In short, I was impressed by the automated system’s ability to save labor costs, but the hospital faced several problems. Sometimes the equipment did not function properly, and the mechanics were not trained to fix it. Second, the employees found it difficult to adapt to the automation. The previous administrative staff had not been able to make the Friesen concept work because all the staff members came from an old facility and either could not adapt or were resistant to change.
After familiarizing myself with how Friesen’s concepts should work, I began observing the SPD Department, which centralized all of the hospital supplies. In a traditional hospital, each department has its own storage area where it kept supplies, but at Providence, all of the supplies were stored in one place and distributed throughout the different departments on the mono-rail system. Even the instruments for the surgery department were kept in the preparation and sterilization section of the SPD Department where all dirty instruments were transported on monorail carts to be reprocessed and sent back out, based on the number of surgeries scheduled for the next day. Again, at a traditional hospital, the instruments would be washed, sterilized, and packaged directly within the surgery department. However, at Providence, the reprocessing section was centralized for all soiled material, regardless of whether it was trash, linens, dietary trays, or instruments.
Within two to three months, I had made my observations and developed recommendations that I discussed with Mr. Gilreath. One change we needed to implement involved the way in which the instruments were being transported from the Surgery Department to the centralized reprocessing area. Currently, the instruments were not being soaked in saline solution while transported on the carts, so that by the time the instruments reached their destination, the blood on them would be so dried out that they took much longer to clean, and sometimes when they were sent back to the operating rooms, they would come out of the packages still dirty.
Of course, the preparation and sterilization personnel were blamed, but based on my academic background, I knew that I needed to further analyze the issue and get to the root cause of the problem. “Why don’t we try placing the instruments in the saline solution while they are being transported to the reprocessing section” I suggested to Mr. Gilreath one day. He accepted the recommendation, but we also needed to discuss it with Dr. Thomas Wright, the assistant administrator, who also headed the SPD and Pharmacy Departments and had a PhD in Pharmacology.
When Dr. Wright heard my recommendation, he became obstinate. “We cannot do it that way,” he said. “I am doing it the best way I know, and if we place the instruments in saline while they are being transported on the carts, the saline will splash all over the place. I think it is better to do it the way we have been doing it.”
A long discussion took place with Mr. Gilreath trying to persuade Dr. Wright to at least try my suggestion for a while to see how it worked. Finally, Dr. Wright agreed to test my recommendation. We set a date and time for Dr. Wright and me to meet so we could both observe my recommended method. Mr. Gilreath indicated that he also would like to be there to oversee our experiment.
On the scheduled day, I happened to arrive earlier than the set time. As I walked into the SPD area, I saw that Dr. Wright was already there, and he was testing my recommendation without me, hoping that he’d be able to prove that it didn’t work. Also, he did not want to be embarrassed if we both gave it a try and found that the new method did work.
I communicated what I saw to Mr. Gilreath who became furious and called Dr. Wright into his office. “Why did you try this process alone when we decided it would be done in the presence of Kris and you both?”
Dr. Wright felt terrible and did not have a good answer. Instead, he began crying. Mr. Gilreath’s expression softened. “Excuse us, Kris,” he said.
I left the office, and later, Mr. Gilreath told me that Dr. Wright cried his heart out and kept saying, “I can’t take this anymore.”
“Kris, I realized that Dr. Wright does not have the expertise to make the new design of this hospital work,” Mr. Gilreath said. “That is why I brought you here. Your background is in analyzing hospital systems and finding solutions. The Friesen concept for this hospital is putting too much stress on Dr. Wright.”
It turned out that Dr. Wright and Providence Hospital Staff were not the only ones experiencing this problem. Of the five or six hospitals adopting Friesen’s concept, only one or two could make it function successfully according to design.
Later, in October 1972, Mr. Gilreath explained that he and Dr. Wright had talked in great length about the best course of action regarding Dr. Wright’s position. He clearly did not have either the appropriate education or experience to handle the SPD Department which, due to the centralization system, branched out into nearly all areas of the hospital. He and Mr. Gilreath came to a mutual decision: Dr. Wright would step down from being assistant administrator, and instead, he would simply be the Director of the Pharmacy Department.
“The memo appointing you as assistant administrator over the SPD department will go out tomorrow,” Mr. Gilreath informed me.
I was happy to hear this, although at the same time, I was sad for Dr. Wright. Mr. Gilreath explained that this was best for the hospital and the patients.
The next day, many people congratulated me on my promotion. It was one of the happiest days of my life. I would have a tremendous amount of responsibility and authority, something I thrived on. I loved the challenge and eagerly anticipated the high
