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For the exclusive use of R. JAFRIN
Harvard Business School

Rev. April 9, 2001

Montefiore Medical Center
I did not want to spend my life reducing head count. I had to make some major changes to have Montefiore grow and become more customer-focused. Elaine Brennan was remarking on the challenges she faced in 1996 as the newly-appointed senior vice president of operations at the Acute Care Division of Montefiore Medical Center. The Center, the result of a merger of a large urban teaching hospital with a small university hospital, had a $57 million annual budget deficit and operated within strong functional silos. It was the largest provider of medical care to the 1.2 million residents of the Bronx, 65% of whom were Hispanic and African-American. The borough had become a national symbol of urban decay, with deteriorating tenements, and high rates of unemployment, addiction, poverty and disease. Montefiore’s patients came from all the ethnic groups of the Bronx, and included more Medicare patients than any other US institution.

The Montefiore Home for Chronic Invalids was dedicated on the morning of October 26, th
1884, to honor the 100 birthday of Sir Moses Montefiore, a Jewish leader and philanthropist. The Home cared for the chronically ill patients that other hospitals could not help—patients with tuberculosis, syphilis, “the opium habit,” arthritis, and chronic kidney disease. The Home grew larger and moved from Manhattan’s Upper East Side to Harlem, and then finally to the Bronx. Some of the best doctors in the city donated their time for patient care, teaching and research, and Montefiore soon became known for its commitment to social service and scientific progress through innovative health care, information and discoveries.

In a separate development, Yeshiva University sponsored the creation of The Albert Einstein College of Medicine2 in the Bronx in 1955. Einstein quickly became a highly successful medical school. In...
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