It was a stifling hot August night in the city. Bill Russell, MD, Director of the City Hospital Emergency Room was deeply troubled. Driving from his favorite fast food joint with a bag of French fries on the seat, he headed back to the Emergency Room. It was nearing 8pm on a Saturday night and he knew what to expect. He heard the wail of an ambulance siren as he pushed open the door of the ER and observed the crowd in the waiting room. Nearly all of the chairs were filled and those sitting shared a look of resignation that comes from knowing it is going to be a long wait.
Russell had recently attended a seminar on continuous quality improvement (CQI) in health care and the speakers had all emphasized that a hospital was a service system or process and that patients were customers. One of the speakers was the quality director for a five star hotel chain who talked about listening to the voice of the customer.
City Hospital had lately hired a leading health care consulting firm, Bulldog Consulting Group, to lead them in a reengineering effort. Russell welcomed any help he could get, but he associated reengineering with cost reduction, not service improvement. On Monday morning the Bulldog project leader, Vanessa Rogers, and two other consultants, would be attending the weekly ER staff meeting. Russell was skeptical about what Bulldog could accomplish, but he was willing to listen.
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Arthur J. Swersey, “ City Hospital Emergency Room”, Yale SOM Case 09-041, December 21, 2009
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