Far from the frustrated rantings of my last blog post, my latest musings are more about genuine puzzlement over why some managers seem intent on making extremely straightforward processes unnecessarily complicated.
I was at the Outpatient’s department of my local hospital today for a follow-up appointment to treat injuries sustained during one of my many recent acts of heroism (actually the real reason is too boring to share with you, so I just made that up). The booking-in process perplexed me – patients go to the reception desk and show the attendant their appointment letter, then are told to take a deli-style ticket from a nearby machine, before walking a few feet to a seated area in front of another reception desk and waiting there.
Above this second reception desk there is a large LED display that flashes up with big bright red ticket numbers every so often, in tandem with a cold, emotionless robotic voice that barks, “Ticket number (pause) Seventy (pause) four! (pause) Operator number (pause) two!” The patient with ticket number 74 then goes to the desk, speaks to the appropriate operator, shows their appointment letter again and the operator books them in. The process for booking-in therefore looks like this:
I couldn’t work out what additional benefit there was in having two reception desks in sequence, or why the ticket system was the chosen method of registration, so I politely asked why it was considered a better process than me just walking straight up to Desk 2, handing over my appointment letter and letting the nice helpful lady book me in, as she was doing now anyway. First of all she looked at me as though I had two heads, then gently explained (as one does to a very small child who doesn’t understand something extremely obvious) that it was ‘better with the tickets because it reduces queuing time’.
Actually it doesn’t – it increases queuing time. If Desk 2 can process two patients at a time (as there were two operators), yet Desk 1 only has one operator, then the speed that patients can be processed through Desk 2 is contingent on the speed that Desk 1 drip-feeds them through. Therefore, if there is a queue at Desk 1, this means that Desk 2 is under-utilised. Furthermore, the design of this process does not reduce queuing at any stage, nor remove the need to queue at Desk 2 – it merely puts patients into a seated queue instead. Smoke and mirrors. There is nothing at all to suggest the approach reduces end-to-end time one iota. Also, because the appointment letter has to be presented twice, the process introduces unnecessary activity, which is by definition, waste.
From a totally different perspective, the process is also quite dehumanizing. Patients effectively become numbers instead of people as they wait in the seated queue before Desk 2, and are ordered about by an inhuman, disembodied, automated master of ceremonies. How impersonal. Eventually after these hurdles, they get to speak to the helpful, personable human being behind Desk 2, who does the only thing of value in the entire booking-in process; i.e. booking in.
I maintain that the ticket system is rubbish. It takes longer, grates on people like me, is more costly (more desks, more staff, ticket machine, LED panel, robot announcer), does not reduce queues at all and has no discernible benefits whatsoever.
In contrast, what about this for an alternative model? – Patients go straight to the first available operator at a single reception desk and get booked in by the helpful human being sitting behind it.
Here’s the process map: