This paper reviews the extant literature on TBI care systems, systems reengineering, and emergency leadership literature.
The application of lean thinking and systems reengineering techniques, such as process analysis, risk management, root cause analysis, and value analysis, to the TBI care processes holds the potential for greater efficiencies [56 58].
To provide sustained quality levels of care in the face of diminishing resources and increasing cohorts of patients with TBIs, system transformation through reengineering will become essential.
An effective R&D system is an efficient one, but reengineering the system in the way we know is possible requires support, and with funding at critically low levels, the ripple effects could be devastating.
Lots of systems have tried reengineering with poor results, often because local and national leadership are missing".
Crucially, the savings have been accompanied by a substantial decline in quality – as revealed by treatment waiting time targets – and many of them have been achieved through one-off savings rather than reengineering the system.
Thus, biological photosynthesis should be adapted for new energy applications by reengineering the system based on the key lessons of nature.
"Procter & Gamble was reengineering their manufacturing system to a hub-and-spoke system, and there was no way we could make it work," Harley recalls.
When reengineering software systems, maintainers should be able to assess and compare multiple change scenarios for a given goal, so as to choose the most pertinent one.
As a result, there is increasing interest in migrating and reengineering legacy systems to these new hardware technologies and software development paradigms.
