Lean Healthcare - Voice of the Customer

Well, it has been an interesting week...

About 3:00p.m. on Monday, I was in the genba and had a twinge of pain in my abdomen. My co-worker asked if I was alright, to which I jokingly replied, "Probably just appendicitis." About four hours later, I was in the hospital emergency room as doctors poked and probed right around the area where that vestigial organ resides.

By 11:00p.m. I was calling Megan, who is pregnant with our fourth son, due any day now, was having labor pains, and couldn't believe what she was hearing: I was going under for appendicitis. We were so thrilled with the timing of it all! By 2:00a.m., I was in my room recovering.

Overall, I am very, very happy with the level of care provided. And given the fact that appendicitis, left untreated, can end a life we are very grateful for Dr. Kennedy and professionals at Northwest Medical Center.

But, I'm a leanster, and little things just don't slip under my radar anymore. Plus, I was bored out of my mind for two days and was thinking about Lean. Here are a couple of things...small, very small things that I think would have made the experience even better.

1) When I first entered the ER, I couldn't turn that well because of the pain. They also put an IV in me and I hate needles. So, as I tried to put the johnny on, I faced two problems: a) I couldn't turn enough to grab the ties and b) I was afraid that if I bent my arm with the IV, it would poke through my arm or something crazy like that. (yes, I'm a big baby when it comes to needles) So, I sat around for quite awhile with an open johnny. Finally, the ER nurse said with a chuckle that I could bend my IV arm, so I quickly tied that darn thing in a straight knot. Apparently the OR nurse does not share my knot tying skills, she cut it with scissors during surgery. When I woke up, I couldn't get it tied back up again! Call me modest, but I wasn't prepared to ask for help with my backside open until I was feeling like a #8 on the smiley pain scale. Is velcro out of the question?

2) O.k., I'm a hairy guy. When the first IV went in and I watched the ER nurse wrap a 3 x 3 inch slab of clear flexible tape over the carpet of my arm, I felt a little piece of me die inside knowing the pain that was to come upon removal. (I didn't know I had appendicitis at that point, so you will forgive me for feeling this way.)

When I was wheeled into the operating room, and strapped down onto the table, the nurse informed me that they would be shaving me. "No problem", I replied as the oxygen mask was tightened down, thinking that at least someone was thinking ahead. The last thing I remember was that chemically sweet smell of anesthesia, maybe for a half second. I don't remember anything after that.

When I woke up, the pain from the laproscopic incisions was surprisingly not so bad. But whenever I moved for the next two days, the hair that they didn't shave on my stomach pulled because the iodine had dried it all in place. I was forbidden to shower for 48 hours. To give you an idea of what this feels like, go get some shellac and smear it all over your belly and let dry. Now, cough, turn, sit up, laugh, hiccup and breathe. As every hair that moves is pulled, it all hurts. Now, try washing it off. Yup, it doesn't come off immediately. You need to wait another day! In addition, the area shaved around one incision area wasn't big enough, so those band-aids did some damage yesterday when I finally could shower and take those off. Ouch!

Here is my small kaizen idea: why not shave the whole darn area? Yeah, those spots itch like crazy right now, but I can take it and it looks better than three bald spots on my stomach. The alternative is potential Band-aid carpet removal? I suspect that is second only to water boarding. No, thanks. Shave it all.

3) Here is a Lean Product Development idea from my hospital experience. This one isn't hard. I had to be carted out in a wheelchair upon discharge. When I sat down in the wheelchair, something hard was pushing into my left shoulder blade. It was really uncomfortable, forcing me to sit forward, which wasn't easy in my post-op condition. When I got out of the wheelchair later, I couldn't wait to turn around and see the little dastardly bracket or handle the nurse forgot to fold away. Imagine my surprise when I turned to see a the top of an oxygen tank in its standardized holder! At the entrance of the hospital, a small fleet of these wheelchairs are at the ready, with oxygen tanks in the same position. For those of you who design these folding wheelchairs, try sitting in them before you commit to manufacture.

4) Talking wrist bands. If I had a dollar for the number of times I had to repeat my name and birth date as a healthcare professional was reading said information on my wristband, riveted to my wrist, yes, I could pay my healthcare premiums for the year. The technology exists to make this go away! Hallmark uses it in greeting cards for crying out loud! Here is how it works. You check into the hospital and get your wristband: "State your name and birth date, Mr. Lund, speak into the wristband, please." There, its over. I never have to repeat those words until I call the insurance company over billing issues. Now, I know the objection you will offer: "Bryan, this is for your own protection." O.k. fine. What happens if I code and need emergency medical treatment? A doctor can't wake me up and ask me to state my name and birthdate can he? I don't see the point except for some crazy liability B.S. No, you mark my words. Talking wrist bands. Next healthcare innovation.

Well, there you go. Four, small, kaizen ideas that could lead to increased patient (at least this patient's) satisfaction: velcro johnnies, shaving standard work and wheelchairs that don't bruise the patients and talking wrist bands. We always have time to spot an opportunity for improvement!

The best news though is that I did not miss the birth! On the night of my surgery, Megan was having false contractions. What luck! I'm already back on my feet, albeit tenderly, and should be able to fully recover in time to be there for her and the baby.

And in all seriousness, we have the best damn healthcare system ever!