians, physician assistants, and pharmacists--to assume their rightful role in directing change."The first question I want answered in any book I'm considering is whether it is a good read. The answer on Reengineering Healthcare is a resounding "yes". Champy's writing has always been high on a readability scale and Champy and Greenspun have delivered a book that is easy to read and engaging from beginning to end. It is an excellent mixture of case studies, narrative, inspiration, challenge, and technique. The book is long enough to convey knowledge and inspiration, but not long enough to become tedious. If its desire was to inspire as well as instruct, it is a very successful book.Their book begins by reviewing what reengineering is, and touches on ideas such as the idea that reengineering is not simply a look at discrete issues for resolution, but is an examination of the entire system of getting things accomplished. The authors place a focus on examining systemic issues and solving them in a comprehensive way. They recognize that reengineering is focused on fundamental change (not simply incrementalist tweaks), radical approaches that do not simply touch the surface, and focusing on areas that can create dramatic results. In brief, they state, "the methodologies and techniques may vary in name, but they all share the same ambition for dramatic improvement in the performance of work by focusing on process."They then turn to reengineering specific to healthcare. They lay the book around three areas of reengineering: Technology, Processes, and people. A thesis of the book is that any reengineering that is to be substantive must incorporate all three elements in order to fully create the kind of massive change that is needed.Another strength of the book is that while it strongly highlights cost improvements, reduction in time-to-results, and reduced duplication; it always maintains a focus on delivering quality healthcare and on maintaining a focus on patient safety.The book covers topics from selecting which processes/organizations need to be improved (and what criteria go into that decision) to a focus on continual interaction with the "front line"--the people who actually deliver healthcare. This effort may be authorized and funded by top executives, but the root cause analysis and proposals for process improvement are derived from and approved by those who actually deliver healthcare to patients--physicians, nurses, pharmacists, medical technicians, etc.A review seems incomplete without one criticsm, so if I had to come up with one deficit in the book, I would have like to have seen a couple of the case studies accompanied by simplified process flow charts showing a before and after architectural view of the process.For those interested in improving all aspects of healthcare delivery and in harnessing the power of innovative reengineering to accomplish this, Reengineering Healthcare is a must read.

I found a lot of useful ideas and interesting stories in Reengineering Health Care, and it was an entertaining read (at least for me, a process improvement wonk).I read it this week to help me prepare for a meeting I had with a hospital. Our conversation was mostly about how to engage physicians in changing the patient experience, something that is focused on a lot in this book. I particularly liked the various stories of Zeev Neuwirth, such as the way he used data about physicians as a fact-based way to defuse defensiveness, and his approach to choosing 20 high potential up-and-coming physicians for a leadership program.The process, people, technology framework worked well. There was a little too much on electronic health records for my taste. Traditional reengineering focuses on big change in core end-to-end processes, such as order fulfillment, and this book covers this territory and takes a wider view of organizational change that surrounds process reengineering to highlight the importance of engaging people.

Bought for a class. Interesting insights especially when it came to what other nations are doing to deliver affordable safe Healthcare. From what I gathered, doctors are stubborn little Jerks when it comes to getting them to buy in changing healthcare delivery systems.

My basic review is that it is a good book. Not very detailed in how nor very rich in data, as it contains mostly stories of how new innovation is occurring in healthcare. The authors make a lot of assumptions, and being an IT person in the healthcare industry I can notice where some of those assumptions were made. It seemed to me the authors assume you are familiar with how healthcare works, though that is their target audience.They make good points that it is the work of people that is needed to make the changes, not just fancy new tech or slick sounding government programs. While new technology is essential, and improved regulation (not necessarily more) will benefit the healthcare industry, much of what needs to change is the culture and delivery of healthcare. We have more knowledge than we ever have, but getting it to people and using it to improve heath is difficult.

It was easy to relate to the struggles and challenges highlighted in the book, but great to get some practical advice on how to tackle them. While many books focus on health policy, this one has helped me figure out how to move my department in a much more productive direction. It has also given me a "call to action" for my managers, helping them understand the rationale moving forward.

The pages are hard to separate. The book keeps closing and I have to forcibly hold it open to read the pages.

give the most insightful look at how to run a medical facility with apartnership between the workforce and management and a partnership in-between departments

This is a complimentary book for health care administrators. It describes a series of anecdotes in which some hospitals made radical changes in their processes, in their staff efficiency, or in the use of the available technology. It is not scientific though; anecdotes cannot be generalized and failure cases are not described.