title: Using business process redesign to reduce wait times at a university hospital in the Netherlands.
abstract: BACKGROUND
  Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in Amsterdam.
  
  
  METHODS
  The BPR consisted of process analysis, identification of bottlenecks and goals for redesign, selection of interventions, and evaluation of effects. After identifying and selecting interventions with the greatest expected benefits, changes were implemented and effects were evaluated.
  
  
  RESULTS
  For gynecologic oncology patients, access time (from telephone call to first visit) was reduced from 14 days to < 7 days, and the proportion of patients who completed all diagnostic examinations within 14 days increased from 49% to 83%. For dyspnea patients, access time was reduced to < 6 days, and the number of visits was halved.
  
  
  CONCLUSIONS
  Despite the fact that we applied the same approach in these two projects, the interventions turned out to be quite different. Whereas changes in communication and planning were sufficient to eliminate bottlenecks in the gynecologic oncology project, the dyspnea project required a radical redesign of processes. Experience since these projects suggests that process redesign may have only marginal impact when the greatest bottleneck occurs, as was the case for the two BPR projects, at the point of access to central diagnostic facilities.
authors.affiliation: Department of Innovation and Process Management, Academic Medical Center, University of Amsterdam. s.g.elkhuizen@amc.uva.nl
authors.forename: Sylvia G
authors.initials: SG
authors.lastname: Elkhuizen
authors.forename: Matthe P M
authors.initials: MP
authors.lastname: Burger
authors.forename: Rene E
authors.initials: RE
authors.lastname: Jonkers
authors.forename: Martien
authors.initials: M
authors.lastname: Limburg
authors.forename: Niek
authors.initials: N
authors.lastname: Klazinga
authors.forename: Piet J M
authors.initials: PJ
authors.lastname: Bakker
mesh_terms: D017598:Efficiency, Organizational; D005260:Female; D006739:Hospital Administration / Q000379:methods*; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration; D009426:Netherlands; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration; D016522:Oncology Service, Hospital / Q000458:organization & administration; D010346:Patient Care Management / Q000458:organization & administration*; D010865:Pilot Projects; D012139:Respiratory Therapy Department, Hospital / Q000458:organization & administration; D014850:Waiting Lists