McDonald’s medicine it’s called: patients in the US want their health care like their food–served up speedily and made “your way”. ” The prospect of
waiting for health care is not only distasteful to Americans; its downright threatening”, say the MD authors of the recent Time (Jan. 26,2011) article. The mere specter of Canadian-style waiting lists for tests and procedures evokes enough fear to challenge the concept of government subsidized health care, they add.
We have blogged about waiting for medical care earlier and it’s clear that convenience has become an important part of the way people think. CVS drug stores offer walk-in “Minute Clinics”, many ERs have billboards advertising guaranteed wait times (offering free movie tickets if they run longer), while other hospitals have even experimented with drive-thru ERs!
The real question is whether it is feasible to implement a reasonable waiting time for “urgent” conditions—like heart attacks, strokes, and lung infections. The good news is that convenient care clinics do a good job of handling coughs, colds, a swollen knee, and even a nagging hernia that hurts a bit more than usual today. But the root problem may be that the current system of medical care is not set up to triage acute health needs.
This is where OM can help. So many of the issues tied to creating more efficient heath care can be tackled by re-engineering, process analysis, layout changes, JIT, lean,and all the other topics we teach in OM. You can click on Mark Graban’s Lean Blog to see his excellent discussions.
Discussion questions:
1. Why do we need to reorganize ER treatment centers?
2. What is the difference between “severity” and “urgency” in selecting a treatment?
3. How can OM help shorten ER queues?
I recently had an experience that illustrates the problem. While pruning some trees at my home, I fell off the ladder, and impaled my leg on the clippers. My wife called the ambulance, and they promised a response time of five minutes or less, or I would get a free pizza. They arrived in eight minutes, but there was some arguement about the elapsed time. My wife ran back into the house, and downloaded the phone message to her iphone, and showed the driver the time stamp. With great reluctance, they agreed to the pizza, but that took up more time as we waited for the Domino’s guy to get there, and it was darn difficult to eat that pizza in the rocking ambulance, on my way to the emergency room. I added a second-degree cheese burn to my leg trauma.
We drove past three hospitals before we spotted the one with the shortest advertised wait time on the LED board outside. (We did enjoy getting the exact time and temperature,however. Unfortunately, one of the signs used Celsius, which caused a raging argument among the driver, the EMT and the nurse as to the exact calculations to convert it.) When we finally chose a hospital, we were again disappointed. The short wait time was for a quickie amputation! If I wanted the leg treated and LEFT ATTACHED, then I had to wait longer.
Even then, they missed the time, and I got another free pizza – plus a couple of free magazine subscriptions. The ER nurses ended up with the pizza, and the magazines turned out to be “New Bride” and “Popular Demography” so that was a waste as well.
I settled for a shot of morphine, and a ride home. My wife pulled the trimming shears out of my leg, and she seemed to get some satisfaction about the pain it gave me. (Probably because I stopped off for a few beers after work the day before, and forgot to call her and tell her I would be late. How did I know this was the night she had invited her parents over?)
The one consolation I had was that I kept seeing OM in Action during the trip.
I always enjoy Prof. Quain’s humor and sense of imagination.