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Thursday, October 22, 2009

Unexpected Demand for Health Care in Flu Season?

I spent 20 minutes on hold for the pediatric triage nurse this morning. When I asked how she was, she responded, “busy”. No doubt. Cold & flu season isn’t even in full swing yet, but doctors’ offices are full of the unwell.

She asked me some basic questions about my children’s symptoms, and then gave me the, “monitor and report back” response. Relieved that neither of my boys was in immediate danger, I grew annoyed with their management of the demand for their services.

Pediatric care practices are all over-capacity right now. But with H1N1 having been telegraphed for 6 months, increased demand was not unexpected. Still, this office relied on the standard processes that are in place 365 days a year.


Variability of demand, coupled with the fact that in any process involving human service, capacity is difficult to bring on- and take off-line, combine to make service operations difficult to manage at the best of times.

Still, they knew this was going to happen. Where was the proactive response?

The on-hold messaging indicates that the response process is first-in-first-out (FIFO), but is that the best when demand is outstripping capacity? You don’t have to be visibly fair to customers in a telephone queue, so why not prioritize even before the call gets answered?

How about changing the IVR to automate triage and engage the caller in provision of their own service?

In the case: one line for flu, one line for everything else.

The flu line could ask qualifying questions such as temperature range, duration, and additional symptoms that could be aggregated on a desktop system that would allow the triage nurses to prioritize before answering a line, and respond most quickly in critical cases. If a parent is really only looking for the comfort of having spoken with a professional, they can wait awhile.

Managing demand better allows caregivers the ability to keep the community more healthy. It also lets them serve more customers and take in more money.

Thankfully, the first message in the on-hold system indicates that if this is an emergency, hang up and call 911. At least it is unlikely that response is delayed to a serious health issue because of the mismanagement of demand.

1 comment:

Chris Reaburn said...

(As a follow-up: The IVR message made me chuckle. “Availability of flu vaccine has been delayed, as production of H1N1 vaccine has slowed the production of regular flu vaccine.” For as much as Tom Peters cringes about standards in non-industrial businesses, it’s good to know that the manufacturers still get caught with their capacity pants down every once in awhile.)