Last Monday was not a good day! My 77-year old mother had a nasty fall in her home, and as a result, was rushed by ambulance to the emergency ward of the nearest hospital. When I arrived at the hospital, she was on a stretcher waiting in a line of stretchers in a long hallway, her neck in a brace and her small frame tightly strapped to a body board. The two paramedics accompanying her explained that because she might have a spinal injury, they had braced her back and neck. They were now waiting for her turn to get a CAT scan, x-rays, and a bed in the emergency room. For the next five hours, the four of us – the two paramedics, my father, and I – waited in the hallway, leaning up against the wall, while the wheels of the healthcare system turned slowly. Eventually she got her CAT scan, then we waited some more. Finally, she went in for x-rays, then we waited again. It was impossible to move her off the stretcher until the results of the CAT scan and x-rays came in; besides there were still no open beds in the emergency ward, so where could they have moved her to? Eventually, almost five hours later, a bed opened up and they moved her, neck brace, body board and all, into the emergency ward. At last, the paramedics were able to complete the transfer of custody and leave the hospital.
If this entire ordeal sounds awful, it was, but surprisingly, my mother was not an isolated case! As I stood in the hospital hallway, I saw numerous other people on stretchers waiting for emergency care, and in each case, the sick or injured person was accompanied by the two paramedics who had brought that casualty in to the hospital on an ambulance. As I looked down the long hallway, I saw a sea of blue uniforms leaning up against the wall, all of them waiting to transfer custody of the patient from their stretcher to a hospital bed. My mother’s paramedics explained to me that until the patient is moved from the stretcher to a hospital bed, responsibility for that patient still lies with the paramedics, so they cannot leave the patient until a bed becomes available.
“Does this length of wait happen often?” I asked, surprised.
“Very often,” came the quick reply. “Some days, we spend a good portion of our day just standing around in the hospital waiting to transfer custody.”
“Does this ever result in a shortage of emergency units in the field?” I asked, curious.
“All the time!” He must have seen my next question in my eyes, because he continued. “When the number of ambulances on the streets fall below critical levels, ambulances from neighbouring communities are called in. And when those are no longer an option, fire department personnel step in for emergency situations.”
“Isn’t it crazy?” he said with a mixture of frustration and embarrassment. “We’re skilled medical professionals and we spend our time standing in the hallways instead of being out in the streets where we can do our best work.”
I had no other response but to agree. Crazy indeed! Intelligent and skilled people were being under-utilized because of resource shortages and procedural bottlenecks. Talk about losing productivity AND de-motivating your workforce!
I realize that this blog post could open up the whole debate about the challenges and benefits of a national health-care system, and since I try to keep this blog focused on leadership issues, I have no desire to go there. However, I do want to ask you this question: do you have resource shortages or process bottlenecks in your organization that are producing the same lack of productivity as I observed last Monday? Are your intelligent and skilled employees being under-utilized because the “procedures” in your organization are getting in the way of getting things done? Talk to me, and please, I’d love to hear some good news – tell me how you’re taking positive steps to overcome this type of problem.
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