Velocity Over Length of Stay
episode
ChalkTalkJim: Breaking Down the Game - A Guide to the Future of Healthcare
42 min
1 speaker
8 chapters
transcribed 1 month ago
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What does John D’Alessandro mean by measuring “velocity” instead of length of stay?
Welcome to the Chalk Talk Gym Podcast, where we explore insights into healthcare that help uncover new opportunities for growth and success. I'm your host, Jim Jordan.
My guest today is John Diaglesandro. And he's an operations engineer who came to healthcare the hard way, through the supply chains of General Motors, Ford, and Domino's Pizza. And in these environments, when things break, you fix them fast or you lose money fast. For two decades he worked beside hospital frontline teams, and what he saw made no sense to him. They were smart, committed people set up to lose by the way the work was designed. John argues hospitals borrow lean and six sigma without the context that makes them work. John believes that the real signal lives in the word on the street, not a billion data points. So John, tell me in the audience a little bit more about yourself and your perspectives.
Okay, well, I didn't cut to health care. Really for me healthcare is hospitals. In a normal way. I started as a manufacturing engineer. Doing supply chain operations. Or G M Ford. Domino's pizza. Uh places where things break. You fix it up fast. Or you lose buddy fast. Then I walked into a hospital. What I saw made no sense. Spark, committed people. Working insanely hard. They should they should be worked for the joy of it, right? But instead They're guaranteed to deal with delays, confusion. And now a real problem is burnout. Not because anybody's incompetent. Абиз о way до work is decided. They did almost the possible wet. Rewind it t two decades later. We've been working at hospitals, frontline teeps, side by side.
To remove the friction. That adding more technology More meetings, more initiatives. Or of anything. Is offered Rought with self inflicted. Rob up.
Do you want to share that a little bit about that with the audience?
Yeah, absolutely. I think that Lotta times Wh hospitals in particular have borrowed for manufacturing. You know, they look at bleed at Six Sigba, which are very powerful. But they also come with Sub podcast. Yeah, one of just as some examples. Where do you store work and process? Inventory. You don't have that. What do you do with ya? Make a mistake. Do you throw it in the Trash cat. And do what? See it manufacturing. They have to say that Statistical variation. It dependent events. at hospitals That have that. They also have A Human element. А all the safeguards. Your day. in a manufacturing world. Just don't exist. Hospitals. The Tobaya system. Is not always driven. by the market. It's driven by Who walked in the door? They don't get a
I'll be sued. Or it out of stock. So if you think about inventory management and Reject rates and all that stuff. All these techniques are manufacturing. Or decide to minimize it. Add There's no minimizing these. Or already
I believe it's a German word. We used to call it tack time. T A K T, right? So we try to anticipate which to your point is hard to do. And the other piece is the process was fixed input, fixed process, fixed output. But in our case in healthcare, we have variable input. depending on your co-mobile variable process, trying to get to a fixed output. So I guess by the very nature Those two items are quite challenging.
They are and they're not. Logical. They are Cubid. Well it's it's a What could COVID? You had no problem getting in a hospital COVID, it'd be short of breath. But today Third triage. How many how many are waiting? Sleeping in the hallway. I wrote an article. In April of twenty twenty. About Ventilators. You know, with the defense thing that the government has. Okay. In New York, they were g they needed Forty thousand. Ventilators. So my article was Well who's gonna staff 'em? eighty thousand or hundred twenty thousand nurses. That you need for somebody. Who's out of a sheet? That is so sick. That machine stops working. For a minute you could kill the guy. I mean It's just not. The same physics. Is it?
For example Where do you keep your supplies? How many steps do you have to go? These kinds of things. So when you walk into a hospital and you help them, where do you start? What's the process and what's the attitude that people have?
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Chapters
8 chapters
1
What does John D’Alessandro mean by measuring “velocity” instead of length of stay?
0:02–5:42
2
How did John’s manufacturing background shape his view of hospital operations?
5:42–10:37
3
Why do most hospitals get the “admit‑versus‑discharge” graph wrong and what does it reveal?
10:37–15:59
4
What’s the real bottleneck in a full ICU – sick patients or a missing tele‑bed?
15:59–21:35
5
How can you use simple process‑mapping to uncover hidden flow problems?
21:35–26:57
6
What is a “failure analysis” and how can it be applied to healthcare?
26:57–32:36
7
How will AI and new technology change the way we solve these flow issues?
32:36–37:44
8
What are the biggest growth opportunities for hospitals in the next five years?
37:44–42:45