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June 2007 - Just in Time!

"Just in Time" is a common philosophy in manufacturing. The premise is that components required for the manufacturing process are delivered from the supplier just as they are required on the assembly line. The risk associated with this approach, of course, is that a supplier will fail to deliver, which results in shut down of the assembly line. The benefit, which generally outweighs the risk, is that the manufacturer doesn't have to invest in warehousing space, the technology that goes with it and the costs associated with running a warehouse.

I suspect that many of us also operate on a "Just in Time" principle. We pay our bills just in time; we get our abstracts ready just in time; we finalise our meeting registrations just in time; and so it goes on. It is as if we need deadlines in order to get something done. The reality is, this is the way Society works today.

I am as guilty, if not more guilty, than anyone in this context. This approach may work well in industry but it plays havoc with my extra-work activities. The frenetic chasing of deadlines all day leaves little energy for other activities after work. This leads to frustration and I occasionally hear rumours about grumpiness - unjustified of course!

Winter is one of my favourite times of the year. I get to enjoy all sorts of food that just doesn't work through most of the year, at least here in the West. And of course one can't have good heart warming winter food without a glass or two of a good red to wash it down. And then after dinner, a comfortable chair in front of the flaming gas fire satisfies most needs. The satiety of all the senses obviates the need to hunt so who needs energy for other activities? It really seems silly to go out in the cold for a walk or a run?

Perhaps the obesity epidemic is more complex than simply being a consequence of the food we eat. Perhaps filling our days with deadlines and pressure as a result of our "just in time" approach to life has something to do with it. Maybe taking more time to "smell the roses" during the day could help with our quality of life. Most organisations have programmes that aim to improve the balance between work and life but, those I have seen tend not to focus on what happens during the working day but rather ways to fit more work in with more flexibility. Similarly, "Time Management" courses and advice generally focus on getting more done in the allotted time. Is this the right approach, or does it perhaps add to the deadlines burden?

I don't know why we do it to ourselves. Even more perplexing, is that we frequently choose to add to our workaday pressures. When the focus of work is to simply deliver a report - whether it be clinical or management in nature - we fail to see around the issues and this can lead to bad management or, potentially clinical, decisions. The focus becomes short term in the extreme.

I recently reviewed a Government document, which came my way serendipitously, that demonstrated a total lack of understanding of the issues the advice pertained to and demonstrated a lack of scientific acumen in using poor quality data to back up a recommendation. This document could potentially have serious consequences because the recommendations may be accepted by decision-makers who know no more than the authors - possibly even less. This was a classic example of people simply doing a job with no care for the quality or consequences of their decisions. They appeared to be simply meeting a deadline "just in time".

In similar vein, I have recently been troubled by the software on our new plethysmograph. Of course, the manuals don't describe the logic and calculations being used within the software, and some strange results were being produced. After much playing and perturbing of the system we believed we developed a reasonable understanding of what was going on. The algorithms were sound when applied to an ideal subject. I have counted them recently and found we do not get too many of these ideal subjects - even amongst our biological control subjects yours truly has been sacked because of instability, pulmonary rather than psychological, I hasten to add. With patients queuing up for tests it is very tempting to simply print a report, but we have to take the time to evaluate every result so we can make informed decisions about the data to be presented in our report.

Filling our lives with deadlines and prioritising so that everything gets done "just in time" doesn't do anybody a service. In the same way that manufacturers have to balance the risks of holding components versus depending on "just in time" delivery, we need to consider the risks inherent in this approach. Rarely, however, do we give these risks credence.

Take the time to "smell the roses" now. Waiting until "just in time" to do so, may in reality be too late. You owe it to yourselves and to your clients.

'til next month,

K

June, 2007

kevin.gain@health.wa.gov.au

 

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