Abstract
This paper is concerned with the organizational change and project management issues raised by the implementation of a business process re-engineering (BPR) approach in the politicized hospital context. This is a report of research in progress, focusing on the issues arising at the problem definition and project planning stages of a BPR application in an operating theaters department experiencing problems with scheduling and delays. The research design relies on a case study approach, with the researcher as participant observer, as both an adviser to the project team and as field interviewer. The paper argues that an ambitious BPR agenda is compromised in at least two regards. First, the lack of precision surrounding the focus and methodology of BPR gives politically motivated actors considerable influence with respect to defining terms of reference in ways which will shape potential outcomes in their favor. Second, the complexity and indeterminacy of the business process or "patient trail" can also dilute redesign attempts. The principal limitations of the approach thus concern the impracticality of embarking on rapid and radical change working from a "blank sheet of paper" with respect to organizational and job design. BPR, unlike other organization development interventions, is not a "context sensitive" approach. The role of project manager is critical in establishing a working balance between individual, occupational, and organizational goals in a manner perceived to be legitimate in the context. Effective BPR project management thus requires a combination of political and process analysis skills. The principal opportunities of BPR derive from its process orientation, which brings a fresh perspective to a traditionally and functionally fragmented organizational setting, and which presents a potentially valuable platform for an evolutionary approach to process improvement.