Your editorial on the effectiveness of re-engineering (May 15, p. 33) is right on the money.
The major problem with re-engineering is implementation. True re-engineering leads to fundamental changes in the way an organization functions at all levels, including management. If the management structure does not change, including what the CEO does and how he or she does it, then re-engineering is something that management does to the organization. The staff can see right through that disguise. Re-engineering becomes synonymous with downsizing.
There is another approach growing in industries outside of healthcare that's producing dramatic results in service and profitability. It's called open-book management. The approach offers the only certain way to put management and staff in pursuit of the same goals. It is a radical departure for management and staff, but it's not rocket science. You teach your staff to be businesspeople, share all information with them, and share the rewards as well.
Staffs of healthcare organizations are some of the most educated in any industry, yet they are generally treated like mushrooms. We often underexpect from our people. We don't think they can handle too much change at any one time. Management complains staff members don't understand the market today and what must be done to survive. The main reason for this is simply that the staff doesn't know much about the business of healthcare and what the results need to be only because management hasn't taught them.
This goes way beyond creating a budget. It is truly making staff and management responsible for the organization's success. Open-book management can unleash the creative talents that abound in organizations to produce great performances for customers.
Management's challenge is to let it happen.
Principal, Paradigm Solutions