Early Risers in Healthcare!
I always thought manufacturing people were early risers. In my last manufacturing job, the factory started production at 5 AM and I started most days at 6:30 AM (I was an internal lean consultant). I sometimes surprised the teams by showing up at 5 AM (much earlier than their supervisors, which is a whole different blog posting).
Tuesday, I'm starting a lean assessment with a hospital laboratory. They are a 24/7 operation by nature, but their first shift phlebotomists (people who draw blood from patients) start arriving at 3 AM and the peak is between 4 and 5 AM, hence I'll have to arrive at 4 AM to follow the "activity of the product."
I'm going to ask tomorrow, as I always do, "Why is it necessary to wake up sick patients at 4 AM? Is this really best for them as patients?" I'll try to report back the answer tomorrow night if I'm not too tired after my early start. I know the typical answers and I'll let you speculate on those reasons here, if you like (click comments), but I'll report something back tomorrow.
At the least, this is the furthest thing from "level loading" the lab. At worst, it's poor "customer service" (and patient satisfaction studies generally show complaints from early blood draws). Many hospitals are attempting to level load the blood draws to benefit both the lab and the patient.
Labels: Healthcare
by Mark Graban - Permalink
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Looking ofrward to your next post. I'm making this same transition myself just now. Watch for couriers and batching from satellite hospitals / physician practices!
You may find the reason is that Doctors want the information when THEY come to work. My observation is that the health care system is optimized around doctor time, not patient well being or patient time. Patients are inventory. Patients wait for doctors, doctors don't wait for patients. Be interested if you find that this is true or not.
Yes, the most common reason given is the MD's. MD's want their test results by morning rounds, usually by 7 AM or 8 AM, so they can check on patients and get out (the MD's) of the hospital ASAP to go back to their private practice office. Hospitals are not just competing for patients, they are competing for doc's. Hospital admin will claim "if we don't provide the test results by 7 AM, they'll go and take their business to a hospital who will."
The challenge is to reduce Turnaround Times (Cycle Time) to do the tests as late as possible to maybe wake patients later. But, it still doesn't address the lack of level loading unless you wake patients all night long and spread out the tests. Then, there's an issue of whether or not the docs/patients need "fresh" test results or if the lab needs "fresh" samples for testing.
A complex system, but one worth fixing.
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