It’s been discussed here before, how hospitals are just as susceptible as manufacturers are to the “Siren Song” of technology. This time, it appears Parkland Hospital (here in Dallas) is presenting with such symptoms…
You might know Parkland as the historic hospital JFK was taken to after being shot in Dealey Plaza. It’s still open as the large county hospital for Dallas County. I presume they have long waits for ER treatment, as is common in hospitals. Many hospitals are taking the “Lean” approach to reducing waiting times in the ER. Strategies I’ve heard recently about include:
- Changing the “triage” process so patients are seen immediately by an MD — providing more accurate assessment than an RN could with the added benefit of reducing the need for a patient to repeat the same story to multiple people.
- Separating the ER into two separate “value streams” or “patient pathways” — patients who will be treated and sent home versus those patients who are likely to be admitted. A hospital in Australia implemented such a process and started seeing patients in each stream in a “FIFO” (first-in-first-out) process that cleared up delays immediately.
The Lean hospitals are fundamentally rethinking the process, not just automating parts of the process. Parkland went the technology route:
Parkland Health & Hospital System, based in Dallas, recently launched self-service check-in kiosks in the emergency room to speed the delivery of care and streamline registration processes. The technology, called MediKiosk, is provided by Galvanon, a subsidiary of NCR Corporation (NYSE:NCR).
So, basically, you have the “option” of pushing buttons on a glorified ATM machine? This is considered an advancement in healthcare? I’d think not, it certainly doesn’t seem very “Lean” at first glance. This article claims Parkland is the first to implement this system. Do we want to see others? Here is the MediKiosk website with their PDF brochure (with pictures)
Three self-service check-in stations in the Parkland emergency room triage area offer patients the option of interacting in either English or Spanish. Instead of waiting in line to explain their symptoms, patients can identify themselves at one of the kiosks by entering their name, along with an additional identifier, such as a birth date. Patients then use the kiosk‘s touch screen to identify their symptoms by pointing to areas on a body diagram where they feel pain and answering brief questions about the nature of their visit.
What amazes me is that this “innovation” is referred to as “more comfortable” and “less stressful” for patients.
I’ll go out on a limb and say what we need are real patient flow improvements, using Lean methods, instead of throwing technology at one part the problem.
I’d be curious to get involved and ask “why” patients are waiting to be seen at the ER. Is triage really the bottleneck? Is a computer system cost effective compared to adding more people? Is it more humane? Is the ATM more effective?
Rather than throwing resources (ATMs or people) at it, can we streamline the process so triage can be done more effectives? Better yet, let’s question if triage is really necessary… the goal isn’t efficient triage, it’s improved care, improved patient outcomes, and reduced waiting times. I’ll be curious to see if there is a press release bragging about the actual results of this new technology…
About LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the Chief Improvement Officer for the technology company KaiNexus.