The walk is the easy part
Ask someone where a hospital visit goes wrong and they will describe getting lost. That is the visible part of the day, and it is the part that maps have largely solved. A clear sign, a floor plan, and a phone in the hand get almost everyone to the right door. What they leave alone is the four hours around it.
What a route cannot carry
A route answers one question, which way, and a hospital day asks five.
- Where
- Which entrance, which floor, which counter, and how far that is from the door you came in by.
- When
- Whether the scanner is running late, whether the slot you booked still holds, and when to start walking.
- In what order
- Two investigations and a consult have an order that is cheaper to follow than to discover.
- Who takes over
- The desk that owns the next step, and the person there who is expecting you.
- What to do while you wait
- Water or none, the referral letter, the previous scan, and where to leave a bag.
The wait is a place
Waiting is the largest single block of most hospital visits. In a busy outpatient department it runs from twenty minutes to well over two hours, and it happens in a room nobody has described. A person sitting in it knows one number, their own, and sometimes not even that.
| Phase | What the person needs | What they usually get |
|---|---|---|
| Arrive | Which entrance, and how far | A postcode |
| Wait | Where they are in the queue | A number on a screen |
| Move | Which corridor, which floor | An arrow |
| Do | What happens next, and for how long | A closed door |
| Follow up | When results arrive, and who calls | Silence |
A day is a sequence
- The day is planned against its slowest step, which is usually the scanner.
- One step slipping moves every step after it.
- Re-planning is the normal case, and it should happen before the person notices.
What a venue gets back
The same view that guides a patient tells the operations team where people stop. In one outpatient area we log the walking time between counters, a median of 4.2 minutes, the minutes spent waiting with no update, and the number of times somebody stops a member of staff to ask the way. Each of those is a number most hospitals already collect by hand, at one desk, in a notebook.
A four week pilot is enough to see whether the numbers move. How a pilot runs
Where this leaves the map
A map is where guidance starts. Three things sit past the last corridor:
- The wait, with a position in it and a predicted time to leave.
- The sequence, which re-plans when a step slips.
- The handoff, and who owns the step after it.