Skip to main content

Using Business Process Redesign to Reduce Wait Times at a University Hospital in the Netherlands

Buy Article:

$12.00 plus tax (Refund Policy)


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.

Discussion: 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.

Document Type: Research Article

Publication date: 2007-06-01

More about this publication?
  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect ( For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit for more information. All other readers, please visit to subscribe to the journal or to claim your access for an existing subscription.
  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • Information for Advertisers
  • Reprints and Permissions
  • Index
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more