Monday, April 7, 2008

I Can Feel The Intelligence Leaving My Body.....

When you replace a medical unit in a clinic, it is a good idea to conduct a complete inventory, as things, usually shiny and/or expensive, somehow get "lost" during the transition. Sitting through a review of said complete inventory, some suggestions on what shouldn't have been done:

Assign overall responsibility of the inventory to someone whose experience in a clinic or hospital is only on the receiving end of care. 'Cause right now isn't a good time to find out you don't know the difference between clean vs sterile items, and that they definitely aren't one and the same.

Have fifteen individuals (most of whom fall under the previous sentence) inventory several different areas at the same time, giving their own interpretation of what they think the item should be named, rather than what is on the packaging.

Decide that the stock/reorder numbers on the packaging are extra work to write down, so we'll skip it.

Gather all the individual inventories of cabinets, storage areas, and rooms, hand three or four sheets of them to a different person than the one who compiled the list, and give the following instructions to the assembled group of soldiers, half of whom are not medics:

"I will read the item off my list; I want you to look through your lists and
find stuff that's the same thing but with a
different label, then scratch it out
and replace it with the name I just said."

Which results in an approximate rate of one item named every three to four minutes while receiving personnel look for items that are probably the same thing under a different name. Or in the case of a certain very pissed off medic at this point, asking if they honestly expect him to read the six pages of items in his hand looking for alternatively named items for every individual item listed on the four sheets of paper in the Staff Sergeant's hand.

Insist that rather than using the army naming system of subject, then adjectives in order of general to specific, it will be much easier if the Staff Sergeant Without Clinical Experience names the item, and the rest of you will learn to call it that (e.g., when you have literally twenty types of bandages, it is easier to organize by using the terms bandage (actual item), gauze (most general adjective), 4x4 (more specific), #1333 (most specific); bandage, non-adhesive, 4x4, #2304, etc. than the following : 4x4 gauze (ok, which one? The sterile individual 4x4, the bulk pack of clean but non-sterile 4x4 gauze, or the individual sterile 4x4 non-adhesive dressing that you call gauze because you've never seen or used them before?) rolled gauze (the three or four inch wide? Which length? What reorder number? Because the supply sergeant is going to ask you exactly that.))

Above all, DO NOT POINT OUT IN PUBLIC that if the stock numbers had been included, everything could have been sorted on the spreadsheet in minutes with duplicates listed along side each other, enabling consolidation in less than an hour by one person. Pointing out the number of man-hours lost with current method vs suggested method will also result in unwanted individual attention.


jon spencer said...

A long time ago I was working at a Great Lakes Naval Station engine repair shop.
We had a supply cage with thousands of parts.
We would take parts out, put some back and take others.
We would use some of the parts from a parts kit on one engine and some on another engine.
About once a week someone would check on what we used (written on the clip board) and order more stock.
Supply types came in to do a inventory.
While we were working, parts going-parts coming back and going again to and from the cage.
Drove them goofy.
We did not tell them until they started to have a fit that it was a pre-expended bin.
For non parts users this means that everything in the cage was considered as expended.
It, the pre-expended part just made work much easier.

BobG said...

There is the right way to do things.
There is the wrong way to do things.
There is the government way to do things.