About five years ago, I had the opportunity to participate on an improvement project in a radiation oncology department. The goal was to reduce the time to provide treatment recommendations through a process involving x-ray scanning. Roughly speaking, the task we were observing took about 70 minutes, 10 minutes longer than scheduled. I accompanied a cross-functional team on a walk-through and observation of the then current process.
At the scanning process, a simulation technologist (Simtech) from the team explained why there was not enough time in the hour she was given with the patient to complete all of the tasks associated with the job. These involved putting the patient at ease (a priority), preparing the equipment and patient for CT scanning, and then generating and annotating the images to be used for diagnosis. So many things slowed the process down: the gowning station was far away, supplies needed for the process were not always at hand, instructions from the doctor might not be clear. She emphasized one step in particular that slowed her down:
“We have to take a photo of the patient in the location of the scan and annotate the view so it can be compared to the x-ray,” she said as she pointed to the place on the scanner where the patient was placed.
She continued, “We used to use a Polaroid camera for this. I’d snap the picture, place the camera to the side and continue to prep the patient and scanner. When the photo popped out I’d take my pen and annotate it. Done. The photo was part of the records to travel with the x-rays.
“But now,” she said while holding up a digital camera, “the IT department has made a technological improvement.” She exaggerated the word ‘technological’.
“Now I take a digital photo, and while the nervous patient is lying on the scanner I walk two doors down to dock the camera with a computer.” The team followed her as she walked to the docking computer.
“Sometimes I have to wait in line,” she said as she downloaded the photo. After I download the photo, I run a program which enables me to annotate the digital photo. And sometimes the computer is slow.
She completed the process by saving the annotated photo. We timed it at just under five minutes to complete. The digital camera method compared very unfavorably to the low tech Polaroid that took about a minute. The IT solution as implemented was at best a partial solution, one that took five times longer than previous method and left the patient alone during the process.
The time lost through this particular high tech innovation represented fifty percent of the excess time taken to serve the patient. What may have been an enhancement for a downstream process was actually slowing the entire system down. Because the Simtech could not complete her work in one hour, the final steps of the process for each patient were set aside until time became available – usually during breaks or lunch. Each hour another patient arrived, compounding the delay of patient x-rays to be passed on for analysis. What was intended to be an hour-by-hour transmittal of patient information had become a once per day batch.
Sometimes a well-intentioned IT solution can be counterproductive if it is not followed up with direct observation. Can you think of any IT solutions in your work that have added more time than they’ve saved? Let me hear from you.
Ha! Too many to mention. Sites like Facebook, LinkedIn, and GoogleDocs “improve” all the time, and unexpected learning time has to be consumed. At a job I once had, a process where I sent copy to a web admin to load into the site was replaced by a multi-screen process to “save time.” On one screen I counted 50 data elements that my process did not use — I was expected to click one hard-to-discover button. To be fair to IT, the process for analyzing the end product and its value stream was poor, and they were expected to cobble the application over another one that had never been designed for the new one.
Lean is the way to GO!