Process Improvement Lessons from a Hospital Emergency Room Experience

“A recent experience in a public hospital emergency room sparked my thoughts on process improvement.”

During a family emergency, we received a priority number at triage and were quickly seen by a doctor, who ordered a CT scan. However, the subsequent steps—registration at the CT desk, waiting in long lines, multiple hand‑offs, and even a new check‑in machine at the pharmacy—added significant delays. We spent over two hours from arrival to receiving medication, much of it waiting and walking between buildings.

The author notes that similar chaotic scenes appear in media, where patients’ lives are at risk while families scramble to handle payments, medication, and equipment, often causing dangerous delays.

Analyzing the process, the author maps eight distinct queuing points: triage, registration, doctor call, CT order, CT registration, CT waiting, medication order, and pharmacy check‑in. These steps occur across different locations, further increasing waste.

Using a Value Stream Mapping diagram, the author shows that out of 110 minutes total, 84 minutes (76%) are spent waiting or queuing, while only 15 minutes (13.6%) add real value.

The piece argues that public hospitals design processes for their own convenience rather than patient needs, leading to unnecessary steps for patients and families.

Drawing a parallel to software development, the author suggests that any transformation—agile or DevOps—is a continuous process improvement effort. The software industry, like healthcare, should focus on customer‑centric design, simplifying user interactions while handling complexity internally.

Common agile transformation pitfalls are highlighted: over‑emphasis on tooling and insufficient user‑centric thinking, which mirrors the self‑centered approach seen in the hospital example.

The author concludes that true customer‑centricity means making the user interface and interactions as simple as possible, leaving complexity to the service provider, citing examples like Google Search and modern smartphone interfaces.

Images illustrating the process steps and value stream mapping are included throughout the article.