Business Process Reengineering in Indonesian Public Hospitals: A Multiple Case Study
DOI:
https://doi.org/10.47747/jbme.v7i2.3582Keywords:
business process reengineering, qualitative case study, hospital management, change management, IndonesiaAbstract
Business Process Reengineering (BPR) represents a radical and fundamental strategy for improving organizational performance in healthcare settings, yet its implementation dynamics in Indonesian public hospitals remain insufficiently understood. This study employs a qualitative multiple case study design to explore how BPR is implemented across three Type B public hospitals in Indonesia, referred to pseudonymously as RS Alpha, RS Beta, and RS Gamma. Data were collected through 27 in-depth interviews with hospital directors, clinical department heads, administrative managers, and frontline healthcare staff, supplemented by document analysis and non-participant observation conducted over a six-month period. Thematic analysis following Braun and Clarke (2006) revealed four overarching themes: (1) enabling conditions for BPR adoption, (2) process redesign and IT integration challenges, (3) human resource dimensions of BPR implementation, and (4) organizational outcomes and sustainability of reengineered processes. Findings indicate that leadership commitment and change management capacity are pivotal determinants of BPR success, while resistance from clinical staff, inadequate IT infrastructure, and bureaucratic rigidity constitute the primary barriers. Cross-case comparison reveals that hospitals with stronger human resource development programs achieved more sustainable process improvements. The study contributes an empirically grounded, context-sensitive understanding of BPR in Indonesia's public health sector, with implications for hospital management and health system reform policy
References
Al-Mashari, M., & Zairi, M. (1999). BPR implementation process: an analysis of key success and failure factors. Business Process Management Journal, 5(1), 87-112. https://doi.org/10.1108/14637159910249108
Barney, J. (1991). Firm resources and sustained competitive advantage. Journal of Management, 17(1), 99-120. https://doi.org/10.1177/014920639101700108
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Creswell, J. W., & Poth, C. N. (2018). Qualitative Inquiry and Research Design: Choosing Among Five Approaches (4th ed.). SAGE Publications.
Davenport, T. H. (1993). Process Innovation: Reengineering Work through Information Technology. Harvard Business School Press.
DiMaggio, P. J., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48(2), 147-160. https://doi.org/10.2307/2095101
Efawati, Y., Rachman, A., Andriani, R., & Veranita, M. (2025). Digital transformation and organizational resilience: The mediating role of digital literacy. International Journal Administration Business and Organization, 6(1), 1-12.
Hammer, M. (1990). Reengineering work: Don't automate, obliterate. Harvard Business Review, 68(4), 104-112.
Hammer, M., & Champy, J. (1993). Reengineering the Corporation: A Manifesto for Business Revolution. HarperBusiness.
Hammer, M., & Stanton, S. A. (1995). The Reengineering Revolution. HarperCollins.
Heskett, J. L., Jones, T. O., Loveman, G. W., Sasser, W. E., & Schlesinger, L. A. (1994). Putting the service-profit chain to work. Harvard Business Review, 72(2), 164-174
Kemenkes RI. (2022). Profil Kesehatan Indonesia 2022. Kementerian Kesehatan Republik Indonesia.
Kotter, J. P. (1996). Leading Change. Harvard Business School Press.
Kusharini, O. Y., Praniti, S. D., Martal, L. F., & Veranita, M. (2024). Analisa implementasi business process reengineering: Study literature review. Journal of Economic Business and Accounting (COSTING), 8(1), 1-12. https://doi.org/10.31539/costing.v8i1.9821
Locock, L. (2003). Healthcare redesign: meaning, origins and application. Quality and Safety in Health Care, 12(1), 53-57. https://doi.org/10.1136/qhc.12.1.53
Miles, M. B., Huberman, A. M., & Saldana, J. (2014). Qualitative Data Analysis: A Methods Sourcebook (3rd ed.). SAGE Publications
Nazaria, R., Wijaya, I. M. S., Pranudia, A. D., & Veranita, M. (2024). Business process reengineering in hospitals: A literature review of related methodologies and approaches. RADINKA Journal of Science and Systematic Literature Review, 2(2), 134-145.
Rahayu, P. N. A., Purwadhi, P., & Veranita, M. (2025). Strategi optimalisasi klaim JKN di Rumah Sakit Umum Daerah Kota Bandung. Jurnal Sosial Teknologi, 5(1), 1-14.
Teng, C. I., Chang, S. S., & Hsu, K. H. (2020). IT-enabled process innovation in hospitals: A multi-hospital investigation. Journal of Medical Systems, 44(8), 1-10. https://doi.org/10.1007/s10916-020-01594-5
Veranita, M., & Purwanto, B. H. (2023). Implementation of business process reengineering (BPR) in courier business services to improve the quality of public services. Jurnal Manajemen Pelayanan Publik, 6(2), 1-15.
Walston, S. L., & Kimberly, J. R. (1997). Reengineering hospitals: Evidence from the field. Journal of Healthcare Management, 42(2), 143-159.
Yin, R. K. (2018). Case Study Research and Applications: Design and Methods (6th ed.). SAGE Publications.
Zairi, M., & Sinclair, D. (1995). Business process re-engineering and process management: A survey of current practice and future trends in integrated management. Business Process Management Journal, 1(1), 8-30. https://doi.org/10.1108/14637159510798248
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Copyright (c) 2026 Guruh Satriya, Mei Vita Ariyani, Melina Budiarti, Mira Veranita

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