It’s a picture I took that morning, at 6 AM in the Marriott Hotel lobby, with a cup of coffee in my hand. The instructions above the key pad say “Enter the desired floor number (once please). Then proceed to assigned elevator.” When I had checked in the night before, the registration person had simply said “Enter your floor number in the keypad at the elevator.” I was really half listening, but when I saw the sign, I pressed 1 and 4 for the 14th floor, not knowing what to expect. A few seconds later with a three ring alert the pad read “D”. I looked up and the six elevators were labeled A,B,C,D,E,F. So I went over to “D” and the door opened, and I went in. When I went to press”14″, there were no buttons, but I noticed that the number “14″ was there in red at the door frame edge. The next thing I knew I was non-stop to 14 and the doors opened.
Over the next day or two I noticed that most people quickly figured out the system. Those who had a problem were instructed by other riders. There were no long waiting lines at the elevators as I’m accustomed to at these Conventions, and I usually reached my floor non-stop. There were a few indications that old habits do die hard -like one rushing lady who inserted her hand (at some personal peril) to keep the elevator door from closing only to realize there were no buttons for her floor inside the elevator.
Back to my address, the focus of the talk was on the transformation of health delivery around a center loop that went from home to care team and back to home, rather then the current power loop that goes from hospital to doctor’s office and back to hospital (with home a mere after-thought). With the last slide above, I gave the audience their homework for that evening. I said, “When you lay your head down on the pillow tonight, try to imagine the discussion that went on in the Marriott executive suite when they decided to invest in this new system – what were they trying to accomplish, what evidence were they provided, what was their understanding of shifting roles and responsibilities, why did they consider this necessary at this time? Finally, I asked the audience to consider what this elevator could teach us about health care transformation.
Today I’m back home, and the Conference is completing its’ final sessions. This morning, I called the New Orlean’s Marriott and spoke to its head of engineering. Turns out the system is the Schindler Miconic 10 . Schindler, for those who don’t know, is the 2nd largest elevator company and the leading escalator company in the US. The engineer told me that the driving force behind the conversion was improved dispatching efficiency. In short, the hotel needed expanded carrying capacity (line delays were becoming a problem) but they had no room for more elevators. By using this system, they expanded the carrying capacity of their existing elevators by 30%. What else did they realize?
1. Guests felt more empowered and in control.
2. Lobbys were less congested and guests more relaxed.
3. Training requirements for staff were minimal.
4. Guests picked up the intuitive system easily and naturally assisted each other.
5. Guests experienced increased service speed and reduced time to destination.
6. Overall system efficiency increased by 30% and energy consumption declined by a similar amount.
7. Personalized elevator service for passengers with special needs was now possible.
8. Satisfaction levels of guests and employees increased and these increases were sustained.
Back to health care. What are we trying to accomplish? What evidence do we have that anticipation might improve resource allocation? What are our specific roles and responsibilities, and are we adequately empowered and encouraged to help each other? Were we to get a 30% increase in primary care capacity by a more efficient system, would we really need more primary care doctors? With national deficits all the rage, and Medicare cuts under consideration (even at the White House), have we concluded that a new way of looking at things is now a reasonable option? Finally, if we the people are in the lobby, and the people caring for the people are the elevator car, should we continue to wait in line for a crowded and unpleasant “ride”, or should we figure out a new mobile and technology powered system that allows them to come to us on command as needed?