Workflow & Workarounds

Eating breakfast at our favorite restaurant, which rhymes with Rob Blevins, my husband and I observed and discussed the process by which the waitresses take orders and convey them to the cooks. It worked like this: the waitress took an order and wrote it down with pen on paper. She no doubt included the little special requests, such as "please burn my bacon to a crisp" or "I would like honey for the english muffins, please, because my dentist needs another Lamborghini".

She then left the table side and went to a computer terminal into which she typed the requested order. The order ticket printed on a small printer located about two yards from where she entered the information, and almost directly in front of the cook's work area. The waitress walked over, removed the ticket, and gave it to the cook.

When the cook completed the order, he set the filled plates up on the counter, with the ticket next to them. The waitress put the ticket into a small plastic bin, and brought the food to the table. Near that plastic bin was a scanner, though we never saw it used.

We wondered why the waitress didn't put the order directly into a handheld device of some sort (though Lamborghini might be hard to type when one's in a hurry), from which it could be wirelessly received in the cook's work area. Upon completion the cook could send a short message (tweet?) to the waitress, who would then pick up the food. All transactions would be stored electronically, eliminating the need to kill trees and put papers into a bin. Of course there would need to be a downtime plan, but it's not unachievable. It may be that the only reason they aren't doing this already is that technology isn't cheap and these are tough times.

By now you wonder why my husband and I have such pathetic lives that this is how we entertain ourselves over breakfast, but I really do have a point. How much work and energy do we put into workarounds when we don't have, or won't use, efficient systems available to us? If I had a dollar for every time a caregiver enters a patient room, provides care, writes notes down on paper and then comes out to the nursing station to enter those notes into the computer, I would have my own Lamborghini.

Yes we have COWs; in some departments we also have tablets, but we continue to carefully fold that paper into a square (admit it, you all know how nurses fold those papers that get tucked into pockets for note-taking) and make extra work for ourselves.

It is important for all of us who are involved in HIT to look at workflow, develop process maps, and brainstorm better ways to do things. More important, however, is the involvement of caregivers who are actually going to be using those so-called "solutions"....or not.

Disclaimer: We love the Rob Blevins restaurant chain. We eat there once each weekend. We usually just talk about the grandkids or the garden or stuff like that. There may be way more to their order process than we even noticed. We will continue to eat there every weekend, at least until my husband's teeth rot out from all that honey.