Local hospital wasting over 90% of its time

| 23/11/2011

hospital entrance.jpg(CNS): Cayman’s healthcare system has a massive opportunity to dramatically cut waste, says a healthcare management expert. Cindy Jimmerson, founder and president of Lean Healthcare West, revealed that on a visit to the hospital’s A&E last week, only six percent of the time she spent there was valuable to her as a patient. Jimmerman told an audience at last week’s health conference that she spent five and a half hours at the George Town Hospital with a medical condition which needed urgent attention. She said she had met great people and the time wasted was not necessarily a bad thing but it illustrated that there was a huge opportunity for the hospital to improve efficiency.

Speaking at this’s year’s 20/20 Health Conference Jimmerson said the authority had a 94 percent opportunity to make things better. Estimating that she had spent 330 minutes in the ER she said that only 20 of those minutes were actual patient involvement. “I see an opportunity to make a dent,” she added

Jimmerson told the audience she had met wonderful staff at the hospital and such time wasting was not a particularly bad thing and typical of the type of healthcare services in places elsewhere in the world as well.

Cutting waste was the focus of her company, which had been aligned with similar principles found at the Toyota Motor Company. 

Lean Healthcare West had undertaken extensive research into the state of healthcare offerings in many different countries, working alongside 150 organisations in the US, Canada, Denmark and Australia. Her findings generally showed an average of 60 percent of everyday work practices within the healthcare system was wastage, including things like activities that had to be repeated, travel, errors, delays and confusion.

The ideal situation for any healthcare provider was to give the customers what they needed, no more and no less, providing care that was defect-free, on demand, with zero wastage within a safe working environment for all.

Introducing her company’s ‘Lean’ principles that encouraged entities to cut waste that did not add value to the patient, which frustrated healthcare workers out of their jobs but did not cut important projects, meant a higher capacity for work, lower operating costs, happier customers and workers and better leadership.

With 76 million baby boomers in the United States approaching an age when their medical needs were increasing, the need to address waste there was very important she added. Jimmerson said with the following generations, known as Generation X, Generation Y and those born in the millennium era, being far fewer in number there would be less people eventually to take care of the aging population.

Given that the US spends $3 trillion on healthcare, if it was able to cut waste by just half of the 60 percent that Jimmerson estimated was currently taking place, that would still equate to around a trillion dollars in savings.

Read more on the 20/20 Health Conference:

Local workforce must be priority for medical tourism

Doctor reveals key to affordable quality healthcare

CS will want more benefits if charged for health cover

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  1. the presenter says:

    As the speaker referenced in the article, (please note, my name is Jimmerson not Jimmerman) I would like to offer some points of clarifcation.  I am chagrined that the headline suggested such a broad-reaching accusation, when the intent and tenor of the presentation focused on OPPORTUNITY. I found the staff courteous and professional with the same obstacles and opportunities as most emergency departments abroad.

    • The number quoted was an example of a new way to look at service times that refers to value perceived through the eyes of the patient/customer, ie, how much time was a caregiver delivering direct care.  The presentation was an introduction to a currently successful method used internationally with great success to increase value to patients.
    • No reference was made to “good waste” but there was acknowledgement that with the way work happens now some “non-value added” time and activities are required to complete the service to the patient.  The question posed is, could we redesign how we perform tasks of daily work (ie, ordering and completing lab analysis, contacting resources, travel of consultants to the hospital, etc) to reduce that perceived “non-value added” time to the patient?

    The message being delivered to the professional attendees of the conference was that if the people who do the work (the resident experts, not theadmin suite) look at the processes of everyday work with new eyes, always evaluating the work with the goal of increasing “value” to our patients/customers, they could likely find ways to redesign the work that would improve the value quotient and enhance the patient experience.

    • Healthcare workers, from neurosurgeons to housekeepers, rarely leave their jobs due to poor pay, unfriendly co-workers or dislike of the work of their chosen careers.  They almost always leave as a result of frustration created when broken processes don’t support them in doing their good work.  It has taken many years for healthcare workers around the world to realize that incremental improvements in how we deliver care make for happier patients, caregivers and support staff (and more fiscally successful organizations).  This presentation was made to demonstrate that opportunities to improve the value quotient for both patients and workers exist everywhere, every day.  We just need to be brave enough to face the way work happens now and exercise those opportunities, one improvement at a time.

    CNS: I have corrected the error in your name. Apologies for that.

  2. Name changed by moderator says:

    This is a terribly mean-spirited article that has nothing to do with good reporting for the community, but instead is motivated simply to generate mouse clicks and sell newspapers.  The reporter knows full well that Ms. Jimmerson used the “96% waste” comment as a dramatic statement of example, to simply generate discussion and thought at the conference.  Her compliments to HSA and A&E for her “excellent care” were forthcoming and numerous.


    While certainly there is waste in healthcare, and we in healthcare fully acknowledge and are working dilgently to eliminate such, it is totally inappropriate to characterize Ms. Jimmerson’s comments literally—neither HSA nor A&E are burdened with 96% waste.  Ms. Jimmerson was referring to the amount of time that she was directly engaged in care as a patient vs. the total time she was at the hospital for her visit. While she was admittedly sometimes idle during her A&E visit, her numerous lab tests and radiology exams were undergoing thorough review by HSA physicians, nurses, and technicians, working in the background.  Ms. Jimmerson’s time is not the only indicator of activity supporting her healthcare.


    Freedom of the press is the most powerful force in modern democracy and a free society, but articles like these serve no good purpose except to create unnecessary conflict in a community and degrade the overall credibility of news services.    It’s very unfortunate and unfair.


    CNS: I think you are confused between the article, written by CNS, and the comments, which are not. There is nothing disparaging about Ms Jimmerson in this report and it is posted because her talk was interesting. This is not a topic that generates a lot of reads.


    • Anonymous says:

      I am referring primarily to the unfounded headline in the article which paints a false impression of HSA.  I am the first to admit the need for continued improvements and reduction of waste– but this headline is inappropriate and serves no good purpose:  "Local Hospital wasting over 90% of its time."  Thank you for posting.

      • Anonymous says:

        You make a good point. Ignore the thumbs down. There seems to be a concerted effort to cast Cayman in the worst possible light from every direction. Good news is understated and not so good news is sensationalised. I am disappointed, CNS.

  3. Anonymous says:

    I had the misfortune to be admitted to the hospital about 2 years ago with chest pains.  Once out of emergency and into general ward, things went quickly downhill.  No soap, towels, water, blankets.  Freezing cold all night.  A nurse walked in, grabbed my arm with the IV and started to hook more medication up.  Not one word to me.  I then spoke to her and asked her what she was doing and who she was.  She then complained how her back was hurting.  At around 3am, it sounded like there was a party going on outside at the nurses's station.  Laughing, screaming, loud talking went on for hours.  Next day at around 9.30 am  the other patient and myself called the nurse to see if they were serving breakfast.  Half an hour later, some cold, stale looking food arrived.  The other patient was not from here and did not have any family to visit, so whenever I asked my husband to bring something in, I asked him to bring something for her as well.  We had to beg for water and did not receive soap or towels until 2 days after – when the nursing manager or supervisor returned to work.  I dread to think whathappens to people who can't get out of bed.  I must say that some of the emergency doctors are wonderful.  I know of one  lovely lady doctor who worked in emergency for years, who left recently because of the way she was treated. 

  4. Anonymous says:


    Don't let me even start here. I have been blessed with good health and solve all my minor health issues myself with home remedies. But one day, let’s skip the details, I ended up going to an emergency room, and worse, I came to GT Hospital not knowing that CT Hospital open 24/7. I spent 12 hours in GT hospital and based on the medical tests done, my condition required immediate medical attention, one of those where a person can drop dead without immediate medical intervention. Let me tell you, if some medical emergency happens to me again, I will never ever go to GT Hospital. I will stay at home and pray, and if I am to die, at least I will die in dignity and I don't have to pay for anything. In my 12 hours in that hospital I saw no sign of the slightest bit of human kindness or compassion from anyone. Cold indifference and ignorance. Not a word of comfort for a terrified patient, not a glass of water was offered. Lying on the floor while someone  (if) was looking for a gurney which took forever. When they finally found, it was broken and a security guard, or whoever he was had to lift me up on it. I was shaking violently in the ice cold "room" for hours ,before someone acknowledged my presence. I spent the rest of 12 hours waiting- for x-ray, for ultrasound. Keep in mind my blood markers indicated of DVT or pulmonary embolism. Never the less, only in 7 hours since I stepped into the emergency room, some tests have been conducted.  I felt like I was an irritant, distracting the hospital personnel from never ending chatting and laughs. Emergency room reminded more a social gathering where patients were just the nuisance.

    How could that happen in a medical establishment, let alone emergency room? What is wrong with the GT Hospital staff? What are they paid for? Who quialified them to be medical professionals? 

    The next day, after consulting my friend doctor in US, I went back to CT Hospital. All tests were re-done in less than 2 hours.

    All my CT Hospital medical bills were already paid by my insurance, but GT Hospital  staff is still trying to get it right, third time now.

    So how much time was wasted? 99%. 

  5. Anonymous says:

    What is this article about? 

  6. LMAO says:

    Am confused by this story. 

    Tell me what she mean by the following statements means. 

    "the time wasted was not necessarily a bad thing"

    "such time wasting was not a particularly bad thing and typical of the type of healthcare services in places elsewhere in the world as well."

    Under what circumstances is time wasting a good thing? I think that particularly in a hospital time is the most precious thing they got. 

    I also didn't miss the fact that Ms. Jimmerman is the "founder and president of Lean Healthcare West" which is a company which supposedly assist companies in becoming more efficient. 

    Don't get me wrong anyone who has indeed been to the Government hospital's ER knows very well that when you go be prepared with a pillow, blanket and snacks because you are going to be there awhile but it seems as though Ms. Jimmerman is offering her assistance to make the hospital more efficient but when she makes the statement that wastng time is not necessarily a bad thing, is she then saying it is okay to waste time, just not as much as they are currently doing so she is going to show them how to waste time efficiently?  


  7. Anonymous says:

    What a negative crowd on this website.

  8. Subway Cookie says:

    Nothing new here.  I have been to the HSA A&E several times:

    1. Come in and register – IF someone is actually there, get attitude and no customer service

    2. See the nurse – this is usually pleasant and but fools patients into thinking they will see a doctor soon. 

    3.  After telling the nurse what your problem is, go back and wait and wait and wait.  During this wait you may notice a baby puking blood, or someone with a finger hanging off their hand. 

    4. About 2 and a half to 3 hours later you will be beckoned to see a doctor.  If it is the fellow who works the graveyard shift, he is disinterested and will only prescribe antibiotics doesnt matter whats actually wrong with you, he just wants you to go. 

    5.  If you have the misfortune of having to be nebulized you will have insight into what happens behind the big door when you are waiting to see the doctor.  NOTHING people just sitting there and eventually they take a patient.

    6.  Armed with your prescription you are returned to the registration person, if there, more attitude and you are told to pay.  HOWEVER if you pay with cash and they don't have change you will be told not to bother and just go.

    7.  Forward to the pharmacy, they are all pretty pleasant and work hard, but if the cashier is not there or has no change for yuor cash no-one can take payment for the meds so you just take them and go.  This explains the HSA's failure to collect because once we go we are GONE! 

    8.  All in all a draining experience, but who wants to go to the other hospital where you have to pay a deposit before you can get in the door?

    • Anonymous says:

      So if you don't want to pay the deposit, quit complaining about getting much cheaper but maybe slower service. And by the way, speaking as an older person who has had to use the A and E, this is desperately unfair to them.

  9. Anonymous says:

    Now time to look at the rest of civil service!

  10. Anonymous says:

    Well Caymanians have been saying for decades that a lot of waste is occurring there but no one listens.  So, good luck to Ms. Jimmerman in trying to get anyone to do anything about it. I hope she brought them all a good loud pair of hearing aids and a couple buckets of common sense.



  11. Anonymous says:

    This makes sense.

    I wish she would introduce her company's "lean" principles to Mr Bush and the entire CS!

  12. Anonymous says:

    All generalizations, any specifics. It's easy to be general.

    • Anonymous says:

      Do you find many things to be so obtuse to you?

      • Anonymous says:

        UMMM let's see


        I'll answer yes to that, especially when there is nothing in the article to get one's head around. Tell me one specific recommendation in that article that tells me what;s wrong with the Hospital. I have no affiliation with the hospital what so ever, other than as a consumer/patient of their services several times. Great people wotk there, even the author of the article owns up to that, but recommendations, yah, I guess I am obtuse in this case. Too bad that you couldn't expound on my "obtusiveness" Ha Ha. Please explain to me what the author is saying other than generalizations, then I will cease being obtusive and become illuminated, a better thinker, more understanding of generalization and concepts.