Programmer at the hospital

- Where? - grandmother asked sternly, standing with his back to the door.

- Kudy need. - mocked untidy guy with red eyes, disheveled hair and a black T-shirt with the inscription "King and Jester."

- Well, do not let him! - rose from the bench another grandmother. - Look, vumnnye, climb without a queue! We are here with the morning stand!
')
- Do not stand, and sit. - answered the guy. - Let me pass, I'm on the case.

- We know what you are doing! - entered a pretty girl of about thirty. - Just ask?

- What is wrong with you, huh? - the guy was indignant. - I work here! I am a programmer!

- Come on, tell me. - smiled girl. - Where is the robe?

- On footcloths let. - replied the guy in tone. - Let me pass.

- I will not let you go! - Grandma at the door, it seems, not all the words understood. “Though a programmer, even an anarchist, I won't let you go!”

“Listen, grandma ...” the guy said in a conspiratorial tone, leaning closer to the hearing aid. “I’ll go to the Internet right now, and cancel your ticket.” Let go, I say!

The door for the grandmother tried to open, but buried in the bony back.

- Madam, aside, there is someone trying to get out. - smiled guy.

- Oh, and I ... - grandma hurriedly stepped aside.

A doctor looked out of the door - a young guy with glasses, bald, with a tattoo on his neck. The sleeves of the dressing gown were rolled up, and the forearms were also in tatuha.

- Holy, holy ... - grandma backed up.

- What are you doing here? - the doctor shouted. - I will now arrange quartz for half an hour, dance with me! Ruslan, come in!

- Can you take it faster? - the girl shouted after the closing door, but no one heard her. - Take half an hour, nightmare ...

There was no one in the office except a doctor and a programmer.

- What's up with you, Vasya? - Ruslan asked, sitting down at the table on which the computer stood.

- Yes, hung up, the creature, the system is fucking. - Vasily was very annoyed. - They made up some kind of shit, mediocrity, evil is not enough.

- Well, the system was assigned to us from the ministry. The programmer shrugged. - SchA fix, do not yell.

A few minutes later Ruslan finished. Helped the old grandfather's method - preventive reboot.

- Done. Why don't you take it? - Ruslan asked, getting up from his chair.

- What's the point? Said the doctor wearily. - Now the rules are - it is necessary immediately, at the reception, to drive in the data, otherwise they will blow up later. Not a hospital, but shit. Soon all the doctors will run away, tired of feeling like an idiot. You don't communicate with the patient, but you hammer in the data like an office rat.

- Let me pobivayu. - Ruslan shrugged.

- In terms of? - the doctor was surprised. - Seriously?

- Well, is there something complicated?

- Yes, what there ... - Vasya waved his hand. - The same thing, every time, for each patient. How I was born, where I studied, the chair is hard or not, it already suffers ...

- Come on, I have one hell to do nothing.

- Next! - the doctor shouted loudly.

The recent grandmother quickly ran into the door. Seeing Ruslana, stopped, rooted to the spot.

- And entot, antichrist, what is doing here? She pointed with a bony finger at the programmer.

- This is Grandma, a representative of the pension fund. - the doctor said soothingly. - He came with the inspection, checks how we, the satrap savage, with the elderly treat.

- Yeah! - the grandmother was delighted. - All Herods in one place gathered! Well, I chichas you ...

- Get undressed! - strictly said the doctor.

“Your mother ...” Ruslan confused, and, as he could, he leaned closer to the monitor not to see the unfolding - the action and the gray knitted grandmother's jacket.

An hour later, when the next patient came out, it suddenly became very quiet. Nobody entered the door, or even looked at it. The doctor looked out into the corridor, turned his head in different directions, clicked his tongue and returned to the office.

- Has resolved. He shrugged. - Until the end of the shift, two more hours, what to do?

- Well, the job is with you. - Ruslan got up from the chair. “What a mess you’re not listening to.”

- And I liked it. - smiled doctor. - Can you imagine? The first time, probably liked. I felt like a doctor, not a typist. Has managed to go to the therapists ... Listen, can you come tomorrow too?

- Data to drive? No, thank you. You have systemic problems here, not medical ones.

“Okay, not bad.” Where to go?

- To yourself.

Ruslan went out into the corridor, and was stunned by the imbalance. There was not a single patient in Vasily's office, but in the rest, his mother was honest ... Having thought a little, he came back.

- Let's take the rest too? He suggested. - It is also possible?

- Can. The doctor shrugged. - Just what for?

- As part of the experiment.

- Well go, please the crowd. - Vasya smiled.

Ruslan smiled in response, leaned out the door and shouted loudly: "Free cash!". The expected reaction was not followed, only people began to look fearfully at the unshaven, disheveled hair, screaming face.

- Citizens, come, do not be shy! - after thinking a bit, the programmer shouted again. - Free therapist! Who has zero tickets, all here! Unless, of course, it does not matter to you who will treat your poor souls.

- I have zero! - A woman of forty was separated from the crowd. - I’m standing in the morning, they don’t let me through, just by appointment!

- Wellcome! - Ruslan helpfully opened the door, letting the lady.

In the crowd, the ferment began, and after the woman a few more people approached the office - a queue formed.

Until the end of the shift, they managed to take another twenty patients. Ruslan quickly drove out meaningless information, and then, dictated by the doctor, wrote down the diagnosis and treatment recommendations.

When the shift was over, the doctor — tired but pleased — plopped down on the couch.

- A grymsa not eat you? - Ruslan asked.

- Not. - the doctor has waved a hand. - She now has such hemorrhoids that doctors have no strength or desire to have lunch.

- What are you talking about?

- Well, this, crap, like her ... Lean hospital.

- Oh, yes, I heard.

- Here you go. The implementation period is almost out, and not a damn thing is done The other day, checking, she screamed at us this morning, well, that we ... How can I say something ...

- Hand-to-hand?

- Yes, yes, sort of. I heard that it will be removed if the project ends badly.

- It's strange ...

- What exactly?

- Lean hospital. This, as I understand it, Lean?

- What?

- Well, lean manufacturing, Lean. Probably, someone very clever decided that the same methods can be applied in the hospital. It does not work in production, it does not work in logistics, so they decided to stick in hospitals. All will not die.

- Who? Ministerial?

- No, the consultants are freaking. Who do not know anything but Lin. Nowhere can they achieve any useful result, so they are looking for new sales markets. To get to the state structures here.

- And what are you, seethe in this? - squinted the doctor.

- Pf, what is there to flog something ... Well, I worked in the factories at the hospital, and in logistics. I've seen it all. Soon, look, in the hospitals will be scrambled to implement. Or a balanced scorecard, or 5S.

- This is what?

- Yes, crap on a stick. Make you workplace in order to keep. On the left - the sticks, which push in the throat, on the right - the patient's card, on top - the phonendoscope, and so on.

- Who is holding a phonendoscope on the table? - smiled doctor. - All decent people wear it around their necks.

- Well, when they come to implement 5S, they will say to put on the table. Or in your pocket to carry - always in the left. This technique.

- Some kind of game ...

- Eh, you didn’t go to the factories ... There used to be men who were tugged out of work in their pockets. Because it is necessary to keep it on the frame. And he from there, bitch, falls all the time, from vibration, and straight into the emulsion. And to the consultants with these things in the forehead, on the forehead - they say, so it is necessary, keep it on the frame.

- Hmm ... Well, have we done beautifully with you today? Let's repeat tomorrow, eh? Damn, Ruslya, really ... I have a whiskey bubble if you come tomorrow.

- Yes, I'll come, che me. The programmer shrugged. - You and I have a normal TOC turned out.

- What?

- I'll tell you right now.

In the morning, Ruslan calmly sat at his desk and drank tea. Vasya worked on the second shift, and there was nothing to do before lunch.

Suddenly the phone rang. Ruslan took the phone and heard Vasya - he ordered an urgent escape to the head physician’s office.

- Yes, I tell you, this is a real topic! - Ruslan heard when he entered the office - Vasya very actively convinced Natalya Petrovna in some way.

- Vasya, well, listen. - the head doctor answered wearily. - I don’t care for it now, you know, soon I’m going to check, I’ll be hanged, if the rates taken for a specialist do not grow. Whoever comes up with these norms ... Fifteen minutes for one for the therapist, and with the data entered into the computer ...

- So I am about the same! I told you about something broken half an hour?

- About some TOC ...

- Not! Do you know how many patients I took for a shift yesterday?

“Something to know, I'll see right now ...” Natalya Petrovna began digging around at the computer.
Vasya fell silent, smiling with satisfaction. Ruslan, using the pause, greeted him softly and sat down on an empty chair.

- Thirty three?! - the head physician has rounded eyes. - In one shift? This is how much it turns out ...

- Just over seven minutes per patient. - prompted Ruslan. - But, to be more precise, the two of us worked not in the morning, but in the last three hours, and accepted ... How much?

- Thirty. - Vasya picked up, taking out his smartphone and frantically searching for a calculator. - So, this is how much it turns out ...

- One hundred eighty to thirty can not divide? - smiled the programmer. - Six minutes. And in the morning you took three patients in an hour. Twenty minutes per capita.

- Did you take them at all? - the head doctor frowned. - Or so, divided aspirin into two halves, this one for the head, this one for asses, and do not mix it up?

- Yes, I never took it! Well this is a nightmare when you sit like a double-headed eagle - and you have to talk with the patient, and drive these data, and even think about the norm! And then I was only engaged in business, nothing more. Do you know how satisfied they were leaving? Especially those who need to work.

- What kind of job? They are sick.

- Patients are sick, but we have capitalism. The hospital take only child care, the rest immediately run to work. And zero so in general, I almost kissed.

- Ok, I understood ... - Natalya Petrovna thought a little. - What's the point? Why did this happen?

- Ruslya, come on!

- What to give?

- Explain!

“Ah ...” the programmer confused. - This is TOC, the theory of system limitations. A doctor's appointment is a business process like this, and to him ...

- What? - the head doctor frowned.

- Oh, yes ... - stopped the programmer. - Well, the process is shorter. The patient came, you need to perform certain actions, right? To ask what hurts him, to listen, to watch his throat there, well, you know better than me.

The head doctor nodded.

- Here you go. And still need to drive data into the system. Then print out a piece of paper, paste it into the card, write a prescription to the patient and tell him when to come next time. Such a process.

- Well, yes, I know that. And where is your CBT?

- Any process has a limitation, bottleneck, bottleneck. What is the slowest.

- Oh, I understand. - the head doctor nodded. - In our case, is it driving data into a computer?

- Yes. And the speed of the whole process - patient reception - is limited by the speed of driving in data. This action takes the most time.

- So, what is next? - in the voice of the head physician there was an interest.

- Further simple. We identified a bottleneck, and we have two options - either to protect it as much as possible, or to revise the process so that part of the load goes beyond the limit.

“And what have you made of it?” And, I understood ... You sat down to drive in the data, thereby unloading Vasya?

- Well yes. Removed non-core load from a specialist. Now the process has a new restriction - Vasya.

- I? - the doctor intervened. - What is wrong with me?

“You are fine, you are a key part of the process.” Take a look yourself. No matter how much we protect you, unload you, you still have to talk to the patient, listen to him there, look at your throat, and so on.

- Well yes.

- Here. These actions can not be thrown out, so the rate of reception will now be determined by the speed of these actions - normal, normal, medical procedures. The trick is that, besides the reception speed, now nothing interferes - there are no unnecessary links, such as driving data. Although…

- What? - picked up the chief doctor.

- The theory of restrictions, or rather, its creator - says that you can always do faster and better. For example…

Ruslan thought for a few minutes. The others were silent, knowing that they could be misled.

- Yes, I remembered. - smiled the programmer. “So far as I remember, the doctor had a nurse before you had computers.” She did about the same thing as I did yesterday - removing the non-core stress from the restriction, that is, from the doctor. I worked with the card, maybe even watched my throat ...

- No, the doctor's throat is always looking. - the head doctor shook her head.

- Well, no matter. Perhaps something else you can think of ...

- What for? - Vasya could not stand it. - So we are with you, without preparation and all sorts of systems and restrictions, we took six minutes!

- Ruslan, but somehow you can try it on other doctors?

- Ruslan is mine! - Vasya cried. - He promised me that today will be with me the whole shift!

- No, that's not good. - Natalia Petrovna grimaced. - Ruslan is an important specialist; we cannot use it for such work. In the end, we pay him serious money.

- Do not tell my sneakers. - Ruslan smiled. - Since when has the spot become serious money? You at least twice pay Vasya.

- So, let's not argue about what is beyond our control. - strictly said the head doctor. - The rates are approved by the ministry, not me.

- Yes, I do not mind, I knew what was going on. The programmer shrugged. - But I do not mind data whipping, if for the benefit of the case.

- Okay. But you're alone.

- No, not one. You walk along the corridors, look in the offices. Especially those around yours where all sorts of administrative workers are sitting. A lot of people who have nothing to do all day. And everyone is good at using a computer.

- For example?

- Helen.

- Hmm ... Lena is my secretary, she has a lot of work.

“Is that what she told you?” - smiled the programmer. - I honestly zadolbalsya already messing with her computer. Every time the internet goes down, a tantrum raises.

- Why? Documents can not send?

- “Pirates' treasures” in the orange social network do not work. - Ruslan smiled. - In short, take my word for it, her time is a wagon and a small truck.

- Lena! - shouted the head doctor. - Come on in!

A young, very pretty, painted red-haired girl in a white blouse, short skirt and heels entered the door.

- Yes, Natalya Petrovna, I'm here. - she said languidly. - Tea?

- Are you friends with the computer?

- Yes of course. - Helen nodded, looking suspiciously at Ruslana. - Why?

- Today you will go ... So, to whom ... To Babayev, or what?

- Let us go with us. - said Ruslan. - Under my supervision, Vasya will work. Let's do an experiment.

- Where? What for? - Helen was worried.

- Great idea, Ruslan! - supported the chief doctor. - So, Lena. Go with the guys, you will do what they say. To drive in data on receptions. There will be no other tasks from me today.

- What? - cried Lenochka. - Why me? I am not a nurse, but an office manager!

- Listen! - with a head told the chief physician. - Are you aware of the situation? Soon the check, and if everything goes bad, I will be removed from the post. Do you know who they will put in my place?

- No ... - in the voice of Lena sounded uncertainty.

- This, as his ... Effective manager, as in one hundred and eighth. So you will, for a couple - an effective manager and office manager. Watched "Arrhythmia"? So you will be the manager, that the skirt at the seams crackling. Remember me still a good word.

- Yes, I, Natalya Petrovna ... You are the best manager I have had to work with. - rattled Helen. “I am for you ...”

- You will go with Vasya and Ruslan for me, and you will do what they say. It is only for today. Do you understand?

- Yes understood! - nodded Helen. - Guys, where to go?

- Vas, come on, do it. Ruslan, you stay.

Vasya smiled vaguely, got up from the chair and walked to the door. Helen seeded after.

- And then what? The chief doctor asked when the door closed.

- Let's see how it goes today. Helen is needed only for the experiment, we will try others. From the help desk we will remove, there are three of them, maidens. All the same, sit do nothing, there come more swearing than asking.

- What to swear about?

- About long reception, about rudeness, “where is your boss here, call immediately”. Many more complain about the electronic queue - well, in which you need to take a ticket in order to take a ticket.

- This is generally an ambush. - the head doctor said contritely. “They made her install ...”

- Yes, I know.

- But I'm not talking about that. What's next? Next week, the ministerial will shut up, watch what I tell them?

- What will they watch?

- Indicators, first. For doctors pass. I think they will get to the bottom of a lean hospital. There is such a Talmud, I could not even finish reading. Is this your CBT - this is not a thrifty hospital?

“Well, both are abstractions.”

- What?

- Damn ... Universals. In Latin, probably unversalia?

- Universalis. - corrected the head doctor. - What are you talking about?

- We pack one into the other, they are unlikely to understand. TOC and lean manufacturing are similar if you look only at the outside. Fundamental differences in philosophy, but who understands this philosophy in the ministry.

“You can do this, as you said there ...”

- To wrap up.

- Yes.

- I can. - Ruslan nodded. - Business something. The main thing, after all, indicators?

- Yes.

“Okay, we'll do it.” You tell the girls from the reception to obey?

- From where?

- Damn, terminology ... From the help desk.

- Yes, right now. Let's go together.