Home > The ATTC/NIATx Service Improvement Blog > How do you spell EKG?
December 12, 2017
Maureen Fitzgerald
ATTC Network
NIATx
The story behind the NIATx walk-through
If you've done a NIATx change project, chances are it started with a walk-through.
“I was working with a hospital to find out ways to improve its cardiac surgery program. So, I took on the role of a patient and checked in to the department. The first thing I was told to do was to go and get an EKG. The person behind the desk told me to just follow the signs. When I got to the EKG department, I asked the staff person there what could be done to make her job easier in terms of helping patients through the process. She said, “Change the signs that people are supposed to follow to get here.”
Gustafson asked her to explain, because he hadn’t had any trouble getting to the EKG department.
"She asked me to look again, and that's when I noticed that none of the signs said ‘EKG.’ They all said ‘Electrocardiogram.’”
“I didn’t know anything about addiction treatment when I came into the field, so I got myself admitted for heroin addiction. I figured it was the only way that I could get a feeling for what the field was like, and so with the help of two treatment agencies in Madison and New York City, I created a fake persona. I let everybody know ahead of time I was coming in. The persona I created was one of being a heroin addict for 30 years. Finally, my wife had gotten rid of me, I had lost my job, and I desperately needed help. I went through the admission process, and I lay in the detox facility for several hours to feel what that would be like, and so on.
Many rich experiences came out of that, but one of them was that after two and a half hours of interviewing me and collecting information they said, “You do need to be admitted into residential treatment. But we do not have a bed now. I tell you what. Call back once a week and let us know if you are still interested.” My reaction was that if I really were a heroin addict, I don’t think I would been motivated to call back once a week until a bed was ready for me.”
It turns out that the walk-through wasn’t a new concept in process improvement, Gustafson says—Toyota had been using it as part of kaizen, its approach to continuous improvement. Union Pacific Railroad had also used the concept in designating a Vice President of Tracks, whose job was to ride all 52K miles of track in the U.S. and live the life of a train.
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