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TB Fanatic
Story on Poor Choice Of Tools To Increase Productivity
A tool chosen by IT to increase productivity should reflect a decrease in the amount of time necessary to do a given task. When poorly implemented it can often represent a tenfold increase in the amount of time to do a given task.
GOODLUCKMemorialHospital
To:Staff
From:CEO Ashley Whipit
Subject: Hospital Reorganization
Date:December 11, 2007
INTEROFFICE MEMORANDUM
I have wonderful news to share with all Associates. The results of the efficient and cost study is in and we have determine a more efficient and cost-effective method for our business. Effective immediately, we will operate within the constraints of three areas, Admit, Schedule, and Surgery.
The study, led by Imma Kisup determined everything we do falls in these three areas so we are dividing the business into these components. This reorganization provides a methodology to allow us to deliver superior Customer Service, maximize hospital Profits, and minimize the time it takes from admittance to patient check out.
While we haven’t exactly defined what the ASS model means, we know enough to create Silos of expertise to provide the best of class in each group. Silos represent Admitting, Insurance, Scheduling, Pre-Surgery, General Nursing, Surgical Crew, General Physicians, Surgeons, Specialists, Surgical Equipment, Emergency Post-Op care, Janitorial Services, and Supplies and Procurement.
Each department Silo has a 24 hour SLA to ensure a quick trip through this process. I know everyone will adapt and embrace the new model.
The next day.
John Smith checks into GOODLUCKMemorialHospital. Amanda from Admittance using the world class System Centric tracking tool submits a request for an Insurance Specialist. John is told to go back to the waiting room and he will be called. Twenty-four hours later System Centric issues an alert to Amanda notifying her that the Insurance Specialist Group has not gotten back with her. Amanda leans her head over the cube wall separating her and the Admitting Department. “Irene, why haven’t you responded to the SC ticket? There’s a guy in the waiting room that has been there a long time.”
Irene looks up from filing her nails. “I was on vacation yesterday and the twenty-four hours does not start until I open the System Centric ticket.”
“It won’t be long now.” Amanda calls out in John Smith’s general direction. She notices he looks a little pale and is sweating. Modeling the new Superior Customer Service model she asks him “Can I get you anything, a cola or something?” He didn’t respond so she figures he is ok.
Irene finished catching up Susan from Scheduling about what she did on her day off. Looking at her watch Irene notices it’s close to lunch time. Irene and Susan go to lunch.
They take a half hour more rationalizing that they deserve a little extra time since they are working so hard at providing Superior Customer Service. Irene returns and calls for John Smith. When no one responds after the third call she almost closed the ticket but she remembered to go the extra mile. Walking out to the waiting room she calls one more time. A man struggled to lift his head, his eyes crossed but he responds in a raspy voice “I’m John Smith.”
Irene says excellent, if you’ll just walk this way. John rolls off the chair to his knees. He grasps the arms of the chair with one hand to pull up. His other hand is place over his stomach. Groaning, he follows her to the chair while she goes around to the other side of the desk in the Insurance Department cube.
“Now then, may I have your Insurance Card.?”
John retrieves his wallet and extracts his insurance card handing it to her with a trembling hand. Irene takes the card and says “I’ll be right back.” She goes through a door behind the cubical areas and hands the card to Carla, the copy girl.
“Carla, I need this STAT.”
Carla says “I’ll get to it as fast as I can; I had to open a ticket with the copier service folks to come and get the machine fixed.”
Irene returns to her desk shaking her head. “I’m not supposed to continue until the card has been copied but you poor thing, you’ve waited long enough.” She picks up the phone and calls HeartFord, the Insurance Company to verify John’s coverage.
John put’s his head on her desk with a groan while Irene spends the next half hour navigating the various voice options HeartFord company recently implemented to improve Customer Service. Irene finally talked to a real person and determined that John indeed did have coverage.
“Okay, you’re all set to go Mr. Smith. I’ll notify scheduling.”
John lifted his head from her desk and mumbled something unintelligible and hobbled back to the waiting room, doubled over.
Irene brought up the S.C. and created a ticket for the schedule group. Satisfied she’d performed her job, she and Susan resumed their conversation. Forty-five minutes went by when Susan exclaimed “Oh, I’ve got a ticket. I’d better see what it is.”
“That’s from me. I just verified a patient’s Insurance information so he’s good to go on.”
Susan and Irene spent another ten minutes wrapping up their conversation and Susan brought the S.C. ticket up. Since the Doctor’s availability was not part of the scheduling department Susan had to send this SC Ticket to the Emergency Room surgeon that would operate on John. She depressed the Enter key and the ticket electronically flew to the Inbox for the ER Surgeons. Luckily, this was a group mailbox and not dependent on a single individual. Almost immediately a response came back that all the Surgeons were tied up for the next two hours.
Susan replied back “I didn’t know there were that many surgeries today.”
Their reply informed her “We don’t, the Doctor’s are trying to get caught up with their System Centric Tickets before they can continue.”
Susan smiled knowingly and went on break.
She sat down and reviewed her monitor. “Mr. Smith.” When no one came she remembered from early that he did not respond too fast. She walked over to the chair to find Mr. Smith slumped over. She shook his shoulder. “Mr. Smith, Mr. Smith, we can take you to the Pre-Surgery room now.
Mr. Smith made a feeble attempt to rise but could not manage it.
“You sit right there, I’ll get someone to help.”
Susan went back to her desk and created a SC Ticket for an orderly to wheel a gurney over to the semi-conscious patient and take him to the pre-op room.
An hour later two orderlies placed the near comatose Mr. Smith on the mobile bed on wheels and took him to the room outside the surgery center. The screening attendant, Priscilla, wanted to go over the required consent forms he would have to sign but the system just tanked and she had to wait to get back into the System Centric program to acknowledge the transfer. The system came back after a half hour and Priscilla clicked the transfer button and took her clipboard over to the gurney.
“Mr. Smith. Mr. Smith.”
“Ohhhhhh.”
“I have some forms for you to sign sir.”
“Huh, what, where am I?”
“Silly, you’re about to go into surgery but first I have to get you to sign these.”
His eyes rolled back and forth a few times and he slowly opened his eyes. After blinking a few times he focused somewhat on the clipboard.
“I’ll read this consent forms to you and then you can sign them.”
Without waiting for a reply, Prissy, that’s what her friends called her, started reading the obligatory form ending with “I, patient, that’s you by the way, hereby release GoodLuckMemorialHospital, all Doctors and Nurses, Administrative personnel, and anyone else associated from any and all liability.”
“This form is the standard disclaimer, nothing to worry about.”
“I, patient, that’s you.” She giggled. “Understand that any medical procedure such as surgery could include the following risks: Infections, boils, lesions, swelling, itching, vomiting, diarrhea, impotence, internal bleeding, other complications and/or death. Do you understand what I’ve read to you Mr. Smith?”
The prone patient looked from side to side as if confused. He groaned then Prissy said “Allrighty then, if you’ll just sign here and here.”
Placing a pen in his hand and holding the clipboard up for him she managed to obtain a squiggly line on one of the forms and more or less a straight line on the other.
Obligations satisfied she entered the appropriate information and notified the Surgical Nurses with a ticket. Thirty minutes later the nurses registered his vital signs into the system and transferred the ticket to the anesthesiologist, Neal. He notified them he’d just finished eight hours of surgery and now had to update the information collected by the System Centric application and that he’d be about an hour.
Three hours later Neal looked down at the patient as he added some medicine to the IV. “He doesn’t look so well.” He commented to no one in particular.
The lead surgical nurse, Nancy, snorted behind her mask. “No shit that’s why he’s here.”
The entire medical team indicated their readiness. Nancy nodded to an administrative type sitting by a computer through the window who duly entered the SC info.
“We’re ready Doctor Bombay.”
“Thank you Nancy.” emanated a voice from a speaker with a visual on the monitor above the operating table. “Dr. Isaac, are you ready?”
“Yes Dr.Bombay.”
“Good, could you be so kind as to position the camera downward a little. Yes, that is good, thank you.”
“The reception from India is pretty good today.” Nancy said.
“Yes, Yes, very good. Now Dr. Isaac, have you ever performed this surgery before.”
Dr. Isaac shook his head and then remembered the lead surgeon directed the operation from India. “No, I’ve watched it done several times but not since we outsourced to you guys.”
“Okay, let’s start.” The sound of a page turning crackled from the speaker. “Step one. Insert the scalpel …..”
A tool chosen by IT to increase productivity should reflect a decrease in the amount of time necessary to do a given task. When poorly implemented it can often represent a tenfold increase in the amount of time to do a given task.
GOODLUCKMemorialHospital
To:Staff
From:CEO Ashley Whipit
Subject: Hospital Reorganization
Date:December 11, 2007
INTEROFFICE MEMORANDUM
I have wonderful news to share with all Associates. The results of the efficient and cost study is in and we have determine a more efficient and cost-effective method for our business. Effective immediately, we will operate within the constraints of three areas, Admit, Schedule, and Surgery.
The study, led by Imma Kisup determined everything we do falls in these three areas so we are dividing the business into these components. This reorganization provides a methodology to allow us to deliver superior Customer Service, maximize hospital Profits, and minimize the time it takes from admittance to patient check out.
While we haven’t exactly defined what the ASS model means, we know enough to create Silos of expertise to provide the best of class in each group. Silos represent Admitting, Insurance, Scheduling, Pre-Surgery, General Nursing, Surgical Crew, General Physicians, Surgeons, Specialists, Surgical Equipment, Emergency Post-Op care, Janitorial Services, and Supplies and Procurement.
Each department Silo has a 24 hour SLA to ensure a quick trip through this process. I know everyone will adapt and embrace the new model.
The next day.
John Smith checks into GOODLUCKMemorialHospital. Amanda from Admittance using the world class System Centric tracking tool submits a request for an Insurance Specialist. John is told to go back to the waiting room and he will be called. Twenty-four hours later System Centric issues an alert to Amanda notifying her that the Insurance Specialist Group has not gotten back with her. Amanda leans her head over the cube wall separating her and the Admitting Department. “Irene, why haven’t you responded to the SC ticket? There’s a guy in the waiting room that has been there a long time.”
Irene looks up from filing her nails. “I was on vacation yesterday and the twenty-four hours does not start until I open the System Centric ticket.”
“It won’t be long now.” Amanda calls out in John Smith’s general direction. She notices he looks a little pale and is sweating. Modeling the new Superior Customer Service model she asks him “Can I get you anything, a cola or something?” He didn’t respond so she figures he is ok.
Irene finished catching up Susan from Scheduling about what she did on her day off. Looking at her watch Irene notices it’s close to lunch time. Irene and Susan go to lunch.
They take a half hour more rationalizing that they deserve a little extra time since they are working so hard at providing Superior Customer Service. Irene returns and calls for John Smith. When no one responds after the third call she almost closed the ticket but she remembered to go the extra mile. Walking out to the waiting room she calls one more time. A man struggled to lift his head, his eyes crossed but he responds in a raspy voice “I’m John Smith.”
Irene says excellent, if you’ll just walk this way. John rolls off the chair to his knees. He grasps the arms of the chair with one hand to pull up. His other hand is place over his stomach. Groaning, he follows her to the chair while she goes around to the other side of the desk in the Insurance Department cube.
“Now then, may I have your Insurance Card.?”
John retrieves his wallet and extracts his insurance card handing it to her with a trembling hand. Irene takes the card and says “I’ll be right back.” She goes through a door behind the cubical areas and hands the card to Carla, the copy girl.
“Carla, I need this STAT.”
Carla says “I’ll get to it as fast as I can; I had to open a ticket with the copier service folks to come and get the machine fixed.”
Irene returns to her desk shaking her head. “I’m not supposed to continue until the card has been copied but you poor thing, you’ve waited long enough.” She picks up the phone and calls HeartFord, the Insurance Company to verify John’s coverage.
John put’s his head on her desk with a groan while Irene spends the next half hour navigating the various voice options HeartFord company recently implemented to improve Customer Service. Irene finally talked to a real person and determined that John indeed did have coverage.
“Okay, you’re all set to go Mr. Smith. I’ll notify scheduling.”
John lifted his head from her desk and mumbled something unintelligible and hobbled back to the waiting room, doubled over.
Irene brought up the S.C. and created a ticket for the schedule group. Satisfied she’d performed her job, she and Susan resumed their conversation. Forty-five minutes went by when Susan exclaimed “Oh, I’ve got a ticket. I’d better see what it is.”
“That’s from me. I just verified a patient’s Insurance information so he’s good to go on.”
Susan and Irene spent another ten minutes wrapping up their conversation and Susan brought the S.C. ticket up. Since the Doctor’s availability was not part of the scheduling department Susan had to send this SC Ticket to the Emergency Room surgeon that would operate on John. She depressed the Enter key and the ticket electronically flew to the Inbox for the ER Surgeons. Luckily, this was a group mailbox and not dependent on a single individual. Almost immediately a response came back that all the Surgeons were tied up for the next two hours.
Susan replied back “I didn’t know there were that many surgeries today.”
Their reply informed her “We don’t, the Doctor’s are trying to get caught up with their System Centric Tickets before they can continue.”
Susan smiled knowingly and went on break.
She sat down and reviewed her monitor. “Mr. Smith.” When no one came she remembered from early that he did not respond too fast. She walked over to the chair to find Mr. Smith slumped over. She shook his shoulder. “Mr. Smith, Mr. Smith, we can take you to the Pre-Surgery room now.
Mr. Smith made a feeble attempt to rise but could not manage it.
“You sit right there, I’ll get someone to help.”
Susan went back to her desk and created a SC Ticket for an orderly to wheel a gurney over to the semi-conscious patient and take him to the pre-op room.
An hour later two orderlies placed the near comatose Mr. Smith on the mobile bed on wheels and took him to the room outside the surgery center. The screening attendant, Priscilla, wanted to go over the required consent forms he would have to sign but the system just tanked and she had to wait to get back into the System Centric program to acknowledge the transfer. The system came back after a half hour and Priscilla clicked the transfer button and took her clipboard over to the gurney.
“Mr. Smith. Mr. Smith.”
“Ohhhhhh.”
“I have some forms for you to sign sir.”
“Huh, what, where am I?”
“Silly, you’re about to go into surgery but first I have to get you to sign these.”
His eyes rolled back and forth a few times and he slowly opened his eyes. After blinking a few times he focused somewhat on the clipboard.
“I’ll read this consent forms to you and then you can sign them.”
Without waiting for a reply, Prissy, that’s what her friends called her, started reading the obligatory form ending with “I, patient, that’s you by the way, hereby release GoodLuckMemorialHospital, all Doctors and Nurses, Administrative personnel, and anyone else associated from any and all liability.”
“This form is the standard disclaimer, nothing to worry about.”
“I, patient, that’s you.” She giggled. “Understand that any medical procedure such as surgery could include the following risks: Infections, boils, lesions, swelling, itching, vomiting, diarrhea, impotence, internal bleeding, other complications and/or death. Do you understand what I’ve read to you Mr. Smith?”
The prone patient looked from side to side as if confused. He groaned then Prissy said “Allrighty then, if you’ll just sign here and here.”
Placing a pen in his hand and holding the clipboard up for him she managed to obtain a squiggly line on one of the forms and more or less a straight line on the other.
Obligations satisfied she entered the appropriate information and notified the Surgical Nurses with a ticket. Thirty minutes later the nurses registered his vital signs into the system and transferred the ticket to the anesthesiologist, Neal. He notified them he’d just finished eight hours of surgery and now had to update the information collected by the System Centric application and that he’d be about an hour.
Three hours later Neal looked down at the patient as he added some medicine to the IV. “He doesn’t look so well.” He commented to no one in particular.
The lead surgical nurse, Nancy, snorted behind her mask. “No shit that’s why he’s here.”
The entire medical team indicated their readiness. Nancy nodded to an administrative type sitting by a computer through the window who duly entered the SC info.
“We’re ready Doctor Bombay.”
“Thank you Nancy.” emanated a voice from a speaker with a visual on the monitor above the operating table. “Dr. Isaac, are you ready?”
“Yes Dr.Bombay.”
“Good, could you be so kind as to position the camera downward a little. Yes, that is good, thank you.”
“The reception from India is pretty good today.” Nancy said.
“Yes, Yes, very good. Now Dr. Isaac, have you ever performed this surgery before.”
Dr. Isaac shook his head and then remembered the lead surgeon directed the operation from India. “No, I’ve watched it done several times but not since we outsourced to you guys.”
“Okay, let’s start.” The sound of a page turning crackled from the speaker. “Step one. Insert the scalpel …..”
