I’m just returning from a brief sojourn that included:

  1. Marrying off my older daughter, Christine, in Disneyworld, followed by
  2. A short vacation for our younger kids, and then,
  3. A short illness and trip to the hospital for me.

No relationship between the third event and the former two is implied, but their sequence afforded me material for another post.

First came the wedding that by all accounts was well managed despite torrential rains that necessitated an on-the-spot change of venue.  This move would have been less impressive had there not been several dozen other weddings that were affected at about the same time.  The Disney organization is superior at moving and staging crowds, a skill without which the park would grind to a halt.  They manage the process, not just the operations.  And the outcome in our case was a “Magical Experience’ despite adverse conditions.

Arising a little late the morning after the wedding we began the vacation part of our trip at what is billed as the ‘best ride in the park’:  Soarin’ provides its riders the illusion of hang-gliding through striking panoramic video scenery.  As we entered the ride line, a digital timer indicated that there would be a wait of 60 minutes.  While the actual ride lasts only 5 minutes (see clip) we decided it was still worth the wait.

About halfway through the line however there was an announcement: “The wait for non-FastPass riders is now 85 minutes.”   Sometime later we discovered also that the 85-minute estimate was only for the big line.   At about the 85-minute mark, a small group (batch) from the big line was ushered to a smaller line, and shortly after that again to what might be considered “shipping lanes” just prior to loading onto the ride.  At the 96-minute mark, the ride doors flung open, and we climbed into our gliders.  It struck me that the ratio between the ride and total elapsed time was remarkably close to the typical ratio of value-added to non-value added often given by Shigeo Shingo:  95% waste. (When you’re standing in line for an hour and a half, there’s time to reflect on these things.)  In this process, the product (us) was moved and staged three times -- four if you count loading to the ride.

If we’d been smarter, we would have opted for the “FastPass” lane, introduced at the park some years back presumably to levelize the flow into equal 15 minute batches of riders; not quite a “pull” since the actual departure time is determined by ride availability not customer need.  But, hey: the apparent lead time once you get to the ride is only the five minutes you stand in the final staging line just before the ride.  Seems like a good concept to me, approaching a 50% ratio of value-added to non-value-added.  This is the end of my Disney story.  Here’s how it relates to my less magical experience at the hospital:

As the vacation drew to a close, I developed an infection (I will spare you the details) that didn’t respond to home remedies.  It being the weekend at this point, and me having an aversion to emergency rooms (topic for another post), I opted to wait it out until Monday when I could see my regular doc.  His advice as he examined the problem: “I’m going to send you to the emergency room.”   He left me briefly, and then came back with a prescription for the ER.  “I’ve called ahead,” he said, “They’ll be waiting for you.”  “Oh!” I thought, “maybe this is like Disney’s FastPass.

Actually not.

When I arrived at the emergency department, except for urgent cases (the real emergencies) arriving by ambulance, the process was pretty standard for everyone:  register at reception, wait, visit with the triage nurse, wait, visit with someone who checks insurance, wait, and then finally move to the treatment area.  By this time 90 minutes had elapsed. “Hmm,” I thought as I walked out of the ER lobby, “about the same as the wait in the walk-up line for Soarin’.”

This was not to be, however.  I was actually moved into the work-in-process queue, one resembling the scene at right.  By my estimate there were two gurneys in the hall for every treatment area; crowded enough that the actual transport lane appeared narrower than a gurney.

After 20 minutes, a nurse greeted me cheerfully: “How you doin’ today?”

“I’ve felt better.” I said, “it looks like a busy day in here."

“It get’s worse than this,” she replied.  She left me after setting up an IV.

About an hour went by before my next visitor, a doc.  Following a quick exam, less than a minute, he explained, “We’re going to have a surgeon take a look at you.”

“Fine, thank you,” I replied.

“What do you do for a living?” he asked.

“I’m a consultant,” I responded.

“What kind of consulting do you do?” he continued.

“I help docs like you manage patient queues like this,” I quipped.

He smiled and said, “I guess we’re not doing very well today.”

“I’m sure you’re doing the best you can,” I replied.

When nearly four hours time in the ER had passed, I was greeted by the surgeon, who explained the procedure, finished his work in about 15 minutes, and then prescribed a one-hour antibiotic drip.  Altogether, counting the drip time, I estimated the total value-added time to be about 80 minutes compared to a total elapsed time of 5 hours.  I thought to myself, “That’s a VA to NVA ratio of better than 25% -- five times better than the walk-up line at Soarin’.”  But, maybe the FastPass concept for non-urgent cases like mine (which I’m told constitute the vast majority of ER visits) would be preferable.

How much of your work or personal life is spent in batch and queue?  Share a story.


This entry was posted in old lean dude, TPS, lean manufacturing, six sigma, lean thinking, GBMP, Toast Kaizen, muda, autonomation, process improvement, kaizen, lean government, hoshin kanri, TPM, 5S, true north, lean summit, poka-yoke, automation, lean in healthcare, optimization, toyota production system, inventory, Northeast Shingo Prize, made in america, Muri, shigeo shingo, standardized work, Hajime Ohba, set-up reduction, value stream mapping, mura on October 20 , 2011.