A Triage for Hospital Processes

I recently had the pleasure of visiting lovely Ryde Hospital with a rather painful stomach. It was an interesting experience in process. What amazed me most about it was the incredible levels of duplication of effort and the vast inefficiency caused by needless beauraucracy. I have great sympathy for those having to work in such conditions and those that are left waiting in pain whilst healthcare professionals fill in endless forms - a waste of their skills and time.

Before I left for the hospital I was actually intent on seeing a GP. I remembered that Ryde hospital had a late night GP clinic so I googled it to see the opening hours. Great - it was open until 10pm (ideal at 9pm at night!) So off I went, parked the car a short distance away and went to the reception desk.

"Oh there's no GP clinic here anymore" said the lady behind the desk - you'll have to see an emergency doctor. Not a big deal but I couldn't help but think of all the people that must turn up with minor ailments taking up the time of emergency doctors who could be spending their time on more serious things.

So I stand at the desk for 5 minutes filling in details about who I am and being asked "what's wrong with you". I am amazed that I can turn up at hospital with just a medicare card and my DOB and get free medical treatment. I could have given my medicare card to anyone and they could easily use it. I wonder how many people sell healthcare on the black market this way.

Next I am sent to the triage nurse who fills in more details and asks "what's wrong with you" and "what medications are you taking". Triage - a concept invented in WW1 and still with us. (Can you think of anything else from 1914 that might be useful???)

She asks me to wait until I am called. About 15 mins later a nurse calls me in and asks "what's wrong with you" and "what medications are you taking". He takes blood (after butchering both of my hands) and prods my stomach. He then asks me to wait outside.

Another 15 minutes later a doctor appears and asks me to come back in. He asks "what's wrong with you" and "what medications are you taking" and I tell him the story again and he prods my stomach. Eventually he scribbles something down and says that he will inject me with some drug.

15 minutes later another person turns up to inject me. He doesn't tell me what it is until I ask, but he can't actually tell me what it does. Apparently he's just "the injecting guy". Nice job. The doctor then returns. I ask him what the stuff I have been injected with actually does. He's nice enough to actually tell me.

Another 15 minutes of sitting on the bed and I am sent on my way. Guts still sore and thinking that I should have gone to see my GP the next day...

So what could they have done better?

For a start it seems bonkers to me in this day and age that Australia doesn't have a centralised healthcare database. I find it bewildering that I have to go through entering and checking details every time I go to a hospital or doctor. The time spent doing data entry is staggering. What is more staggering is the reliance on bits of paper that travel here, there and everywhere in a hospital. Enter the data once and pass it on electronically - that's the trick. It would eliminate data entry, duplication of effort and improve the quality of healthcare - after all, we are talking about people's lives here. Just one small piece of information could cost a life (and the current system is like russian roulette).

And what about the customer experience?

Well, how wonderful would it be to log onto the internet and be able to see realtime wait times to see doctors, or even to register at the hospital before you leave the house. So much better to be able to enter accurate details of your ailments rather than have someone interpreting them for you. And how much better would it be if there was more than a scratchy TV in the waiting room that no-one can hear. And before anyone says it, it's not free - we all pay taxes so that we receive theses service - we are paying customers!

Unfortunately hospitals (like their triage system) are stuck in Edwardian England. It is a case of we do it this way because we do it this way. Hospitals deserve to have adequate supplies of money to provide services, but we also need to make them work productively, efficiently and improve the customer experience.

The system is sick, let's make it better.

- TPN

Comments

[testudo]

Sir,

You worry too much, it is a quixotic approach to life attempting to solve all the ills.

They must have put you under Triage SMART model 3

3 Those with minor injuries, who need help less urgently!!

Did they cure your ailment? If so I am sure the stats will record a 100% success rate for you and the administrati will have justified their existence.

Still I assume the costs to deliver the technical outweighs the traditional approach.

SS

[Robert]

Your experience is very similar to stories that get shown on the 'current affairs' shows. Everyone describes the long convoluted process.

In my mind, a hospital has two processes. The first is the value-adding process:-

Patient In - Assess&Test - Treat - Patient Out.

Get that right and you are delivering exactly what the customer wants.

The second process is the Administration&Records process. My generic term for this is VS (value-sucking). VS processes need to be efficient, non-duplicative, accurate, lowest possible cost and kept as much as possible away from the patient.

Robert

[The Process Ninja]

Unfortunately as a Process Ninja I must save the world - one process at a time. Saying that, by fixing hospital processes, we can save more than just time and effort - we can save lives.

[franco cyril]

how many hospitals in karnataka who follows triage system

[franco cyril]

is it possible to get a list of hospitals in karnataka who follows the triage system

[Dick Wall]

(Can you think of anything else from 1914 that might be useful???)
Airforces, machine guns, the Haber process, corned beef tins, a lot of successful west end plays, the forestry commission...

It's the question that keeps giving!!!