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The business process improvement (BPI) literature is replete with advice on how to improve business processes, but what is lacking is a holistic approach that encompasses the most important facets for long-term success—methods to facilitate people, an organizational structure conducive to empowerment, and a systematic method for solving problems. The study offers an in-depth examination of the BPI methodology used by Caterpillar. The case details what Caterpillar has done to make BPI work and offers tips to help other organizations overcome obstacles to BPI success. A theoretical model is developed that offers a conceptual view of holistic BPI.

Rising health care costs and customer dissatisfaction with services has prompted many hospital administrators to begin scrutinizing their operations. The initial challenge for administrators is to identify the critical processes of the hospital. Since the main purpose of a hospital is to improve the health of its patients, one of its core processes involves the procedures of the operating room (OR). Focusing on OR processes should prove to be one important lever for improving the overall quality of hospital services.