The company I work for is Productivity driven. They are also Performance driven. They are also Quality and Safety driven. Looking at each of these it would seem that one has nothing to do with the other. They really don’t unless one or more of them reaches a tipping point that will intern skew the others.

We have a productivity goal that is set for us by Corporate based on customer orders. We must achieve this goal every day or risk falling behind and losing the customer. Along with these goals we have to maintain certain preset performance levels to remain fiscally viable. If we spend too much to make the product (labor/overhead) we lose profit. Our quality goals are set both internally and externally by the customer. If we can’t make a ‘perfect’ product they won’t buy it. The orders we need for production will be gone. Wrapped around all of this is maintaining a safe environment.
To sum it up we have to be able to ‘produce’ a ‘quality’ product ‘safely’ and ‘efficiently’.

What we have found is that each of these has its own ‘tipping point’.
When we are functioning at optimal levels for production and labor force all of these areas are ‘green’ in our charts. People are happy that the work is coming through the doors and they like their jobs. During periods of low order volume, like last winter, we decrease our employee volume. Those left, had a tendency get into a mode of ‘automatic’. They sort of just cruise through the day in autopilot and they aren’t sure of their jobs. During these periods we saw product quality go down and injury rates go up. We get the same effect under the opposite circumstances. Later in the spring, order rates mushroomed. We had to increase the labor force with unskilled labor to accommodate. Once again, due to the lack of training and shifts that increased to 12hrs, we saw quality go down and safety incidents go up.

To a customer look in, our ‘brand’ no longer looks very appealing.

The same policies must apply to medical facilities. If patient volume is too low, they will shed staff or close, affecting patient care. If they set their pace to make the most profit by pumping through the most patients, they will be understaffed with the same affect on patient care. While maintaining this balance, physicians must check their own quality ‘patient care’ or lose the important thing…US.



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