I was on jury duty last month. More accurately, I sat around for most of a week at the Hall of Justice on Bryant Street waiting to be on a jury. I did not actually serve, as was true for 90% of the other potential jurors.

It was clear that the jury selection process was designed to be efficient from the perspective of the judge, the district attorney, and the defense attorney. If they thought we might need to be in or near the courtroom, we had to be there. If it turned out that they had something else to do, we waited. When they needed to ask one of us a question, the rest of us watched. Much of the time, we couldn’t even hear what was going on, because of the protective glass.  Mostly, we sat. Once, after waiting all morning, we were sent home just before lunch and told to return the next morning.

Trial and error

While I was waiting, I thought about all the ways the jury selection process could run more efficiently.  Parallel processing would have been a good start. We could have all filled out (simultaneously!) a questionnaire with most of the questions that the judge and lawyers had asked. Then they could have dismissed those of us with obvious conflicts, and then question some of us further.  That would have taken a few hours at the maximum. Instead, they used serial processing, and asked one person at a time the same few questions, while the rest of us waited.

Improving the process

Why am I telling you all of this? Because efficiency is in the eye of the beholder. From the judge’s point of view, the process had been incredibly efficient. He thanked all of us when we were finally dismissed, remarking about how smoothly everything had gone. From his perspective. From the perspective of the potential jurors, efficient was the last word we would have used.

The same “eye of the beholder” problem occurs often in healthcare.  Just like jury selection is designed for the judge and the lawyers—without much regard for the potential jurors—too much of healthcare is designed for those of us who work at a medical center, with not enough regard for our patients. Wait around in the emergency room while we find you a bed upstairs? Or sit in the pre-op “holding area” while we clean the operating room?  Sure, why not? It’s more efficient (for us) that way.

That’s why we’re using QD to take a careful look at all of our processes from the perspective of our patients. If you haven’t yet had a chance to participate in a kaizen (improvement) event, I encourage you to let your manager know that you’re interested in doing so. We need your ideas and experiences.

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