Hospital Badge – Be Patient

Lean Leap to Health Care #5 (click for Part #4) by Scott McDuffee

Why do we call a customer a patient in Health Care? Is it because the customer must be patient given all the waiting? After almost two months of patiently waiting, I finally received my hospital badge.

Certain leadership gurus propose we lead employees as if they are volunteers. This passes a gut check. One can pay, or demand compliance, to get someone’s hands in motion and to meet agreed upon expectations. However, it takes a volunteer spirit to be engaged in mind, emotion, and commitment.

Peter Senge in The Fifth Discipline would say we don´t want to “sell” people or get “buy in”, instead we want to get them “enrolled”. This voluntary engagement inspires the creativity, ownership, and caring necessary makes good companies great, gets people excited to serve customers, and at its best enables continuous and never-ending improvement.

If employees are to be treated as volunteers, how then should volunteers be treated?

Let me not suggest for a minute there aren’t good intentions or caring people at the hospital where I have been trying to volunteer. Not unlike much of our enterprise experience, the processes and systems are broken – not the people. Although I purchased the prerequisite white tennis shoes many weeks ago, they stepped foot on the hospital floor in a contributing capacity about 50 days after my first request.

You may remember from the first blog on Lean Leap to Healthcare, my main intention for volunteering was to get into the hospital environment to learn the language and see opportunities for the application of lean principles. As the great Italian philosopher Yogi Berra supposedly said, “You can observe a lot by watching.” Although I am already getting the indication volunteering will be ultimately rewarding, my experience this far would make an ugly value stream map.

Orientation was scheduled almost three weeks after my first meeting. Though consisting mostly of reading through material which could have been sent and understood in advance, the Orientation did add a lot of value for our batch of a dozen volunteers.

Not only did we learn about the various alerts, spill protocols, HIPPAA, and our job expectations, but we also learned: 96% of unhappy customers never complain; each unhappy customer will tell an average of 16 people about a bad experience; and 68% will change service providers due to the lack of interest or concern of a single employee.

On the other hand, 70% of unhappy customers will continue to do business with the organization if their complaint is resolved. This is powerful information but much may have been forgotten by the time we actually volunteered.

After Orientation, the next available appointments for vaccines and testing were almost a week later. But, these appointments were also delayed an additional week because the nurse was not available on the scheduled day (performed only on Mondays and Fridays) so each of the dozen volunteers were sent home after making the trip.

As we completed the testing, we were invited back a few days later to get the test results back from the lab. (Which I know can be turned around with utmost quality and a very short cycle as I learned at Children´s Medical Center on a recent lab tour with Jim Adams.) When the test results from my next visit gave me the go-ahead to be put on the schedule, I went to the volunteer director’s office and was told she would be out of the office for probably a week.

The second time I stopped by the hospital to get scheduled, the volunteer director was there but told me she was working on a big project – although she pointed to my file right in front of her as she explained it wouldn’t take much time. She asked me if I could come back Monday when she could put me on the schedule.

When I arrived Monday she explained she was still too busy and asked me to come back at the end of the week. That Friday, I stopped by again. She told me she would have to get back with me but I must have let my now ephemeral patience show. In reaction she said, “No, let´s get you on the schedule right now.”

It only took a five minute dialogue to get me on the schedule. Then, she sent me up for my badge photo. Getting the badge in Human Resources (from a volunteer) was immediate and gratifying and took only a few minutes total.


Two of the many major delays were because the nurse and the volunteer director were neither available nor was there a back-up. This is a key leverage point in organizations which is often overlooked. How might there be a process for standardizing back-ups to ensure continuity as well as consistency of care from a patient perspective?

There may have also been capacity issues but given the amount of actual processing time, I have to wonder about that as well. Yogi Berra might have observed that hospitals are ripe with opportunities even just getting a foot in the door as a volunteer.

Was this just an isolated incident for the volunteers in my “batch” or might it be an indication of other hospital processes? How closely does my volunteer experience relate to the patient /customer experience?

Click here for the next post in the series.

Scott McDuffee is an experienced Lean professional who is currently searching for a new career opportunity. He is based in Mansfield, TX.”


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Now Available – The updated, expanded, and revised 3rd Edition of Mark Graban’s Shingo Research Award-Winning Book Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement. You can buy the book today, including signed copies from the author.

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Scott McDuffee

Scott is a Lean Change Leader who has worked in multiple manufacturing sectors. He blogged primarily about his steps taken to investigate switching into healthcare in 2009.

4 Comments on "Hospital Badge – Be Patient"

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  1. Bob Graban says:

    My wife has taught at Detroit Public Schools for 13 years, and still has not received a picture ID, and not for lack of trying. The state-appointed financial turnaround executive is requiring all employees to show up in person at a central location with picture ID to pick up their second paycheck for the month of May, to screen out phantom employees.

    Well, you can imagine how this has raised the priority and interest in getting a picture ID. The process still is not going well, but at least they can’t keep saying “come back next week”.

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