Programmer at the hospital

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

    - Kudy need. - mimicked 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 am on business.

    - We know what your case is! - 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. - A robe where?

    - 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 at the guy.

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

    A doctor looked out 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 away.

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

    - Can you take it faster? - the girl shouted after the closing door, but no one heard her. “They’ve been taking for half an hour, a nightmare ...

    There was no one in the office except for the doctor and the 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 has shrugged shoulders. - SchA fix, do not yell.

    A few minutes later Ruslan finished. The old method of grandfather helped - 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 pobity. - 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 savage satraps, treat the elderly.

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

    - Undress! - 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, and did not even look in. 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, you work. - 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 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 matters 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.

    Fermentation began in the crowd, and a few people followed the woman to the office - a line formed.

    Until the end of the shift, they managed to take another twenty patients. Ruslan quickly drove out meaningless information, and then, under the dictation of 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 grymza 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 deadline for implementation is almost out, and not a damn thing is done. The other day, checking, she screamed at us this morning, well, what are we ... How can I say something ...

    - Shoulders?

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

    - Strange is ...

    - 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? - the doctor squinted.

    - 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 are in the throat to push, 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 introduce 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, it was you who didn’t go to the factories ... There used to be men who were driven out of their pockets who were being dragged from their workplace. 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 by this forehead, that on the forehead - they say, so it is necessary, keep it on the bed.

    - Hmm ... Well, did we get a nice day 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 has shrugged shoulders. - 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 run to the office of the head physician.

    - Yes, I tell you, this is a real topic! - Ruslan heard, entering the office - Vasya very actively convinced Natalya Petrovna of something.

    - Vasya, well, listen. - the head doctor answered tiredly. - I don’t care for it now, you know, soon I’m going to check, I’ll be hung up if the rates of those employed are not growing up. Whoever comes up with these norms ... Fifteen minutes for one for the therapist, but with the data entered into the computer ...

    - So am I 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 was 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 ...

    - A little more than 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 a 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 - you need to talk to 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 generally 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!

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

    - What? The chief 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, 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 a 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. The thing that 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.

    - Easy further. 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, like data driving. Although ...

    - What? - picked up the chief doctor.

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

    Ruslan thought for a few minutes. The rest 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. She worked with a card, maybe even looked at her throat ...

    - No, the doctor always looks at her throat. - the head doctor shook her head.

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

    - Why? - could not resist Vasya. - So we are with you, without preparation and all sorts of systems and restrictions, we took six minutes to complete!

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

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

    - Yes, I do not mind, I knew what was going on. - the programmer has shrugged shoulders. - 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 you, where all administrative staff 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, dyed 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 rattling. 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 table of information we will remove, there are three of them, girls. Still sitting doing 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 to get 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 in the first place. For doctors pass. I think they will get to the bottom of a thrifty 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. The 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. - Delov 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.

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