Public hospitals in Botswana are faced with many challenges. Amongst them are long queues and long waiting time at the outpatients clinics. Long queues and waiting time are a result of uncoordinated internal processes. In order to address the long queues and patient waiting time, the management of one hospital introduced Business Process Reengineering (BPR). The implementation of BPR resulted in improvement as service level was at about ~87%. The change in top level of the management at the hospital led to regression of some of the gains that the hospital had experienced. The key factors which drive BPR success are top management and coherent understanding of the urgency of the situation. The purpose of this paper is to identify the causes of BPR failure and proposals of new interventions to address the problems. Failure factors which have been identified include organizational resistance, lack of organizational readiness to change, lack of training and education, problems related to commitment support and leadership, problems related to championship, problems related to integration mechanism, jobs’ definition and responsibilities allocation, problems related to BPR resources, and ineffective use of consultants. . In conclusion it has been observed that the institution prematurely declared the success of BPR even before change became part of the institution’s culture. This is reflected by the action taken by the current top management as it does not seem to personify the change effort. It is recommended that the top management get the employee buy-in and ownership; appoint and empower a champion; engage supervisors in the re-engineered departments to work with the champion; appoint a BPR team, train them and then make the team to benchmark with other public sector organizations; secure resources for BPR.