Improving health care through redesign

The belief that increasing demand for health care will be solved only by increasing capacity remains common in health communities. Yet other industries have developed a greater understanding of demand and capacity and delivered increased productivity while increasing quality. This occurs within an environment that drives cost efficiency by focusing on what customers want and by applying a rigorous approach to systematic business process re-engineering.1 The improvement methods used in different healthcare systems are often similar yet the drivers, approach, and emphasis differ. Initially the focus of improvement programmes in the United Kingdom has been to achieve targets for patients' waiting times and access to services, while in the United States, through the Institute for Healthcare Improvement (IHI), the focus has been on quality with a recent increased emphasis on patient safety.2^–4 The Institute's latest campaign, to prevent 100 000 deaths in US hospitals over 18 months, reaches its first milestone in mid-June, and is described in this issue (p 1328).5 It exemplifies the merging of …