To the Editor: I note, with a breath of fresh air, your recent column about managing hospital staff rosters1 and, in the same issue, the article by Dietz, calling for a simpler, more resilient health bureaucracy.2

We are stuck in an environment where process seems to be disassociated from outcome and, if the outcome is not what is wanted, then more process is added, thus compounding the problem.

Surely it is time to step back a bit and look strategically at bureaucratic processes, and how they work and don’t work? No one would deny that we need good administration — it is one of the very bastions of our way of life.

We seem to study most things in an evidence-based manner, or at least try to. Why can’t we have chairs of bureaucratic studies in our universities to rigorously research our bureaucratic processes? Armed with sound evidence, we could develop template systems and other tools to break the nexus in which we find ourselves.

Dare I say the spin-off would be greater than just health care.

Food for thought.