Yes… the endless debate of the advantages/disadvantages of government run entities. This post is simply going to point out a couple examples of government run entities. I will talk about the typical thought processes that is prevalent within these organizations and how these same thoughts often prevail in other types of organizations as well.
To begin with the example of ER rooms, why is it that it takes 4 hours to get 4 stitches when one enters the ER of a public hospital? This is the typical process of getting 4 simple stitches for a little cut on the hand. 1. The patient shows up and waits in line to talk to the front desk nurse who takes down all the information. That same nurse may hand the patient a small bandage to wrap around the cut during the wait. 2. The patient is than told to sit down and wait their turn. 3. The patient is than called in to see a different nurse who treats the wound and disinfects it. 4. The patient is than told to sit down again and wait again. (At this point the patient has probably already been able to watch roughly 3 soap operas on the public TV set up). 5. Eventually after a couple more hours the patient is called in to wait again, but this time in a different room. At this point the patient thinks they are getting in to see the doctor only to find out they are only being ushered to another waiting room with another TV. (They continue their soap opera). 6. Finally the Doctor comes, assesses your cut, asks the same questions the nurse already asked, fills out more meaningless paperwork with some type of handwriting that nobody can understand anyways, and then finally starts to work on the cut. Once the Doctor actually starts putting the stitches in, the process only takes roughly 5-10 minutes. Really? After 5 hours of waiting around and filling out of paperwork at 3 different stations, the actual time it takes to fix the cut is only 5-10 minutes. “Touch Time,” or the amount of time in that whole process where value was actually added to the initial problem (your cut) is only about 5%. One could almost learn how to stitch themselves up on their own in that time.
There lies in all of this, a mistaken attempt to match capacity with demand. The focus lands on the search to maximize the utilization of the service providers, while minimizing their total cost. We divide the tasks into too many tiny pieces, and then ask the patient to wait between each service piece. We should have worked to match the capacity with the desired flow. By flow I mean how the process flows from patient walking into the ER to walking out the door once treatment is done. The very nature of an ER requires an over-abundance of generalists. We fool ourselves into thinking that the “specialization of tasks” is increasing the quality while reducing costs. It only ends up slowing down the whole process, complicates it, and ultimately increases costs. Instead of telling a patient to see one “specialist,” than sit down and wait again before seeing another specialist, the process should be set up so it is one continuous process where one “specialist” follows the patient through each step without waits in between.
This same idea actually applies to many different streams in culture. The emphasis is always on “specialization of tasks” instead of working hard at avoiding any kind of specialization unless absolutely needed. We tend to create complicated jobs that can only be performed by the specific person responsible for it instead of simplifying it. Each person is specifically trained in one area instead of trying to broaden the scope of training. An example is that of insurance agencies. Each employee is a specialist in a different area. To get a bottle of Tylenol a patient sometimes has to go through 3 different specialists. Hence why certain modern successful companies are breaking down the typical barriers between departments such as HR, Marketing, and Production to create more generalization of jobs and improve the flow of communication.
Of course, in the example of the ER rooms, at the heart of the problem is that government run hospitals are in no hurry to improve their processes since they are the ones laying down the money for it all.
