Everyone Was Working Faster. So Why Was Service Slowing Down?

When I parked at the emergency room on a recent Sunday, there were one or two other cars in the lot.

I was there with a friend. No one was waiting at the desk. Before we had finished explaining why we’d come, someone was walking us back to a room with a real bed in it. Tests were ordered. There was plenty of help, and everything moved.

Within half an hour, the hallway outside our room had changed. More patients were coming in, and the nurses and support staff were moving noticeably faster. I walked over to a window that looked out on the parking lot. In less than an hour it had gone from nearly empty to nearly full.

Here’s what caught my attention. As the staff sped up, our care slowed down.

No one was ignoring us. We just weren’t the center of attention anymore, and the people now arriving were emergencies too. Our tests were finished and the results were ready. Then we waited for the attending physician, who had a department full of patients needing the same thing from him. We were there between three and three and a half hours.

This is not a story about a badly run emergency room. An ER can’t schedule its customers. It treats the most urgent case first, as it should, and no hospital can staff every Sunday for its worst hour. What I watched was uneven demand meeting fixed capacity.

Busy is not the same as finished

Effort and throughput are different measures. Effort is how hard people are working. Throughput is how much actually gets finished. When the work has to pass through one step, the whole operation moves at that step’s pace, no matter how fast everyone around it goes.

In the ER, that step was the doctor. Every nurse could be moving at full speed and every test could be back, and still no one went home until he got to them.

Most service businesses staff for the average day. But when the spike comes, the work piles up at whichever step has the least room to spare. If you don’t know which step that is, the natural response is to ask everyone to work harder. That rarely helps, because most of them aren’t where the work is stuck.

“Just watch”

In 1998 I was consulting for a client that was consolidating three large manufacturing operations into one. We were all focused on the big things: moving machines, relocating staff, assigning offices.

Before the consolidation, the receptionist greeted visitors, gave directions and answered the phone. When someone inside needed to reach a coworker, they called her, and she paged that person to call back or report to a particular spot.

After the move, she was quickly swamped. She was a very good employee, quick and unflappable, and she knew everyone from her original company. Now she had a new building, a new phone system and a long list of new names to learn, all at the same time.

One morning I saw her struggling and asked her what the problem was.

“Just watch,” she said.

So I did, and the problem was obvious. It wasn’t the visitors or the outside calls. It was the internal calls, one after another, asking her to page someone. The new phone system let anyone make a page from their own phone. Few people were doing it.

This wasn’t part of my scope. I told her I’d see what I could do, and I raised it in one of our meetings later that morning. There was some pushback. People didn’t like using the paging system, and this was the way they had always done it. The president saw the problem and the answer right away. A memo went out, people started making their own pages, and the front desk calmed down. Visitors got her attention again.

She didn’t need to work harder. She needed everyone else to stop routing their work through her.

It was a small change. It mattered because that desk was the first impression every visitor had of the newly consolidated company.

People or process?

When service slows and everyone looks busy, the first instinct is to treat it as a people problem. Anyone walking past that front desk could have concluded the receptionist wasn’t up to the new job. She was. The way the work was routed was the problem.

Sometimes the problem really is the people. More often, in my experience, the work is piling up at one step, because of how it’s routed or because that step was never built for the load. Before you ask anyone to work harder, find the step everything waits on. Look at it on a busy day, not an average one. Then ask the person doing that job what’s going on, and do what she told me to do. Watch.

The doctor did get to us that Sunday. He was rushed and still patient, and on his way out he stopped long enough to talk with me about how the day had gone. I’ve written about that conversation separately.

That Sunday felt familiar. It’s what I still look for when I walk into an organization: everyone working hard, results stuck, and one step quietly setting the pace for everything else.

So here’s the question to ask the next time everyone is busy and customers are still waiting:

Do you have a people problem or a process problem?

If your people are busy and the work still isn’t moving, that’s what Management Consulting is for.

Dan Holland has been in management consulting since 1982, including twenty years leading his own independent practice. Today he works directly with owners and leadership teams at mid-sized companies and nonprofits on the decisions, plans, and organizational problems that deserve more than an internal gut check. No sales calls, no funnels — just a direct reply from Dan at [email protected].