The Patient Transporter: A Bandage Instead of Lean Healthcare

Have you ever heard of a patient transporter? That is a person who works in a hospital whose job is to move a patient from point A to point B. (I thought that is what an orderly does, but I guess my knowledge is out of date.)

A recent article in The New York Times profiles Fuat Sarieminli, a patient transporter working at Long Island College Hospital in Brooklyn. Written by Jan Hoffman, this well-written, gripping article makes it clear that the transporter and others like him, are critical to reducing patient waiting time.

The din builds, the stench ripens, and the backup balloons for X-rays, CT scans and hospital beds. But the patients keep trooping in by foot and by ambulance.

And now there are no stretchers for those new patients. The emergency department is careering toward diversion — that clumsily named, must-avoid status where incoming ambulances will be told to divert to other hospitals…

(The transporter) whips down remote hallways, alights on some empty stretchers huddled together and systematically races them back. With heavy steel bars, sturdy wheels and thick padding, each weighs several hundred pounds (and that is before piling on the patient and monitoring equipment).

“Fuat! Fuat!” hollers the X-ray technician, as Mr. Sarieminli speed-walks by. “Bring on those patients, baby, bring ’em on!”

“Fuat! Fuat!” hails a nurse. “Get this patient to CT scan!”

“Fuat! Fuat! This patient needs a hummer!” a nursing assistant calls out, using the hospital nickname for the sturdy new wide-body wheelchairs for larger patients.

Over the next 15 minutes, Mr. Sarieminli, rescuing stretchers and moving eight patients to the emergency room’s X-ray and CT scan departments, imperceptibly begins to break apart the logjam. Diversion averted.

Even so, it will be two and a half hours before beds upstairs become available so that Mr. Sarieminli can actually transport patients cleared for admission to their hospital rooms…

“Without Fuat, we can’t get the job done,” says Dr. Tucker Woods, vice chairman of the emergency department.

The article notes that at the hospital,

…some 35 patient transporters work under the command of the logistics department. From a central dispatch system, similar to that of a taxi company, transporters are sent to move patients to diagnostic appointments and operations. The dispatcher watches the progress of each job on a computer monitor: blips of red, yellow, green and purple signify “nursing delay,” “patient in bathroom” or that the transporter is taking too long…

Mr. Sarieminli, however, is not tracked by the computer. The emergency department is so busy and his job is so demanding — on a typical shift he will make about 50 trips from Point A to Point B — that the computer cannot keep up with him.

In fact, most transporters do not like working the emergency room. The work is not only faster-paced than elsewhere in the hospital, but “transporters feel disrespected here,” says Mr. Sarieminli, assaulted by the cacophony of so many on-the-spot bosses, commanding him to move someone right now.

I suspect that similar situations exist at many other hospitals.

The important question is: Does anyone at these hospitals recognize that there are systemic problems here? That maybe they need more than a system that tracks transporters? That they should be looking at hospital layout, flow of patients from the emergency room to other points, and where stretchers and wheelchairs are stored, among other items? In other words, that they should be applying lean principles to this situation?

Some hospitals are. I wish more of them were.