Stepwise Success

Quick and Dirty, Part One

As a programmer on the coast of Maine 20 years ago, I liked a quick and dirty solution--the inelegant, simplistic, but often workable idea. Scientists call this lex parsimoniae or Occam's Razor (after a 14^th century English logician), which states the simplest solution is best, all things being equal. It surfaces in Toyota's Lean philosophy, pushing the automobile giant ahead of General Motors.

In the next few entries I'll describe such a solution.

Here's the problem: requisitions without diagnoses generate telephone calls or faxes to doctors' offices, causing delays. If the office isn't open, the patient may be turned away. Data has to be collected that answers at least the following:

• What time of day does the disruption occur?
• Who is the ordering physician?

Requisitions can be tagged and tallied at day's end, but this invites transcription error. An information system "marker" can be used--a dummy test, location or other tag--nice if a user does it and patient billing doesn't mind. Or a paper log can be kept--ugh.

Above all, we need good data--complete and accurate as possible--and process disruptions corrupt data proportionally. Minimal disruption is also crucial to maintain patient throughput at a busy phlebotomy station; we are especially interested in interruptions at busy times. Before we start fitting solutions to the problem, we need to imagine what the ideal solution is.

• Data is captured at point of order entry
• Minimal extra steps
• Collection is novel and easy
• Data is easily mined

A lowly DOS batch file--quick and dirty--does the job. Next entry, I'll describe what that is.