You Don't Need More People

About once a quarter I get data from someone who is trying to prove that they need more people to do the job. This month it was a hospital trying to prove that more nurses result in better care. Intensive care units usually have one nurse for every two patients. Medical nursing units may have one nurse for every four, five or six patients.

Here's the facts: I've looked at lots of data from lots of hospitals. No matter how I look at it, unless the unit is woefully understaffed, there's no correlation between the number of patients per nurse and patient outcomes.

What really matters is how the unit is laid out and how much each nurse commutes every day. Commute time reduces patient care time.

Lean Principle: Walking is Waste!

When my mom was in the hospital recently, I noticed that nurses often came in to do something and then had to go back to the nurses' station to get something they needed. Why weren't the supplies in the room? Some were, but often they hadn't been replenished. Why not?

Lean Principle: Unnecessary movement of people or materials is waste!

You don't need more people, you need better systems and layouts.

Repair is Waste!

When I worked in the phone company, I got put on a project to prove that we needed more technicians in the field. I started to do a little analysis and found that 51% of all calls were for repair. Over 15% of the repairs were repeat repairs, meaning that it didn't get fixed right the first time.

I thought: "This is silly. We don't need more people; we need less repair!" I talked until I was blue in the face. Everyone told me that repair was a fact of life. It's too wet in Seattle, they told me. It's too hot in Arizona. It's too cold in Minneapolis.

Nonsense! They just wanted a solution that met their preconceived notions of the "right" solution: more people = better service.

I finally gave up and muddled along with the rest of the drones until the project failed.

You Don't Need More People!

You need:

  • Less avoidable delay
  • Less unnecessary movement
  • Less repair and rework

After you've fixed all of the problems in your "system", then you'll start to need more people to handle the growing demand from satisfied customers. Until then, simplify, streamline and optimize your business to prevent delay, defects and deviation.

Rights to reprint this article in company periodicals is freely given with the inclusion of the following tag line: "© 2008 Jay Arthur, the KnowWare® Man, (888) 468-1537,"

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