iSixSigma

The Weakest Link

Last week I spent an evening at the local emergency center with my mom. The experience reminded me of the old saying: “You are only as good as your weakest link.” And here’s why. . .

When I walked into the emergency center I was immediately accosted by a huge poster focused on customer service which promised that we would been seen in thirty minutes or less. :) Hmmm I thought, this may be interesting to watch. After a brief check-in we waited about ten minutes before being screened and were immediately shown to a room in the back. (Wow – I thought to myself. I wonder if these folks are doing Six Sigma.) Within the next hour, the doctor stopped by, a knee x-ray was taken and a very nice lady came by to officially “log us in.” Things slowed down a bit and we were advised that nothing was broken but that a steroid shot was needed and that it had been ordered from the pharmacy. OK – bring it on. . . OK – bring it on . . . Hello – is anyone out there?

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Two hours later I stepped up to the front desk to inquire about the prescription. The front desk was very quick to tell me that it was the pharmacy’s fault – “they were the hold up.” The pharmacy – in this case also known as the weakest link – had successfully turned this WOW experience into an OW experience. After a total visit time of five hours and ten minutes, we were finally on our way home.

The experience reminded me that the customer doesn’t really care whose ‘fault’ it is. Suck it up and take responsibility for your process. If you are part of the process then you are part of the process. No matter how good you think your piece of the process performs, the customer feels the whole process and in the end – you are only as good as your weakest link.

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Although great improvement in parts of the overall process had been made, it still needs more work. My suggestion for immediate action would be to take down the customer service poster flaunting quick and excellent service. You wouldn’t want any of your patients to die laughing on their way out.

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Comments 4

  1. Ian Furst

    In an emerg department time to initial assessment is an important KPI (if you’re having a heart attack you shouldn’t be left sitting for 2 hours) but not a particularily important indicator of client satisfaction. In our clinic we’ve found that (at consultation) if people are in the clinic longer than 50min it negatively impacts on intention to follow-through (eg. satisfaction). Therefore we define a “failure” in service terms as keeping the patient in the clinic longer than 50min for a basic consultation. I’ve blogged in more detail on it here .

    The bottom line is that client satisfaction should be judged from the clients point of view. They don’t really care about when there first assessment is (unless they’re having a heart attack) but they care dearly about how long they’re in the emergency department.

    I also don’t think it was the pharmacies fault — a good emerg would have realized it was taking too long and called down to get the prescription a lot sooner. Hope you’re mom’s feeling better. Ian.
    http://www.waittimes.blogspot.com

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  2. michael cardus

    weakest link – is often viewed and known by the employees inside the system. If you just asked the front desk they would tell you immediately, as they did that is was the phara. fault. This view is not helpful to the employee satisfaction chain. Many companies that use 6 Sigma encourage or even force their partners and suppliers to implement some 6 sigma practices because it is a chain. Not a kink in the chain.

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  3. Bob Yokl

    Gianna,

    What time and day of the week were you in the ER?

    It would be interesting if you told us how big the hospital was and what type of hospital it was as well. I think that makes a big difference. If you are in a large University Teaching Hospital or in a small Critical Access type of Hospital.

    Not making any excuse but I am wondering about staffing levels that would be required on hand for your visit but that would be based on the type of hospital.

    In many cases people are a little rough on Hospitals such as a small Critical Access Hospital in my wife’s home town but they must realize that you are lucky to have a hospital there to cover your needs. As opposed to not having a critical access hospital and you having to drive an hour or so to the closest hospital.

    A big hospital…I would say no excuses but wonder as you go down the scale. Hospitals are 24/7 but in reality they are more like 12/7 so anything after 6pm may take a bit longer unfortunately because hospitals have to manage their labor budgets accordingly.

    They probably didn’t need the PR but you may have walked in on the 1st or 2nd day of their new Lean Six Sigma initiative to reduce wait times too—you really don’t know. Not defending them but I have been to a small 150 bed hospital with a similar poster plastered all over their ER, deliver less than 20 minutes on a few occasions with situations with my own wife. But, we happened to walk in on what I would call off times too. Even well run Restaurants have people waiting from time to time.

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  4. rajesh

    I liked your article

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