Managing variation through system redesign

Previous studies of reengineering in healthcare have identified a lack of process standardisation and inherent process variability as barriers to successful redesign. Some regard healthcare as unsuitable for a process redesign approach. The pilot studies and longitudinal case study presented here demonstrate that process stability can be achieved using a reengineering approach and that this can help reduce patient journey times and the variation in flow times. Furthermore, a cellular approach to process streaming did not create process stability at the expense of system flexibility. The process-based view that was introduced by the redesign activity was seen to be extremely valuable because of the way in which it helped to define patient flows.