How is healthcare like pizza?

I stumbled onto this (I think I clicked an ad on accident), but found it pretty interesting:





The very first line is what hooked me:

Even my pizza place stores my information digitally, so why do I have to fill out the same medical forms over and over?

The numbers on everyone are little freaky, but the idea is worthwhile considering.  Think about why the pizza place stores your information?  One of my first jobs during high school days was at Papa John's Pizza.  At one time I won the fastest dough slapping contest in the state Utah - there was only one store in Utah at the time, but I digress.  We opened the first Papa Johns in the state of Utah, so when we first opened taking orders over the phone usually meant taking the time to get all the information from customers: name, address, phone number, etc.  Order taking was a slow process and it required lots of people on the phone and queues built up fairly quickly.  Often the bottleneck was the order taking process and not the pizza making, the dough slapper and pizza assembly workers would often look over the shoulders of the order takers and get a head start on making the pizza.  After several months - maybe even a year - the store had developed a healthy database of most of regular customers that called in and ordered.  Order takers just had to confirm customer's information and could even ask if they wanted the same thing they ordered last time.  Now the bottleneck shifted to pizza making and delivery - the actual value added parts of the service.  We needed less people to handle phones and customers got their food faster.


So how does this apply in a health care system?  Apart from no longer annoying  customers with endless forms to fill out,  a data driven approach to patient health records certainly will have the same effect, mainly that a bottleneck and resource hog that used to be the check-in process can be shifted to a more value-added process like, I don't know, actual health care.  Additionally,  doctors should be able to review quickly the history of patients without having to rely on the patients memory.


Poke around on United Healthcare's new Numbers site and tell me what you think.

You can have my blood, but please don’t take my time

Recently I was contacted by a volunteer from the American Red Cross and asked to sign up to donate blood during a blood drive on campus. I have donated blood several times during my life and have never had a reason to turn down such requests, so I signed up for a 1:30 pm appointment on a Monday. I arrived at 1:30 pm sharp and started the process of the donation. Their website recognizes the 4 step process to donation:

  1. Registration: read about the donation process and eligibility requirement.
  2. Health History and Mini Physical: personal health history questions, temperature, blood pressure, etc.
  3. Donation: Approximately 1 pint of blood is drawn from your arm
  4. Refreshments: Spend a few minutes eating sweets and drinking fluids

Again, from their website: “The donation process, from the time you arrive until the time you leave takes about an hour. The donation itself takes about ten minutes.” From a purely process management standpoint, this statement might raise an eyebrow. If it only takes 10 minutes to draw the blood, why do donors have to spend an hour to donate? The other three process steps surely don’t take 50 minutes. Answer: there is a lot of waiting done by the donors. In my case the process took nearly two hours while the donation itself took about three minutes.

I had lot of time thinking about their process and had a hard time not seeing potential process improvements during my long wait
.

Reservation/Appointment Management: As I arrived, there were about 8 donors in front of me in the registration area. It appeared that there were two separate appointment books: one from the phone calls made by a regional headquarters and one from the local blood drive supporters. My guess is that they did not synchronize the two appointment books and overbooked. In addition, they were taking walk-ins and everyone was served on a first come first serve basis; reservations did not get any priority over walk-ins.

Bottleneck and Capacity Management: With a quick glance to the donation process area, I saw six beds. If the actual donation time takes an average of ten minutes, then the capacity of the donation process is 6 beds * 60 minutes in an hour divided by 10 minutes per donation = 36 donations per hour assuming the area is properly staffed. The health history/ mini physical area also has enough space for 6 donors being service at one time and a 10 minutes average time for this process is probably reasonable. However, there was only 1 dedicated employee in this area restricting the capacity down to 6 donations per hour.

Labor Scheduling & Capacity Planning: At 1:30 employees were coming and going taking lunch breaks. I suspect that the reason there was only 1 staff member working the health history / mini physical step was because someone was on break. Labor scheduling is essentially matching system capacity with expected demand. In the case of a blood drive, the expected demand could be managed by allowing for more appointments during fully staffed times and less appointments during periods of breaks (e.g., lunch time); however, it appeared that blood drive volunteers were asked to find the same number of donors for each time period, e.g., for each half hour block find 4 donors. Perhaps the actual capacity during periods of full staff is higher than what they ask for and much lower during lunch times. This means that donors in the morning and late afternoons will be serviced very fast (maybe 30 to 40 minutes) while the donors during the lunch hours can expect long queues and much longer waits (like mine: 2 hours). The average wait may indeed be 1 hour but the variability in what is experienced by donors varies widely. Perhaps the American Red Cross tries to determine its daily capacity and asks blood drive volunteers to fill this uniformly throughout the day; however, labor scheduling forces the capacity to fluctuate throughout the day and reservations should be scheduled to match the capacity fluctuations.

What is the goal?

Again, according to their website, the number 2 reason people don’t donate after “I don’t like needles” is “I’m too busy”. Only 43% of donors are “repeat and loyal donors.” Perhaps a large percentage of the remaining 57% realized that they didn’t like needles after their first donation, but certainly some of them stopped coming because they were “too busy” which is a nice way of saying “it takes too long”. Blood is highly perishable and donations are needed every day in order to maintain adequate supply for medical patients who need blood. A top priority for the American Red Cross should be to increase the percentage of loyal donors in order to maintain the need blood supply. Any marketer will tell you it is easier and cheaper to maintain an old customer than to win a new one; however, the American Red Cross spends a great deal of its effort in finding new donors.

 
How can the principles of operations management improve donor loyalty?

Where was the bottleneck in my process? Where should it have been if donations where to me maximized?

What could the American Red Cross do to manage their appointment system better? How could they handle walk-ins?

Sources:

The blood donation process:

http://www.givelife2.org/donor/process.asp

Top 10 reason people don’t give blood:

http://www.givelife2.org/donor/top10excuses.asp

50 quick facts about donating blood (including loyalty percentages): http://www.givelife2.org/sponsor/quickfacts.asp

This was originally posted as a guest blog here.