Limited success is reported from most of the projects of new management philosophy such as Total Quality Management, Business Process Reengineering, Information Technologies, and Continuous Improvement. The reason was attributed to the way these initiatives were structured and implemented. Most of the implementations of these transformational strategies are found to concentrate on process improvement instead of dealing with the interacting subsystems of the organization. Hospitals and health-care organizations require more attention in their transformation efforts to guarantee error free operations, with the highest quality service. In the present case study a new methodology is applied to reform a hospital manamenget system in Cairo Egypt which adopting a total system approach.