Seattle RB is a no-show at team minicamp

Hrmph.

If Mr. Alexander is trying to regain the city's love, he's doing a poor job.

Flutie to return to Patriots

How can you not love Doug Flutie? I don't believe his body will let him start all season, but he's bound to have a game or two left. Back up to a champion is a perfect position.

More girls use steroids, often for weight control

Doomsayers Say Benedict Fits World End Prophecy

Exam Room Analysis

So now I'm playing with the data from those reports.

I hope to have visit (appointment) percentages equal room assignment percentages. In other words, if a clinic is conducting half of the total appointments in a day, then they should be assigned half of the total rooms. Something like that.

So far, the historic room assignments and the current volumes come pretty close to hitting this mark. This is heartening news.

I've discovered another challenge: a few of our clinics run into the evening. Since they start in the afternoon, they can't be entirely removed, but appointments starting at 4:30pm and 5pm aren't really a concern. At this point, the numbers of these are so small that it's not something I'm worried about. Room allocation is not a problem at 5:30 in the evening, just as it isn't a problem at 8:00 in the morning.

Export

I just learned how to export reports generated by the hospital's scheduling system into Excel.

Go ME!

And if you think I'm slow on the tech intake, you should see the people I work with...

Steelers sign 12 undrafted rookie free agents

Zach Tuiausosopo (FB from UW) was signed by the Steelers on Monday as an undrafted free agent. I think his run in with the law hurt his draft stock; hopefully he can keep flying right, make the team and start building his NFL career.

http://http://seattletimes.nwsource.com/html/seahawks/2002253137_nfl26.html

April is National Prevention of Child Abuse & Neglect Month

I just learned from our internal website that "Annually, our staff assesses approximately 500 children for concerns of child abuse and neglect."

Damn. There are only 365 days in a year...

I'm not one to get involved in various "National So and So Months" but this bears a moment of reflection.

Cel - PDA

I'm trying to talk myself into buying a cel phone / PDA, but I really can't justify the expense. It would be nice to have a portable calendar and phone/address book, all in one device. I only use my cel phone for emergencies, though. Maybe a straight PDA is the way to go, but I really like the gadget factor of the combined device.

More Medical, Exam Room thinking outloud

There's a "Whale Checkin List" that includes every outpatient scheduled for clinic, it also includes all of their appointments and is sorted by appointment time. Since it sorts by appt time, it doesn't handle multiple appointments well. If a patient comes for a 10am, and an 11am, they will be listed twice, once at each time. This can be confusing or at least cluttered since they only need to check in once. I remember seeing a list that grouped appontments by patient. I will dig more.

The "All Appointments" Report isn't bad. It sorts by service, then by patient, then by time. The bad part is that it includes appointments at the regionals. It's a little too much information.
I'd bet that it would be easy to create a similar report for all patients projected to be seen on any specific floor of the new building.

Medical - more room management

Our largest clinic runs on Mondays; it's a multidisciplinary affair, with patients coming from all across the region to receive care from physicians and other professionals from plastics, dental, cra, audio, speech, social work, nursing, nsr, sleep and probably others that I can't recall. Most of these visits are scheduled by two PCC's and occur on Whale 7. This clinic uses 21 exam rooms, today they have nearly 60 patients scheduled. This is not an unusual day.

They used to track this activity with a white board. Patient's names were on one side, and all of the providers were along the top, along with room number. Scheduled times were charted throughout the grid. This board took hours to write (usually on Friday afternoons) and was very complicated to look at. With all low tech things, to view the information on the board, you had to travel to the board's location, then examine it.

About a year ago this department started tracking this real time information electronically. PCC's run a report which pipes the patient information into an Access database. Several PC's in the clinic area have access to this database which is updated in real time. They use the system to assign and track room assignments, provider locations and schedules, view patient schedules, and to track which appointments the patient has completed, which are remaining and if any have been cancelled or added throughout the day.

I would love to adapt and update this system to do fewer things with more patients. I would love to import the name of every Whale 7 patient into the system, then have room assignments issued early in the visit, immediately upon registration, really. I envision this being done by the Family Service Representatives (or whatever title they plan to give that position), but it could also be done by MA's.

We can rebuild it, we have the technology.

Seahawks Draft weekend round up

According to the team web-site they picked up a few undrafted free agents Sunday afternoon:

Position Name School
SS Jamaal Brimmer UNLV
SN Tim Galloway Washington
G Steven Gibbs Arkansas State
P Chris Kluwe UCLA
RB Jesse Lumsden McMaster (Ontario, Canada)
TE Calen Powel Duke
FB Leonard Weaver Carson-Newman
RB Marquis Weeks Virginia
QB Brian Wrobel Winona State (Minnesota)

Here's summary of their draft pick-ups:
1 (26) Chris Spencer ; OG - Mississippi
2 (45) Lofa Tatupu ; MLB - USC
3 (85) David Greene ; QB - Georgia
3 (98) Leroy Hill ; OLB - Clemson
4 (105) Ray Willis ; OT - Florida State
5 (159) Jeb Huckeba ; DE - Arkansas
6 (196) Tony Jackson ; TE - Iowa
7 (235) Cornelius Wortham ; OLB - Alabama
7 (254) Doug Nienhuis ; OT - Oregon State

NFL Draft III

Seahawks traded up with Carolina for an earlier second round pick: Lofa Tatupu, an MLB / Strong Safety. There is the defensive pick I was expecting earlier. This looks like a solid move, he is a promising young athlete who should help immediately.

NFL Draft II - Matt Jones to Jacksonville

This guy is cool, and I'll have to keep my eye on his NFL career.

NFL Draft

Round 1, Chris Spenser, Center.

I don't get it. They just signed Robbie Tobeck to two more years. Of all positions to bolster, was the offensive line the way to go? Who's going to sit on the bench next season?

They're still thin at linebacker, their receiver corps is shaky, Shaun isn't going to be around for much longer.

I did like the trade with Oakland. It never hurts to get a couple more picks in later rounds, especially for what I consider an inexpensive price.

Books I should read:

Smart Couples Finish Rich : 9 Steps to Creating a Rich Future for You and Your Partner by DAVID BACH

The 7 Habits of Highly Effective People by Stephen R. Covey

I usually shy away from self help books. Lately though, my interest in practical knowledge has grown. Both of these have come recommended by people whose opinons I respect.

Technology

This morning I imported my Yahoo Calendar to Outlook and my Outlook calendar to Yahoo. I use one for work and the other for the rest of my life, and it's been occasionally awkward, especially when the two overlap.

I couldn't get yahoo's synch function to work, and I'm not sure why. It kept telling me that there was a problem with my Yahoo user ID and/or password. I log in to Yahoo every day, so I know I was typing it correctly. It may be a problem caused by my work network's security.

That article about the paperless and clutterless Microsoft fellow really inspired me. I still want most of my books and things, but I can get rid of a lot of stuff and only be happier. This is probably leading to a Palm Pilot / cel phone combo, but the benefits don't yet outweigh the expense.

Computer sage cuts paperwork, converts his life to digital format

I want to be like this guy. Imagine the lack of clutter... That sounds oh so good to me.

DRAFT 2005: Clarett likely a second-day draft pick

Then came legal troubles, NCAA violations and a failed lawsuit against the NFL. A player once spoken of with the kind of awe reserved for a young talent like LeBron James had become synonymous with controversy and poor character.

Now, Clarett is saying and doing all the right things -- enough, perhaps, for a team to select him in this weekend's NFL draft.

``He's definitely a second-day pick,'' said Gil Brandt, the NFL's draft consultant.``He's really tried to turn his life around.''
Brandt knows Clarett hasn't dazzled anyone with his speed. After a disastrous showing at the NFL combine, Clarett improved last month at a private workout near his hometown of Warren, Ohio, running a 4.67-second 40-yard dash.

But Emmitt Smith and Jerome Bettis didn't run
that fast either, Brandt said.

Draft II

Also from the previous article:

Potential Hawks first round pick, Justin Miller (CB) from Clemson was arrested Saturday for disorderly conduct. Lord knows, we don't need another young troublemaker... Holmgren has enough little projects as it is.

Since they let Heath Evans go, I wonder if there'll be room for Zach Tuiausisopo behind Mack Strong on the depth chart in fullback. That would be cool. Then they should get Marques from Oakland to back up Hasselbeck or to play third string behind Seneca Wallace. That's not likely, of course. They need some experience in the 2nd string QB category.

Brown awaits Hawks release

The Hawks want to use Chad Brown as a nickel back; to fit him under the salary cap, they need him to take a significant pay cut. Understandably, he doesn't want a pay cut.

While Brown has been a powerful presence on the field, injuries have severely limited his playing time, and therefore his usefulness. It would be better to keep him than not, but if we lose him, it won't be the end of the world.

Current starting linebacker lineup include Sharper (recent deal) on the right, Niko Koutouvides (is he any good? I'll have to look into that) in the middle, and DD Lewis (I don't even know who that is) on the left.

NFL Draft I

Adrian McPherson, who is looking for a second chance after theft and gambling charges bounced him from college football. While some appear ready to offer McPherson another opportunity, we had a few emails, including one from a Nebraskan, compare his misdeeds to that of Phillips, a former Cornhuskers running back and NFL transient who had a career marred by arrests and emotional outbursts.
On other subjects, the entire state of Arkansas – and probably most of the states that include college teams in the Southeastern Conference – wrote in to extol the talent of Arkansas quarterback (and soon to be wide receiver or tight end) Matt Jones. Apparently, it was the rest of the world sleeping on the kid, not anyone who had ever actually seen him play. We're guessing the NFL scouts who went to his games (and didn't see his super workouts coming) don't count.

The internet is a strange place. More Ultimate Warrior drama.

Which Marvel Superhero are You?

McFarlane Toys Announces "Napoleon Dynamite" Action Figure Line

Napolean, Pedro, and Kip join the McFarlane team!

Napoleon Dynamite, the 2004 comedy starring Jon Heder, Jon Gries, Aaron Ruell, Efren Ramirez, Tina Majorino, Diedrich Bader and Haylie Duff, became the rage of the pop culture nation when it took film critics and film fans by storm last year.

Now, McFarlane Toys, realizing the potential of this hilarous movie, has aquired the licence to produce action figures based on the film's many eccentric characters.

Set to hit store shelves in the fall of 2005, the first line of figures will include the film's quirky anti-hero Napoleon Dynamite, his mustachioed sidekick Pedro Sanchez, and chatroom-junkie brother Kip.

News Source: Spawn.com

Sweet. Action figures are a weakness of mine. I can usually resist, but these might sneak through. Might make good gifts for some friends of mine when Christmas comes around.

Seahawks Schedule

NFL schedules were released on Wed (4/13/05). I couldn't get it to format right on the blog, so you'll have to follow the link to see what the Hawks have scheduled this year.

Medical - herding cats

My next short range project is to revamp the supply carts in the shared utility closet. Over a year ago two clinic spaces were merged into a temporary space while the old wing was demolished and the new one constructed. We'll be moving into the new facility in a little less than a year.

When the clinic spaces were merged, the clean utility closets of each were also merged, with no top down plan or examination. I am now conducting that top down revamp.

The tricky part is that 15 different medical departments depend on those carts for the majority of their medical supplies. I'd like to maximize the efficiency for all of them, but it's not going to be easy to get participation from them all and it may prove even harder to respond to all of their requests.

One piece of good news is that the closet and the carts are in such bad shape now that any improvement will be appreciated.

This is also another way to gear up for our move next year.

Seahawks reach agreement with linebacker Sharper

KIRKLAND, Wash. (AP) -- The Seattle Seahawks agreed to terms Tuesday with free-agent linebacker Jamie Sharper, adding needed experience to the defense.

The Seahawks did not release details of the signing, but the Seattle Post-Intelligencer reported Sharper agreed to a five-year deal worth $17.5 million, including a $1.5 million signing bonus. Calls to Sharper's agent, Tony Agnone, were not immediately returned.

Entering his ninth season, Sharper was released April 1 by the Houston Texans. He started all 48 games at middle linebacker since joining the Texans in the 2002 expansion draft and led Houston in tackles with 137 last season. He became expendable when the Texans decided to add more speed to their 3-4 defense.

It seems like a lot of money for a relatively old player, but he has a history of consistency which is important for the Hawks at linebacker. As long as his body holds up, it will be a great fit.

With Chad Brown on one side and Sharper in the middle, who is on the other side? I just double checked, and I don't believe they've signed a notable free agent for that side; with the two old men (by pro-football standards) already at linebacker, perhaps they're thinking draft.

I hear Anthony Simmons is available... (kidding!)

Keyboards used in hospitals are havens for bacteria

By LEE BOWMANSCRIPPS HOWARD NEWS SERVICE
Electronic recordkeeping in
hospitals and other health care settings may be spreading more than just information. A new study presented yesterday shows that some nasty bacteria can survive and grow for at least 24 hours on computer keyboards.
"Not only do we demonstrate that some bacteria can survive for a long time on keyboards, but that it's possible to transmit them from the keys to the fingertips -- and if you're not careful about washing hands, potentially pass them along through contact with other patients," said Dr. Gary Noskin, medical director of health care epidemiology and quality at Northwestern Memorial Hospital in Chicago

. . . .
His team "inoculated" keyboards and covers with three types of bacteria commonly found in hospitals -- vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PSAE). They found that the first two bugs continued to grow for at least 24 hours. "PSAE, on the other hand, could be recovered only up to one hour on (the) keyboard and five minutes on the keyboard cover," Noskin said.
. . .

Washing the equipment with hospital disinfectants heavy on ammonia killed the germs after it was left on for five to 10 minutes -- which has grim implications for the electronic circuits beneath the keys.

The take away is to wash your hands, wash your hands, wash your hands. It is particularly important to wash after using a shared keyboard. Alcohol based hand sanitizers are a solid and proven alternative. These sanitizers are flammable, however, so they should be kept away from electrical equipment (including outlets and keyboards) and carpeting, and they should be stored in fire proof containers when not in use. It's safe to keep one on your desk, but you shouldn't leave six pump bottles or dispenser refill bags in your desk drawer.

It's also interesting to note that it takes hospital grade disinfectants to kill the germs, and those chemicals need to be in contact with the equipment for 5 - 10 minutes. An alcohol pad wipe down doesn't cut it, neither does a quick wipe with the heavy duty cleansers if you dry it off right away. Those hospital grade cleaning supplies are very caustic to living things, so it isn't particularly safe (to you or your equipment) or practical to wipe down your keyboard with them.

Ionizing Air Cleaners May Pose Health Hazard

By Salynn BoylesWebMD
Medical News
April 4, 2005 -- Some popular ionizing air cleaners could be hazardous to your health, especially if you have asthma or allergies, says a product testing group. An investigation by Consumers Union (CU) -- the products testing group that publishes Consumer Reports -- found that five of the best-selling models tested emitted relatively high levels of ozone.

. . . .

While acknowledging that the new ozone tests did not show that the air cleaners pose a clear health hazard, Consumers Union vice president and spokesman Jeff Asher says they did suggest a potential risk. None of the ionizing air purifiers tested exceeded a generally accepted ozone safety level when the air was measured 3 feet away. "The bottom line is that these products don't work anyway, so why would anyone want to expose themselves to a level of ozone which, when added to the ozone that is already in the home, certainly isn't going to do them any good?" Asher tells WebMD.

[I considered buying one of these when my sinusitis was kicking up. It
turned out I just needed to get away from my old apartment's mold. At the time, my doctor mentioned that there was no data supporting air purifiers; now it looks like the objective data they have is bad.]

A Few Somalia Updates

An exerpt:

April 7, 2005 12:20 PM

Tsunami still hangs over Somalis

By Katie Nguyen

Aid workers say more than 150 people were killed in Somalia, the east African country worst hit by the tsunamithat rippled across the Indian Ocean.

Up to 50,000 Somalis were affected in some way when it made landfall along 650 km (404 miles) of Somalia'scoastline at the height of the fishing season.

The damage was concentrated in the northern Somali region of Puntland, and Harfun was hit hardest.

Unlike the rest of the arid country, people in Puntland have lived in relative safety under autonomous rule sincewarlords overran Somalia 14 years ago.

Factional fighting between rival clans still hampers humanitarian relief to large swathes of the country, but aidworkers were able to distribute food within 48 hours of the tsunami striking Harfun.

More than three months after the tsunami, Harfun resembles a refugee camp of makeshift shelters cobbledtogether from plastic sheeting, pieces of wood and shards of corrugated tin.

A whole article:

Somali militiamen shoot Kenyan

---

Standard Reporter

A Kenyan was on Thursday evening shot dead by suspected Somali militiamen and his colleague seriously wounded at the border town of Bulla Hawa.

Abdilrahim Bishar, 20, was killed and Hassan M Abdulahi 23, wounded when they went to buy food.

The mutilated body of the deceased, who was a donkey-kart operator, was left lying in the streets.

There was chaos in Mandera Town as the deceased’s clan members attacked all suspected Somali nationals.

Anti-riot police, however, dispersed the crows of mostly youths and women after several hours of running battles.

Most business premises remained closed yesterday for fear of attack by the revenge mob.

The District Commissioner, Mr Kimani Waweru, has meanwhile ordered the closure of the Kenya/Somali border to pressurise authorities in that country to hand over the killers.

Addressing journalists after a district security committee meeting, the DC said the border was recently re-opened to spur trade between the two countries.

The administrator said there were negotiating with the self styled authorities in Bulla Hawa to hand over the attackers before the border can be reopened.

More Medical thinking outloud

Right now there is NO standardization regarding what it means to have an appointment in Pathways. For example, some services schedule time for their clinic nurses, nutritionists, social workers and physicians. Others schedule only their physicians' time and other providers drop in throughout the visit as they find time.

The lengths of some procedure codes reflect only the amount of time the provider spends in the room. Others reflect the entire amount of time the family spends in the room. Some have virtually no bearing on reality whatsoever.

Until we have consistency in scheduling, any room allocation system will be flawed and unsustainable.

When appointment types and procedure codes were designed for Pathways, there was no consideration given to the kind of organization wide applications that data would be used for. Now is the time to line up the ducks.

My Plan

1. Standardize Pathways
2. Use that data to update room allocations in the old system.
3. Design and trial Air Traffic Control Room allocation system.
4. Transfer the old system into the new Air traffic control system.
5. All room assignments become real time only.

Ultimate Warrior heel to academic faces

It seems that the College Republicans at the University of Connecticut recently invited Jim Hellwig, aka former wrestler "The Ultimate Warrior" to speak at their school. The results were not what they expected, as Warrior launched into a homophobic, racist tirade.

People started yelling at Warrior as he spoke. Warrior at one point started yelling and stomping his feet, telling everyone to not talk while he is and to ask questions after his speech. Officers were eventually called in to calm things down.

The group that brought Warrior in, the College Republicans, apologized heavily for bringing Warrior in after the speech ended. Statements that really got the crowd upset were when Warrior said "queering don't make the world work" and told an Iranian girl to "get a towel."

The club released an apology for Warrior's appearance.

We brought Warrior to campus because we wanted to host a thought-provoking discussion from an individual who, given his celebrity status, would appeal to a broad range of students.

Sadly, the presentation degenerated into a relay of ad-hominem attacks between the audience and the stage. Though the first amendment fully protects all forms of speech, deliberately inflammatory insults are not what the conservative movement is about. In the future, the College Republicans will be sure to choose speakers that will be more likely to promote intellectual discourse on the UConn campus.

This is too good to pass by.

Then the apology form the UConn Republicans:

Statement to the University Community

Regarding the Warrior Event of April 5, 2005

To the University Community:
Last night, during the College Republican sponsored speech by the "Warrior," there were many comments made that were offensive to many members of the UCONN community, including the College Republicans. As an organization, we brought Warrior to campus, and we acknowledge our part in this disappointing event.

We have written letters of apology to several groups and organizations on campus that represent the people toward whom many of the Warrior's comments were directed. We are strong proponents of free speech, but comments that attack the person and not the issue accomplish nothing, and are therefore inappropriate in a lecture setting.

We brought Warrior to campus because we wanted to host a thought-provoking discussion from an individual who, given his celebrity status, would appeal to a broad range of students.

Sadly, the presentation degenerated into a relay of ad-hominem attacks between the audience and the stage. Though the first amendment fully protects all forms of speech, deliberately inflammatory insults are not what the conservative movement is about. In the future, the College Republicans will be sure to choose speakers that will be more likely to promote intellectual discourse on the UConn campus.

Emily Salisbury

Chairman of the UConn College Republicans

And the Warrior's response (oddly written in third person and too long and rambly to include in its entirety):

In closing, Warrior emphatically rejects and dismisses any attempt to
portray his appearance at UConn as anything other than it was – a
straightforward, honest discussion of Warrior’s philosophical beliefs. That
his words have been mischaracterized and that the speech was occasionally
interrupted by a relative handful of students (who, for some reason, all
seemed to smell like patchouli oil and burnt flag) does not detract from the
fact that the overwhelming majority of those in attendance had a wonderful
time and agreed with most of Warrior’s points – a fact that is corroborated
by dozens upon dozens of emails that Warrior has thus far received from
attendants. Warrior thanks all of his true fans and all of the true
Conservatives who took time out from their studies to welcome him back to
Connecticut, and hopes to see them all again very soon.

Always Believe,
Warrior

More conceptual Medical stuff.

I hope this isn't too rambly:

I’ve been thinking of ways to fairly distribute exam rooms. I’d like to see movement toward members owning parts of a whole, and sharing that whole. What we have now is members owning individual sections, without an attachment to the whole. As a result, they horde resources causing some to do without while others are gluttonous.

I suppose my model is communist in nature. It’s also a model of incorporation. Either way, the individual ceases to exist in favor of the group.

As I think, I’m beginning to see that it isn’t really a communist model. In a communist model, the members give what they have and take what they need. It presupposes that they control the resources to begin with. At the hospital, the members (the individual clinics) never really own anything. They don’t exist without the hospital. They aren’t really giving anything up because they never owned it in the first place. Room assignments and ownership are figments of our imagination.

Saying that is one thing. Maneuvering through the politics is something else.

In a corporate model, distribution must be somehow determined. This is also necessary so we know resources (exam rooms) are being distributed fairly. One problem we have is that the organization is using Pathways data as its gold standard, when that data is anything but standard.

The new standard should use Pathways, but instead of visit volumes, it should be visit length. It’s also important that all appointments be placed into Pathways. Optimally, this would happen in advance, and a day’s reservations would be based on the schedule.

Another option is to add the miscellaneous appointments after the visit. Then, at the end of the day, data will be available for how a family spent its day at Childrens. As it is now, some services expect appointments to take longer, but there’s no data to track what that really means.

Neurodevelopmental and Cranofacial lie at one end of the spectrum. Every visit is placed into Pathways. Pulmonary lies at the other. One appointment is scheduled; nutrition, social work and RT drop in as needed and are never reflected in the schedule past or future. If we put the data in retroactively we could us past data to predict future performance.

Many in U.S. to need passport

By Lornet Turnbull

Seattle Times staff reporter

If you travel to the Caribbean, Mexico or even Canada, the federal government soon will require that you have a valid passport to get back home.

And for the first time, our Canadian neighbors also will need a passport to travel south of the border.

"Border officers now are looking at car after car and all manner of ID — birth certificates, driver's licenses from every state, church-denomination cards — all of which are ripe for creating fraudulent documents. It's much harder to create a fraudulent passport."

I'm a semi-regular traveller to Canada, and I've always felt like I was getting away with something. International travel really ought to require a passport, shouldn't it?

We're still living in a post 9-11 world, and that means no more short cuts.

I suspect some people will increase their international travel. If a traveller already has a passport for her trips to Mexico and Canada, there's one less barrier if she decides to take a trip abroad.

Medical - Exam Room Thoughts II

Advantages: Further reduction of silo feeling. No more ownership of individual rooms; rather than renters of space, all services belong to a co-op and share responsibility.

More standardization, more cross leveling of work load.

Forces centralized awareness of clinical activity. Every change must be shared with the whole. For this to work, employees' loyalty must be to Children's and to all of our patients and families. Right now, most loyalties are on a departmental level. It's not unlike the shift from a confederacy to a federal system of government. I've become a Federalist. (I think that's what a Federalist is.)

(on a side note, this represents a complete mental turnaround on my part. As a PCC, I always strove to stay under the radar, away from centralized activity. Somewhere around my reading of the Toyota Way and going to Genie, I was genuinely converted.)

I need to look into co-ops and how they function.

Law Expands Right to Kill in Self-Defense

By Michael Peltier

TALLAHASSEE, Fla. (Reuters) - People in Florida will be allowed to kill in self-defense on the street without trying to flee under a new law passed by state politicians on Tuesday that critics say will bring a Wild West mentality and innocent deaths.

I've always had a wild-west mentality, so I have no problem with this. Sometimes Florida gets it right. Not usually, but sometimes.

Medical - Exam Room Distribution

When the new Ambulatory Care Building opens next March, we'll need a new system for room distribution. I'm playing with some ideas and here's one of them. It's a lot of thinking outloud, so bear with me:

All Rooms are interchangeable.

JIT principles applied to room reservations. That is, no queue, no keeping rooms in reserve. They are used as they are needed, doing today’s work today, now’s work now.

Air traffic control model: One giant reader board with every exam room labeled. This board is in real time, like air traffic control. A patient comes in, that patient is assigned a room, as near as possible to the conference room of the service they are here to see. It wouldn’t do to assign exam rooms completely randomly. Providers would be wasting too much time walking across the medical center in search of the exam rooms.

At the same time, if a service needed an exam room that was further away, they would have access to it. If rooms on one side were un (or under) used, that information would be transparent.

With this metaphor, patients are airplanes, exam rooms are landing strips, and services are terminals.

I don’t see why it wouldn’t work, but it would require a person to run the operation during business hours. Perhaps a modified greeter?

Strategically, it makes sense. It leaves the key decisions until the maximum information is available. It adjusts throughout the day, it allows for the most flexibility.

Rooms could be assigned based on zone preference. A patient would be assigned to the zone closest to the service; a certain amount of operator judgment would be required to maximize this system.

Option 1: patient registers, goes to waiting area.
Registrar notifies MA of arrival
MA gets family, does vitals, takes family to exam room.
MA finishes charting, hands off to provider.

Option 2: patient registers, is sent (or led) directly to exam room. (restaurant numbers?)
Registrar notifies MA of arrival
MA gets family from exam room, does vitals, takes or sends back to exam room..
MA finishes charting, hands off to provider.

What if the only available room is far, then later, other rooms open? How would we handle lift and shifts?

I want to get rid of the room assignment grid. Instead, we’d have the active, real time grid, matched with expected volumes based on how many providers are scheduled.

Model 1 – the Patient Traffic Controller greets the family, does the registration, and assigns the room, all at the same time.

Model 2 – Patient Traffic Controller assigns the rooms from behind the scenes, based on piped in and pre-prepared data.

The Commonly Confused Words Test

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Drop and give Sgt. Nolan NFC West title

And, most arrestingly, at least for those of us who witnessed almost every shabby play of 2004, Nolan staked a bold and eyebrow-raising claim on the NFC West.

Barlow said Nolan put the 49ers' three NFC West rivals on a board, then put big X's through each team, and I do not have to be a symbolism expert to get that one.

"For us, the target is to take charge of our division," Nolan said in between practices, repeating a statement he made to his players earlier.

Mike, does that mean win the division? This season? With the 49ers?

"Yes it is, that's a 2005 goal," Nolan said. "That's exactly what it means. . . . I think that's a realistic goal."

The new 49ers coach wants the NFC West title, eh? Well, he's going to have to come to Seattle to get it, won't he?

More seriously though, the Seahawks can't coast into the title like they did last year. The 49ers have made significant moves, as has Arizona. Oddly, I worry the most about the Seahawks games against St. Louis, but less about them as a threat to the division title.