Shazzam!

There is an amusement park that is open 24/7, 365 days a year. The queue for their best ride, Shazzam!, is more or less constant and the average wait time is one hour. Still, people can't resist it's allure. The ride itself lasts five minutes (including two minutes for collecting tickets and safely securing and disembarking passengers). There is only one man servicing passengers. In any given period, the same number of people exit the ride as join the line waiting to get on. Occasionally, the line increases or decreases a bit but not dramatically so.

One day, Freddie, the ride operator, had an idea. He figured that since the line moves pretty well at a constant rate, the reason there is an hour wait is due to the constant backlog. So, he went to management and explained "If you put another man on the job to help me with the passengers until there is no queue left, I could then maintain the same pace as now--same number coming as going, and never have anyone wait longer than the five minutes it takes to operate the ride."

Management agreed and hired a temp for Freddie. Sure enough, within a few days, the line had dwindled, the temp was sent on his way (hopefully to do some equally helpful job) and the ride was operating smoothly. Well, you can guess what happened next. As word spread of the decreased wait time, more and more people wanted to ride Shazzam!, including people who had just gotten off. It wasn't long before the queue reached its previous and constant length and the wait time went back to an hour.

This story is not about an amusement park. It is about hospitals. And Shazzam! is not a ride, it is the Emergency Room. Waiting an hour to go on a ride may be unpleasant, but doing so in the ER waiting room could be life-threatening. People have literally died waiting. Why do we accept the unacceptable? Especially when there is a very simple solution?

"But, Vinny", you may be saying, "won't the wait times eventually go back to where they were as in your example?" Absolutely not. People don't decide whether to go to the hospital based on the wait times (or how much they enjoy "the ride")--they go to the ER when and because they have an emergency. Reduce the backlog and you should be able to maintain much faster service times with the current staff going forward.

This solution may not apply to rural hospitals where the number of ER patients fluctuates greatly, but then wait times are probably not as big an issue there, either. In big cities that don't sleep at night, the ER is almost always jammed. This is where it applies. This is where it's needed. Is anyone listening out there?