Wednesday, 21 March 2007
Wasting Money - A Feature of Health Service Life
Every time I think of waste, I think of managers. Can't think why; maybe it's because when I was a student, six wards shared one (nurse) manager. She know all the staff, she knew all the patients; indeed, on alternate week ends, she'd ask a student on each ward to take her round - and invariably she knew more about the patients than the student (and woe betide the student who tried to bluff their way round).
Now, the ward where I work shares managers with a handful of other wards; shares about 15 managers, most of whom wouldn't know a patient if they tripped over one - or most of the staff, either.
But there's so much management waste, and it makes me so angry, that I really cannot compose a useful post about that.
So let's look at lifts (Elevators, for nurses across the pond in North America).
Hospitals require lifts and lots of them; they get caned in daily use, and fail a lot. Or do they? My multi-floor block has five 'public' lifts facing each other in a central foyer. For the second time in ten years they are starting on a program of 'complete replacement' (Last time the program foundered after one new lift).
But why do lifts fail? I did a little research, and by and large, it's door problems, with occasional bearings giving out, and even more rarely, software problems. On a daily basis (if they are lucky), the lifts get swept out and the floor mopped, I guess by the people cleaning each foyer up the tower. There's no specific attention to the lift runners, and the non-specific attention involves dirt being swept into the runners on a daily basis.
At any one time, two or a maximum three lifts work. And at least one of them shows signs of oncoming problems, either the outer door snagging on rubbish on one or more floors - or the inner door catching on very floor. The one 'new' lift (just a few weeks old), the first of the replacement program, already has problems on two floors, and the runners are visibly silting up with grease, dust and grime.
I wouldn't expect the cleaning managers to spot it - they tend to hide, not even answering their bleeps, unless it's an outside phone call (if we need them, we go via switchboard and pretend to call from outside). But what about those other managers who have nothing better to do than design forms for us to fill in? You'd think an ambitious manager would like to be seen saving the trust many thousands of pounds, many wasted hours - and many buckets of frustration? No.
Ah! - why don't I report it? Well, the problem exists in virtually all London hospital tower blocks, and probably in every hospital tower in the country, if not the world. I did once report it at another site. I was, of course, ignored. I'm only a nurse, after all.
But the sadder explanation is that I cannot even find time at work to report the occasions when patients admitted to the Emergency department due to pain, arrive on the ward with no pain prescription. And yes, I have reported such events in the past.
Care to guess what the out come was? Nothing happened. ¶ 02:15
Now, the ward where I work shares managers with a handful of other wards; shares about 15 managers, most of whom wouldn't know a patient if they tripped over one - or most of the staff, either.
But there's so much management waste, and it makes me so angry, that I really cannot compose a useful post about that.
So let's look at lifts (Elevators, for nurses across the pond in North America).
Hospitals require lifts and lots of them; they get caned in daily use, and fail a lot. Or do they? My multi-floor block has five 'public' lifts facing each other in a central foyer. For the second time in ten years they are starting on a program of 'complete replacement' (Last time the program foundered after one new lift).
But why do lifts fail? I did a little research, and by and large, it's door problems, with occasional bearings giving out, and even more rarely, software problems. On a daily basis (if they are lucky), the lifts get swept out and the floor mopped, I guess by the people cleaning each foyer up the tower. There's no specific attention to the lift runners, and the non-specific attention involves dirt being swept into the runners on a daily basis.
At any one time, two or a maximum three lifts work. And at least one of them shows signs of oncoming problems, either the outer door snagging on rubbish on one or more floors - or the inner door catching on very floor. The one 'new' lift (just a few weeks old), the first of the replacement program, already has problems on two floors, and the runners are visibly silting up with grease, dust and grime.
I wouldn't expect the cleaning managers to spot it - they tend to hide, not even answering their bleeps, unless it's an outside phone call (if we need them, we go via switchboard and pretend to call from outside). But what about those other managers who have nothing better to do than design forms for us to fill in? You'd think an ambitious manager would like to be seen saving the trust many thousands of pounds, many wasted hours - and many buckets of frustration? No.
Ah! - why don't I report it? Well, the problem exists in virtually all London hospital tower blocks, and probably in every hospital tower in the country, if not the world. I did once report it at another site. I was, of course, ignored. I'm only a nurse, after all.
But the sadder explanation is that I cannot even find time at work to report the occasions when patients admitted to the Emergency department due to pain, arrive on the ward with no pain prescription. And yes, I have reported such events in the past.
Care to guess what the out come was? Nothing happened. ¶ 02:15
