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

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

Richard Drury/Getty Images



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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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  • New!


    HBR Learning

    Process Improvement Course

    Accelerate your career with Harvard ManageMentor®. HBR Learning’s online leadership training helps you hone your skills with courses like Process Improvement. Earn badges to share on LinkedIn and your resume. Access more than 40 courses trusted by Fortune 500 companies.

    How to get things done—better.

    Read More

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