Monday, April 27, 2009

But What If It IS Broken? (Part 1)

For the past couple of weeks I've been working the adult walk-in clinics that my workplace holds a couple of evenings a week.

Anyone who's been reading this blog for any time at all knows I am the farthest thing there is from a nurse. I know nothing about medicine except what I've learned from watching House (which is that everything initially looks like sarcoidosis, but after you almost kill the patient a couple of times doing random tests, it invariably turns out to be something else).

Also, sick people are kind of a snoozer, because all they ever want to talk about is how sick they are, and how various medications are affecting them.

So, not a nurse. (You may all whistle a sigh of relief.)

Anyway, the reason I've been working the clinics is this:

1) Our adult walk-in clinics start at 5 p.m.

2) We can see somewhere between 20 and 35 patients, depending on how many volunteer physicians we have on a given evening, and how fast they are.

3) Between 40 and 50 patients show up for the average clinic.

4) Patients begin arriving around 4 p.m., but we don't start processing paperwork that early, because if we did, they'd start arriving at 3, and then 2, and you get the picture.

5) We don't take appointments, because our client-base tends to be transportation-challenged, and we wind up with so many no-shows we might as well not bother.

6) The nurses arrive around 5 to start triage.

7) The doctors show up around 6.

So, from the time we open the doors, we have about an hour to talk to 40 or 50 people and figure out who we're going to see, who we're not going to see (because they have something we don't treat (like the clap STDs), or because they really should be at the emergency room, or because they're not as sick as other folks who are there that night) and in what order (based on who's sickest).

In that hour, we also have to figure out who's new and who's returning, either find or make charts (depending on which it is) and pair up the non-English-speaking with a translator (either in person or via phone).

If there was ever a process begging for attention, this is it.

And while I may suck stethoscopes at all things medical, I'm wizard at process improvement.

(Sound of cracking knuckles.)

Hold on tight, kids. It looks like we're in for a bumpy ride.


  1. Good luck.

    It should very challenging, but also very rewarding.

    I have faith in you.

  2. So that last comment wasn't an actual sentence (too early in the morning). I'll give it another try-

    It sounds very challenging, but also very rewarding.

    I think that's better.

  3. Okay, now that's a process challenge I would love to fix. And I thought I had my work cut out with the registration process for the business gym! Good Luck!! x

  4. I used to have a neighbor that worked in gerontology therapy, and after her clinic once a week, she took out her frustrations on clay, and you would see sculptors of elderly laying about the back yard...

  5. LOL, that is great YOU GO GIRL!

  6. So much for my "this isn't life and death" motto!

  7. I am too right brained to give you any systematic plan. But I could do a very cool interpretative rendering, using fruits and vegetables, of what you are describing.

  8. Jeanne, you are a saint and a scholar.
    Good for you for your hard work, somebody's got to get them in line.

  9. Wonderful post!!!

    Very admirable, but not surprising, of you to look beyond the effect in search of the cure. Even if one is on the clock, it is very stressful to handle the pain of others. Take care of yourself. Even the Great Father can't save everyone.

    Your activist streak is enviable.

    Good luck!

  10. Sounds broken to me. Fix it up, girlie!

  11. I see things improving already. Can't wait to hear about it.

  12. Sounds like my office. I think we need some things fixed. Are you busy????

  13. Wow, that can't be easy. Let us know what kind of process you come up with - think factory line. Albeit a human one. I love these kind of things. Mapping processes and looking at how you can cut out steps. I would be all about proforma forms, answer three questions the right way and move to the next part of the queue. If not, out the door, lol. I dont envy you the task but you are well up to it - and if all else fails tell a joke and make their day.

  14. I am ready for the ride, lets go babe.



  15. Sounds like a good challenge!

  16. I am also terrifically gifted in finding the problems in any situation!

  17. I'm so sick right now, blowing my nose, sneezing, and complaining about being sick. Just kidding. But I'm not taking ANY medications. dammit.

  18. All the best.Sounds very challenging!!!!

  19. Sounds challenging but an interesting, cool experience.

  20. People from manufacturing backgrounds would be fired for the mistakes I see made in my doctors office... The last eight years I worked, it was all about continuous improvement..

  21. I'm surprised you don't get double that amount considering so many people are now without health insurance


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