Reengineering the mind, career, system, department.

In 1993, Hammer and Champy inspired many health-care institutions to initiate reengineering projects with their prediction that America's largest corporations would fail if they did not apply the principles of business reengineering. Many of these companies reengineered to simplify their processes but did not achieve radical gains. Who or what is to blame for the failures? Does health care's complexity play a role in these failures? A 1981 study found that health care is more than 2,000% more complex than the standard business. It concluded that "routine" management strategies do not provide a sufficiently comprehensive theory for managing health care's complexity. This article addresses the need to reengineer on four levels--the mind, career, system, and department--to circumvent these complexities. Reengineering on each level enhances the chances for success on the other levels. In today's tumultuous health-care environment, you need to understand your role in reengineering at each level so you can implement it, support it, and live it. If you succeed, you will achieve radical gains, add a valuable tool to your repertoire, enhance your self-confidence, and become a leader in the industry.