Your Own Process and People, not the Internet


    I get sort of tired of seeing questions like this on the internet (on the Yahoo Group for Healthcare Management Engineers):

    Just wondering if anyone has placed computers in each patient room? What layout has worked the best? One that is convenient for the nurse (just inside the room to minimize steps, etc); or a design closer to the patient's bed? These cabinets will be retrofitted into existing rooms as opposed to new room construction. I want to avoid the situation with the nurse's back to the patient. Our facilities director wants to place it without having to take down everything. I think you get the picture.

    I think I do get the picture — this person is expecting someone else to do their work for them?

    Why do people so often want to copy someone else's situation rather than figure things out themself? Why would you go to the internet instead of going to your “gemba” (the place where the work actually takes place)? Get away from the computer (this said by someone here who runs a website and is typing this at a computer) and go talk to the nurses.

    The person asking this question, a “fiscal analyst,” has already started doing some of the work — they talked to facilities… are they talking to the nurses?

    If you have a question of putting computers in the rooms, why isn't a nurse leading this project? Wouldn't they know better? Wouldn't they appreciate being involved?

    Even if someone on the internet could have the right answer — is that even possible? This hospital's room layout is probably somewhat unique or there are other factors that would make it necessary to “figure it out yourself,” not “copy.” Set up one room as a pilot and see how it works… use the Plan-Do-Check-Act cycle to see what works before making a huge bulk purchase of PC cabinets/arms/etc.

    In all honesty, he's probably just looking for advice to see what has worked or what hasn't worked… that's OK… but don't expect it to be a substitute for your own work and your own thinking.

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    Mark Graban
    Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


    1. As an Industrial Engineer I couldn’t agree more. There is no substitute for being “in” the situation. One of the first things I do on the job is talk to the folks who do all of the day-to-day heavy lifting.

    2. Process sharing is somewhat unique in Healthcare considering that there are 5000 hospitals in the US and generally only a handful are competing with any particular hospital.
      I don’t see anything wrong with asking about a particular practice but recognize that this is lower order process improvement.
      There are organizations that provide best practice research or organizational and process benchmarks.
      Again these are often a good starting points for control purposes but my own organization beats the pants off of these so called best practices in a number of ways.
      As you point out the benefits of learning are much diminished when you mimic.

    3. Anon – thanks for the comment. I agree that hospitals could and should share more. There’s no reason every hospital should re-invent the wheel, particularly around quality and patient safety. That said, copying others isn’t the best approach, as you stated.


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