Although there are many business process improvement (BPI) methods, organizations are struggling to apply them effectively. We answer to the call to focus more on the organizational context in BPI projects. We use workaroundsdeviations from the prescribed way of using an information systemas a specific angle to approach BPI. In five healthcare organizations of different contextual types, we study workarounds and make recommendations for process improvements. Based on this explorative multiple-case study, we propose a set of contextual activities for each stage of a BPI project. Thereby, we shed light on the differences in tackling process improvements in organizations that differ in size, culture, and the availability of resources for BPI projects. We evaluate the completeness and expected adoption of the proposed contextual BPI activities by organizing two focus groups and conducting a survey.