I don’t usually start a blog post with jot notes as I write from the heart. I felt compelled this time to put some of the keywords down. This allows me to remember the thread as it will take a while to articulate these thoughts and highlight the key points.
If you own a small business and there is an issue you are front and centre until it’s resolved. Your income is dependent on your capabilities. Your reputation is paramount to your success. This applies whether it is a service based company like a speciality retail store or a family owned dairy farm. Although there are workers in this scenario none of them would be minions as everyone has something on the line.
At a medium sized level there is an accountability that remains connected. If the company isn’t doing well it can affect your employment so there is a vested interest in ensuring that things run smoothly. Should a parting of the ways come about there is an obvious absence the departure will make. If one person in a small office of a dozen people departs there is a shifting of the load so to speak.
The bigger “the beast” the less connected to its reality are the minions. Each have responsibilities but the level of accountability to the bottom line or the top brass is so removed that it becomes a non issue. The system becomes, in itself, a broken clog but no individual effort can fix it. This leads to frustrations and then a level of disconnection that dissolves accountability. It leads to system abuses on so many levels that it is a systemic leak of garganteous proportions. Health care is a perfect example of this but so are governments, educational institutes and big banks. They become cold institutions that can, if allowed, suck out the life of the minion.
This whole post was brought about by the opulence and waste of resources within the health system. Our Lean budgeting long since ran out and yet there were no true systemic fixes so the system continues to careen around corners and smash through walls daily. Hell it does it by the minute. I can only speak to one area and the amount of physical resources wasted is actually staggering.
Keep in mind that I’m “not a lean expert” but just a front line worker with an opinion that had chosen to document it in her own blog. I’ve done a post about work before that went mini viral for a day and there was one negative comment. There were loads of other minions who connected with what I wrote. This isn’t a Rant! but rather a reflection of structural deficiencies in the area that I work.
It seems, to me, that in health care we have all forgotten that we are tax payers. There is a tremendous amount of waste on so many levels. From the amount of supplies opened (and not used) to the billing codes to the time waiting for patients, doctors and nurses when it is a life threatening situation. There is so much focus on Lean processes within the physical supply aspect of the Operating Room that no focus has been done on the bigger issues. It is assumed that if we save a million here we can waste two million over there. There is no real fiscal accountability.
Patients first is always the priority, as it should be. Safer Every Day is a PR tool used by the Saskatoon Health Region to tell us how we are achieving that. But are we really? Are we feeling the pinch? No because we are too far removed from the cost of health care. I have a young colleague practising orthopaedic surgery in Ethiopia. I’m quite sure, from her writings, that it makes Haiti seem luxurious.
My father was fond of saying “waste not want not” but it’s not the buzz word that comes to mind. The words now are “standard of care” but in lots of cases that seems like the BMW or Porsche when a GMC Sunbird would do just fine. We cut back on front line workers regularly enough as the water flows out the dike at the other end from a massive hole.
I fully recognize that I can’t see the big picture but just who is looking at it? There are loads of solutions to a number of these issues but it’s difficult to tackle when it seems that no one listens.
Meanwhile I go to work and give 110% because that’s how I was raised and how I roll.