REENGINEERING A CARDIOVASCULAR-SURGERY SERVICE

Background: Reengineering, involving the radical redesign of business processes, has been used successfully in a variety of health care sett ings. In 1994 New York University (NYU) Medical Center (MC) launched i ts first reengineering team, whose purpose was to redesign the entire process of caring for patients-from referral to discharge-on the cardi ovascular (CV) surgery service. Reengineering team: The multidisciplin ary CV Surgery Reengineering Team was charged with two goals: improvin g customer (patient, family, and referring physician) satisfaction and improving profitability. The methodology to be used was based on a re engineering philosophy-discarding basic assumptions and designing the patient care process from the ground up. The transfer-in initiative: A survey of NYU cardiologists, distributed in April 1994, suggested tha t the organization was considered a difficult place to transfer patien ts. The team's recommendations led to a new, streamlined transfer-in p olicy. The average waiting time from when a referring physician reques ted a patient transfer and the time when an NYUMC physician accepted t he transfer decreased from an average of 9 hours under the old system to immediate acceptance: Other initiatives: Three customer satisfactio n task forces implemented multiple programs to make the service more u ser friendly. In addition, referrals increased and length af stay decr eased, without an adverse impact on the mortality rate. Conclusion: Fo r the first time at NYUMC, a multidisciplinary team was given the mand ate to achieve major changes in an entire patient care process. Simila r projects are now underway.