Human Factors and Health care: Tackling Inefficiencies

I came across two examples of human factors angles in health care. The first is from the NPR show Planet Money.  The show focuses on how much inefficiency and waste there is in medical billing.

The whole podcast is worth listening to, but there is one bit that made me laugh out loud (fast-forward to 10:35).

Codes (NDC number) are used to represent drugs and other medical supplies.  However, two different types of codes are used with some systems only accepting one type.  One type of code is 8 digits long, the other is 11 digits long.  Here is how the user is left to translate one code to another:

Three easy steps to a leaner NDC number.  First, if the NDC number begins with a 0, drop the 0, use the next 8 digits, disregard the last 3 digits.  If the leading digit is not a 0 but the 6th digit is a 0, use the first 5 digits, drop the 0, use the next 3 digits, disregard the last 2 digits.

The second is a story from the New York Times about implementing processes and procedures from factories to the hospital:

There are two bins of each item; when one bin is empty, the second is pulled forward. Empty bins go to the central supply office and the bar codes are scanned to generate a new order. The hospital storeroom is now half its original size, and fewer supplies are discarded for exceeding their expiration dates.

The system is just one example of how Seattle Children’s Hospital says it has improved patient care, and its bottom line, by using practices made famous by Toyota and others. The main goals of the approach, known as kaizen, are to reduce waste and to increase value for customers through continuous small improvements.

It’s not exactly clear from the article what CPI, the approach used, is:

The program, called “continuous performance improvement,” or C.P.I., examines every aspect of patients’ stays at the hospital, from the time they arrive in the parking lot until they are discharged, to see what could work better for them and their families.

Here is one specific outcome of CPI:

Standardization is also a C.P.I. cornerstone. Last year, 10 surgeons at Seattle Children’s performed appendectomies, and each doctor wanted the instrument cart set up differently. The surgeons and other medical staff members used C.P.I. to come up with a cart they all could use, reducing instrument preparation errors as well as inventory costs.

I can’t comment on CPI or the benefits/costs of such an implementation, but I would be very disoriented if someone made me standardize my office or desk!  Final point, just from what I gathered in the article, CPI seems to harken back to time-motion studies of Frederick Taylor.  Good or bad?

3 thoughts on “Human Factors and Health care: Tackling Inefficiencies”

  1. I agree that having someone standardize my desk would be frustrating. However, I am the only one that uses my desk. Surgeons (to my limited knowledge) do not prepare their own carts. When more than one person is involved in the delivery of a service, standardization starts to make more sense.

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