How to Salvage a Useful Process That Isn’t Working Anymore

Inside Singapore General Hospital’s successful effort to redesign and reimplement a longstanding surgical checklist.

July 05, 2024

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It is a familiar story in health care and many other settings: the performance of an innovative process deteriorates over time. Instead of automatically discarding it, organizations should understand the causes. They may then decide to redesign and reimplement the process. Using the reimplementation of a surgical checklist at Singapore General Hospital as an example, this article explains how to conduct a reimplementation.

In health care and many other settings, innovation is a relentless pursuit. But what should organizations do when a promising innovative process fails to live up to expectations or a once-fresh innovation languishes over the years and eventually loses its effectiveness?

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Rachel Moyal-Smith is an implementation scientist and health systems researcher at Ariadne Labs, a joint center for health systems innovation at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital.

Kaisin Yee manages health systems strengthening and innovation strategy at SingHealth Duke-NUS Global Health Institute and Singapore’s MOH Office for Healthcare Transformation.

Mary Brindle, MD, is the director of the safe surgery and safe systems program at Ariadne Labs, a joint center for health systems innovation at Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital. She is also a pediatric surgeon at Alberta Children’s Hospital and a professor of surgery and community health sciences at the University of Calgary’s Cumming School of Medicine.

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