The demand to improve the efficiency of the hospital’s processes and its profitability is especially pertinent in the healthcare sector. As institutions that are required to provide high-quality patient care and thousands of occupations for medical professionals, clinical establishments must rely on the most productive methods of reorganization during difficult times (Musa & Othman, 2016). The case of St. John’s reengineering perfectly exemplifies that it is crucial to implement practices that are appropriate for the healthcare setting and align with the practical considerations of the given organization. This paper focuses on the St. John’s reengineering case, analyzing the change implementation processes and highlighting how these activities could be improved to positively influence the hospital’s financial output and quality of care.
Engineering Issues: Outlining the Primary Concerns
During the reengineering process, St. John’s executives encountered numerous challenges that impeded the success of the endeavor. The most prominent issue was the Medicaid patient’s admission rate, which suffered a tremendous loss due to the decreased numbers of employees that could attend to such clients. As the majority of the admissions personnel were dismissed following the reengineering initiative, request processing and approval rates plummeted, creating a significant obstacle (Walston, 2018). After that, additional time needed for meal breaks also constituted a critical complication, as it reduced the employees’ working hours.
Moreover, the extra position established to counter the cafeteria elimination produced objections from the workers’ union, leading to substantial problems with the waging distribution (Walston, 2018). In the materials sector, the management encountered a devastating lack of personnel, which forced the executives to increase the staff numbers and incurred extra expenses. Finally, the last difficulty emerged when the patients’ satisfaction with the hospital’s meals diminished incredibly due to the aforementioned cafeteria alterations.
Management Activities Analysis
Reengineering Limitations Imposed by the Suggested Plan
In the case presented, a significant number of mistakes were conducted during the initial phase of reengineering integration. Prior to constructing the reengineering plan, it is crucial to devise a clear vision and mission statement that will guide the adjustment process and allow to establish clear goals to be achieved (Musa & Othman, 2016). However, as St. John’s executives decided to focus on the practical changes, failing to delineate the expected outcomes and the hospital’s overall vision for the future, the reengineering activities were less specific and primarily disorganized.
During reengineering, it is beneficial to create a set of rules to be followed, ensuring that processes that should remain unchanged or already function properly are not negatively impacted by the adjustments (Font et al., 2016). St. John’s management did not distinguish between the sectors that required reshaping and efficiently performing ones, resulting in an imbalanced scheme of reengineering implementation. For instance, the cafeteria, which is a major source of profit and a key factor in patient and employee satisfaction, is a prominent example of a hospital element that should not have been removed.
Another vital consideration concerns the elimination of middle managers, who were replaced with employee-led teams. While the changes are being introduced, it is still essential to maintain a number of management positions that overlook the ongoing processes and ensure that a smooth transition to the novel strategy occurs (Vilasdechanon & Sopadang, 2018). As St. John’s executives decided to completely dismiss the middle managers, the emerged disbalance in activities supervision and employee authority led to decentralization and additional hires.
In addition to the initiated changes, it is critical to address the lack of appropriate leadership that could guide the workforce during the difficult times of change. Successful reengineering, similar to other restructuration processes, is highly dependent on the implemented leadership strategies that serve to promote the morale and the motivation of the workers (Freihat, 2020). Each sector should be provided with an efficient leader who could communicate the corporate goals, align them with the employees’ expectations, and address resistance concerns (Freihat, 2020). In contrast with this consideration, St. John’s management not only failed to establish individuals that would fulfill the named responsibilities but also eliminated the middle managers that could potentially mitigate the rising concerns.
Possible Improvements to the Process of Change
Although the initial structure suggested by Alexander could have led to successful outcomes, it would be beneficial to integrate some improvements to maximize the change process’ productivity. As mentioned before, outlining the primary sectors that require alteration could aid with specifying the problem areas and focusing on the least efficient processes. For instance, Alexander stated that access, materials, and delivery of care are the most prominent aspects of a hospital’s profitability that must be adjusted.
Even though it is correct to advance a medical establishment’s output by directing the management’s attention to these elements, such suggestions are too broad and should be further clarified (Musa & Othman, 2016). Considering that healthcare organizations are highly dependent on patients’ monetary contributions, limiting the initiative to enhancing the care standards or securing materials at lower costs might have been more appropriate.
In addition to area specification, it would be extremely advantageous for St. John’s executives to consider how the changes in the current employment positions would affect the personnel and the hospital processes. In the given case, the management should have considered how introducing new positions would affect the employees’ assignments, working hours, and wages (Musa & Othman, 2016). Furthermore, the consequences of eliminating the existing occupations should have also been ascertained before the adjustments. In the long term, such actions might have clarified the eligibility of the suggested changes.
Recommendations for the Future
From my perspective, the most significant steps to be conducted in the future refer to the current concerns regarding the clinical environment’s quality. For example, it would be beneficial to focus on the cafeteria issue, addressing the patients’ and employees’ complaints by establishing a new enterprise. This action is a perfect opportunity to improve the standards of care and the working conditions. After that, of special attention is the elimination of the managing positions, which resulted in a rather chaotic distribution of responsibilities. Reinstalling such occupations or creating similar ones could greatly enhance the current situation (Freihat, 2020).
Furthermore, the issues with materials management should also be evaluated, for instance, by returning to a more centralized version of supervision (Font et al., 2016). As these complications impede the efficiency of patient care and hinder the accumulation of financial resources, addressing them could allow the management to establish a more stable atmosphere, more suitable for introducing future changes.
To conclude, the case of st. John’s reengineering has been discussed in detail in this paper, evaluating how improper use of restructuration processes has negatively impacted the hospital’s outputs. Given that the changes chosen by St. John’s management did not fit the hospital’s actual needs and contradicted the principles of healthcare reengineering, the efficiency and financial stability of the enterprise were negatively impacted. The absence of area focus, outcome evaluation, and clear leadership appears to be the primary causes of the attempt’s failure. Therefore, if the administration was to conduct more adjustments in the future, it would be imperative to assess how particular actions would impact the hospital as a whole system and implement the changes gradually.
Musa, A. M., & Othman, M. (2016). Knowledge map and enterprise ontology for enhancing business process reengineering in healthcare: A case of radiology department. International Journal of Enterprise Information Systems, 12, 26–46. Web.
Font, D., Escarrabill, J., Gómez, M., Ruiz, R., Enfedaque, B., & Altimiras, X. (2016). Integrated Health Care Barcelona Esquerra (Ais-Be): A global view of organisational development, re-engineering of processes and improvement of the information systems. The role of the tertiary university hospital in the transformation. International Journal of Integrated Care, 16(2). Web.
Freihat, S. (2020). The role of transformational leadership in reengineering of marketing strategies within organizations. Problems and Perspectives in Management, 18(4), 364–375. Web.
Musa, M. A., & Othman, M. S. (2016). Business Process Reengineering in healthcare: Literature review on the methodologies and approaches. Review of European Studies, 8(1), 20. Web.
Vilasdechanon, S., & Sopadang, A. (2018). Business process reengineering for the saline management in hospitals. 2018 5th International Conference on Industrial Engineering and Applications (ICIEA), 84–88. Web.
Walston, S. (2018). Strategic healthcare management: Planning and execution, second edition. Health Administration Press.