In February this year I found out that I was pregnant. I gave birth to my baby in October, so it\u2019s hard to talk about the challenges that I\u2019ve faced this past year without discussing my pregnancy \u2013 it did kind of absorb the whole of 2014! As a lean specialist, it\u2019s been very interesting to experience what is the biggest interaction with the National Health Service that I\u2019ve ever had.<\/p>\n
From a technology perspective, the experience was patchy. On the one hand, the technology used to assess me and my baby\u2019s well being was fantastic \u2013 the clarity of the scans, how they could measure limb lengths and fluid volumes at the touch of a button, the sensitivity of the blood tests and, in labour itself, the technology which was monitoring my baby\u2019s health was very reassuring.<\/p>\n
This level of technology was not replicated within the associated reporting administration however. A yellow maternity note file was issued to me upon my first visit to the hospital \u2013 it becomes somewhat of a maternity \u201cpassport\u201d, needing to accompany you at every appointment. If, like me, a few early complications means that you follow a \u201cConsultancy led\u201d path (i.e. you need to see a Consultant for extra care as opposed to midwives) then the notes travel with you many times for multiple scans and appointments where each time more (frankly illegible!) writing is added to the pages \u2013 new appointment times, hand written inside the front cover \u2013 the contents there in, becoming more and more precious.<\/p>\n
These files also become the method to alert the next stage of the hospital process of your attendance, the order of the yellow files becomes your place in the queue. At every appointment, the physician quickly flicks through the file to attempt to decipher what has occurred previously in order to progress your care. Given the immense pressure that the service was under, it was no surprise that often, it became my responsibility to provide a quick summary of \u2018where we were\u2019 in order to trigger the next step. My lean brain found this quite difficult to deal with. There seemed to be a lot of opportunity for human error as key information lay hidden within a mountain of handwriting. Too much relied on the confidence and capability of me as a human to demand my care.\u00a0 Employing lean tactics such as visual management could help to make the process more streamlined and effective and less reliant on the patient.<\/p>\n
I\u2019ve written about the power of visual management before and it seemed to me that there was a great need for more visual management throughout the process\u2026 from where to sit and wait, to how long the queue wait is, to clear markings on my file as to why I was Consultant led and what the major issues were. It would be even better if the visual management solutions could be captured using technology to ensure a seamless, transparent, transferable experience.<\/p>\n
Whilst I spotted the potential for lean improvements at many parts of the process, the NHS staff that I encountered were always helpful, knowledgeable and most importantly, really cared. The problems lay within the process itself, and having the time and space to improve the process, not the people working within it. I felt like every medical issue I was experiencing was carefully examined, but yet I did not feel very confident in the process itself. There was definitely a need to redesign the process from a patient\u2019s perspective, not the clinician\u2019s. For example, I felt compelled to ring to check upon receipt of a gravely worded letter from the \u201cDepartment of Radiology\u201d (not the Antenatal Unit that I was familiar with) for a \u201cFetal Anomaly\u201d scan, that this was just the routine \u201c20 week scan\u201d that I had been warned of.<\/p>\n
Looking back at this experience, I realise that a key problem for me is coming to terms with the beautifully effective process that I can picture in my head, with the reality of how hard this is to actually achieve. When waiting for an appointment, part of me just wanted to stand up, shout \u201cSTOP!\u201d and start running a lean workshop, but I was deeply conscious about how that would be received (!) and also, how na\u00efve I was as to the actual pressures and strains that all of the staff were under.<\/p>\n
In the end, all we can do is have an idea of what a better reality could look like, and do our best to work towards it. Next year will be a challenge for me. I\u2019m finding that babies do not take well to being \u201cleaned\u201d and they can be frankly, illogical. I\u2019m going to have to deal with this whilst having time off from my career, something that I will find quite difficult. I\u2019m hoping that the break will enable me to reflect on my lean knowledge and really consider the practicalities of making lean improvement happen in reality. I\u2019m going to have to learn that achieving perfection is unlikely and I\u2019ll just have to do what I can, when I can, focusing my attention on what\u2019s most important, my lovely new baby. Giving birth to my baby proved, as exciting as \u2018elegantly simple\u2019 processes empowered by technology are, it\u2019s the kindness and diligence of human beings that will always make the critical difference.<\/p>\n","protected":false},"excerpt":{"rendered":"In February this year I found out that I was pregnant. I gave birth to my baby in October, so it\u2019s hard to talk about the challenges that I\u2019ve faced […]","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[5,68,12,6,8],"tags":[],"custom_author":[44],"class_list":["post-31","post","type-post","status-publish","format-standard","hentry","category-lean","category-life","category-operations","category-service-improvement","category-value","custom_author-sarah-lethbridge"],"jetpack_sharing_enabled":true,"meta_box":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/posts\/31","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/comments?post=31"}],"version-history":[{"count":3,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/posts\/31\/revisions"}],"predecessor-version":[{"id":542,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/posts\/31\/revisions\/542"}],"wp:attachment":[{"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/media?parent=31"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/categories?post=31"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/tags?post=31"},{"taxonomy":"custom_author","embeddable":true,"href":"https:\/\/blogs.cardiff.ac.uk\/sarahlethbridgelean\/wp-json\/wp\/v2\/custom_author?post=31"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}