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Accelerating environmental turbulence in the health care industry has led to a significant interest in strategic management and work redesign. This paper examines different types of generic hospital strategies and alternative approaches to work redesign, and proposes a contingency framework consisting of these two important organizational elements for improved hospital effectiveness.

As management innovations become more complex, infrastructure needs to change in order to accommodate new work practices. Different challenges are associated with work practice redesign and infrastructure change however; combining these presents a dual challenge and additional challenges associated with this interaction. The purpose of this paper is to ask: what are the challenges which arise from work practice redesign, infrastructure change and simultaneously attempting both in a single transformation?

The authors present a longitudinal study of three hospitals in three different countries (UK, USA and Canada) transforming both their infrastructure and work practices. Data consists of 155 ethnographic interviews complemented by 205 documents and 36 hours of observations collected over two phases for each case study.

This paper identifies that work practice redesign challenges the cognitive load of organizational members whilst infrastructure change challenges the project management and structure of the organization. Simultaneous transformation represents a disconnect between the two aspects of change resulting in a failure to understand the relationship between work and design.

These challenges suggest that organizations need to make a distinction between the two aspects of transformation and understand the unique tensions of simultaneously tackling these dual challenges. They must ensure that they have adequate skills and resources with which to build this distinction into their change planning.

This paper unpacks two different aspects of complex change and considers the neglected challenges associated with modern change management objectives.

To examine the introduction of role‐redesign in the NHS and highlight implications for employment relations.

A 12‐month independent evaluation (2003‐2004) of a role redesign initiative in the NHS is reported. The study followed a developmental, case‐study design and included secondary data analysis, semi‐structured interviews and observations at five case‐study sites.

The role redesign process involved four types of change to job content: skill‐mix changes; job widening; job deepening; and development of new roles. Each of these changes had implications for employment relations in terms of remuneration, management and accountability, and education and training.

The research involves one initiative in the NHS and was evaluating a developing programme. Whilst implications are suggested for efforts at role redesign generally the research specifically relates to NHS organisations.

Three aspects of employment relations are identified as important when attempting role redesign: remuneration, management and accountability, and education and training.

This paper offers the first account of this national NHS role redesign initiative.

This research proposes how Design for Six Sigma (DFSS) provides a complementary approach for business process management (BPM) lifecycle implementation in order to address gaps identified in the current literature.

The mandatory elements of a method (MEM) framework is used to illustrate DFSS's maturity as a process redesign method. The use of DFSS in a BPM context is described through several action research case examples.

This research specifies the procedure model (order of development activities), techniques, results, roles and information/meta model (conceptual data model of results) associated with using DFSS to address BPM-related challenges. The action research case examples provided discuss the details of implementing BPM using DFSS to design, implement and test redesigned processes to ensure they fulfill the needs of process participants.

While the case examples discussed were performed in only a few settings, which limits the generalizability of their results, they provide evidence regarding the wide range of domains in which the proposed DFSS-BPM approach can be applied and how the tools are used in different contexts.

This research offers a road map for addressing the challenges practitioners often face with BPM lifecycle implementation.

This research provides the first attempt to integrate DFSS as a complementary method for BPM lifecycle implementation.

This paper investigates the use of process redesign tools and techniques in education. We argue that process thinking is an important strategy for improving education. An adaptation of business process redesign to learning is presented by integrating together concepts from educational theory, computer mediated communication, and business process redesign. Three conventional educational processes ‐ questioning, discussion, and document exchange ‐ are analyzed and redesigned with electronic mail, bulletin board, and World Wide Web technologies. The characteristics of each technology and its potential for process redesign are outlined. The results of an exploratory case study show that learning process redesign is viable and can impact ON educational outcomes. We conclude with suggestions for future research.

The continuous redesign of processes is crucial for companies in times of tough competition and fast‐changing surrounding conditions. Since the manual redesign of processes is a time‐ and resource‐consuming task, automated redesign will increasingly become a useful alternative. Hence, future redesign projects need to be valuated based on both a manual and an automated redesign approach. The purpose of this paper is to compare the manual and automated process redesign on the basis of the Business Process Management (BPM) lifecycle.

In this paper, the authors compare the manual and automated process redesign on the basis of the Business Process Management (BPM) lifecycle. The results form the basis for a mathematical model that outlines the general economic characteristics of process redesign as well as for the manual and automated approaches. Subsequently, the authors exemplarily apply their model to a set of empirical data with respective assumptions on particular aspects of the automated approach.

In the problem setting described in the paper, the valuation model shows that automated process redesign induces an equal or higher number of optimized processes in a company. Therefore, the authors present a decision support that outlines how much to invest in automated process redesign.

The model considers the cost side of automated process redesign; therefore, further research should be conducted to analyze the possibility of higher returns induced by automated redesign (e.g., through a quicker adaption to real‐world changes). Moreover, for automated redesign, there is no requirement for broad empirical data that should be collected and analyzed as soon as this approach leaves the basic research and prototyping stages.

This paper presents an approach that can be used by companies to estimate the upper limit for investments in manual and automated process redesign. Working under certain general assumptions and independently from actual cost and return values, the paper demonstrates that automated process redesign induces an equal or higher ratio of optimized processes. Thus, companies introducing automated redesign cannot only apply the model to evaluate their investments but can also expect a higher ratio of optimized processes for this approach.

As existing literature primarily focuses on the technical aspects of automated process redesign, these findings contribute to the current body of literature. This paper discusses a first decision‐support for the economic aspects of automated process redesign, particularly with regard to the investments that are required for it. This information is relevant as soon as the approach leaves the stage of a prototype.

Business process re‐engineering (BPR) is certainly one of the latest buzzwords and is the subject of great interest and also great controversy. Organizations need to shake themselves out of complacency to close competitive gaps and achieve superior performance standards ‐ the reason why many have embarked on huge BPR projects. In view of the high risks associated with radical change, there are, however, many problems associated with BPR. For some BPR is going off the rails before it is properly understood, and many BPR exercises are not delivering the goods. Sometimes, organizations are expecting “quick fixes”, thus displaying their lack of understanding of a complex system. It is unreasonable to expect quick results when so much change is involved, especially when these business processes involve not only machines, but also people. Many believe, such as Mumford, that the management of change is the largest task in re‐engineering. Many people perceive re‐engineering as a threat to both their methods and their jobs. Owing to this recognition, many authors concentrate on the need to take account of the human side of re‐engineering, in particular the management of organizational change.

This special “Anbar Abstracts” issue of Work Study is split into six sections covering abstracts under the following headings: Operational research and statistics; Project management, method study and work measurement; Business process re‐engineering; Design of work; Performance, productivity and motivation; Stock control and supply chain management.

In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves the use of conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, we discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real world practice settings.

The first aim of this paper is to bring empirical evidence from an atypical organizational setting to the debate surrounding the currency of business process re‐engineering, which some commentators have dismissed as a damaging “fad”. The second aim is to suggest how the process orientation advocated by re‐engineering can facilitate a creative visualization of organizational process and a participative approach to redesign. The paper is based on the experience of an acute teaching hospital seeking to reduce patient delays affecting the work of the operating theatres department. The project began towards the end of 1994, was overseen by a hospital steering committee, was conducted by a small internal project team (with researcher as member), and was based initially on a process mapping exercise. The elective surgical in‐patient process (one of the hospital’s “core processes”), from referral to discharge, was mapped using the knowledge of project team members, interview and survey data from 39 respondents, informal discussions with over 50 other hospital staff, and from a photo‐documentation and photo‐elicitation procedure. Interviews, survey questionnaires, informal discussion and the photo‐elicitation sessions were also used to develop a wide series of recommendations from staff with respect to redesigning the patient process and reducing theatre delays.