It goes on in every business and industry, we waste huge efforts to meet unneeded and unrealistic deadlines that the end consumer never demanded or created in the first place. Why does just about every industry release their new models in short focussed time frames, instead of spreading them out through the year. A new car model would be just as valueable in January as in September, in fact it may even earn a greater marketshare if realised at a different time. The adavantage would be it ends the constant shutdown work wave that happens twice yearly, and would spread work out more evenly throughout the year. The number of needless hours of overtime would be reduced, and the odds of a poor underdeveloped product making the market to fail would be reduced. But changing that would mean using common sense.

The entertainment industry pulls the same dumb stunt, by launching all their new shows in a few short weeks instead of looking at where there is an opportunity for a new show to capture a market by fulfilling a need in the market. If every industry slowed down and developed products as they identified specific market needs and opportunities we would launch far fewer failures, because often most failures are the resulkt of failing to actually meet any need or desire of the consumer, or waiting until that need or desire goes away because it is not time to launch something new.

Interesting thoughts as always. In manufacturing, we seem to be our own worst enemy.

I’ve been doing some Lean work the past few years in healthcare and they like to think they’re different. In fact most healthcare professionals absolutely abhor any reference to manufacturing when talking about Lean. (Interestingly, the institutions that have done the most with Lean seem to have the least objection to manufacturing references.) But I digress.

The point I wanted to make is that a common position in healthcare is that they have absolutely no control over when patients need care. That would suggest that “waves” are something normal. On the surface, this is somewhat true. People don’t schedule bus crashes, flu season or natural disasters. But if one peels the onion just a bit further, interesting things appear.

For instance, the second stop for many patients that enter through the Emergency Department is the Observation Unit. In the process of trying to reduce the time it takes to move patients from ED to Observation, we found a huge wave – just before shift change in ED. What was happening was that before providers left for the day, they tried to close everything out. I think we could call this normal behavior. But in doing this, they created a wave in a downstream operation that seriously strained the system – not to mention the patients. So what we have here is good old fashioned batching causing a wave – just like you mentioned.

By the way, when we really started looking into the “patients arrive whenever the need arises” theory, we found some other interesting facts. For instance, the hospital does little or nothing to incent patients to stagger their arrival times to smooth the flow. And there are many things that can be smoothed such as elective surgery and out-patient visits. Ah, opportunity to reduce the wave effect exists!

Tom