title: Reengineering and infection control programs: commentary and a case study.
abstract: Transformation of the health care system has been an ongoing process for generations, but many changes in the past 2 decades have focused on reducing costs in concert with rapidly changing technologies and demands for high quality care. Many cost-containment efforts in the 1990s are characterized by attempts to apply the business model for "reengineering the corporation" to health care systems. This commentary reviews principles of reengineering and how strategies to reduce costs through market forces, competition, and downsizing can result in substantial problems for bureaucratic organizations unaccustomed to rapid change and innovation. A case study drawn from experiences of a large metropolitan academic health care system is presented, with specific focus on lessons that will be helpful to infection control professionals (ICPs) confronted with similar situations.
authors.affiliation: Department of Nursing Research and Education and the Epidemiology Unit, University of California San Diego Medical Center, San Diego, CA 92103-8929, USA.
authors.forename: M
authors.initials: M
authors.lastname: Jackson
authors.forename: R M
authors.initials: RM
authors.lastname: Massanari
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D003363:Cost Control; D004465:Economic Competition; D019981:Health Care Sector / Q000458:organization & administration; D006754:Hospital Restructuring / Q000458:organization & administration*; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D015146:Midwestern United States; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D020415:Personnel Downsizing / Q000458:organization & administration; D011057:Politics