A Short History of Patient Scheduling Tools in Dialysis

The dialysis industry is coming up on the 50th anniversary since Medicare extended coverage to individuals with ESRD. In that time, a lot of things have changed. If you’ve been working in dialysis for 20 years or more, then chances are you’ve seen a number of scheduling methods and tools come and go!

While I know this is just a small, non-clinical part of the rich history of dialysis… this is such a fascinating topic in the history of this industry — at least for my experience in it. I figured that it needs to be recorded somewhere, so I thought to take a stab at it. And in this five-part series, I’ll look specifically at the history of dialysis scheduling tools and applications.

What I will attempt to outline in these posts is a simple timeline of dialysis scheduling tools that I have been witness to during my career in dialysis. But this timeline cannot be considered complete without your input. I know there are other tools out there, so I hope some of you reading this might share what you know (and even the tools you’ve used! or at least a screenshot) and I will share them here and fit them into the timeline.

In a simplistic attempt to categorize these innovations, I have broken up the history into mini-epochs. Let us call them B.C., A.C., A.E., A.I. Pretty soon, you’ll know what they all mean. Let’s begin!

B.C. — Before Computers

That’s right! You thought I was getting religious on you. =] B.C., in this timeline, means before computers! Before computers were adopted as being useful in the clinic for managing the schedule, we had a few different ways to help us track and manage schedules.

Can you believe it? It’s almost unthinkable now that someone would have to write out the schedule every day by hand. But still, even as recently as 5 years ago, I have seen handwritten schedules in use. I guess those clinical managers never saw the need to adopt a new tool, tried and true in their own systems they were! They say that old habits die hard, but geez louise!

PHOTOCOPIER: (a tribute to the photocopier)
How did we make copies of our schedules to distribute before the photocopier came of age? Carbon Copy paper was certainly around, but I’m not so certain that it was all that
practical for making copies of patient schedules. But what is certainly unforgettable is the serious contribution of the photocopier! These machines were in use way before desktop computers, and they allowed us to make copy after copy of schedules for staff and nurses stations. Enter in a few changes manually, and you just saved a LOT of time with your schedule!

Interestingly, this is a technology that has not gone out of style either, as they are still very much depended on even today!

While I never witnessed the use of a white board in person, I have been told that schedules were also managed this way in some clinics. It’s not hard to imagine how it was used. One downside with this method, though, you really couldn’t keep a copy of your schedule. So I’m not sure this qualifies as an innovation, so much as for a point in history.

Alright! Now here is a cool concept! Let’s represent our patients with magnets on a board, and when we put them on dialysis, we’ll move their magnet into place so we know who is running and where they sit. And if they had a magnetic whiteboard, they could write all over it, too. When I started dialysis in 2003, this was the scheduling tool in use at one of the first centers I visited.

And I’m not being sarcastic with my “cool concept” accolade. Believe it or not, these sorts of boards are in use at manufacturing facilities the world over. So yes, I do think this is a cool concept to apply to dialysis patient schedules. It actually gave a visual representation of the floor, and a real-time understanding of who was running. It served as a schedule and a real-time operations tool, though I’m guessing it was used in conjunction with a handwritten schedule, or otherwise you’d lose your schedule as soon as you move magnets around the board.

So let’s not discount the humble magnet board as an innovative step toward scheduling patients!

[NOTE: Pictures tell a thousand words. If you readers have any pictures of these relics of patient scheduling, do please share!]

So that was a healthy dose of nostalgia. =] There is a lot to cover in a 50-year timeline, so I’m keeping each part purposefully short.

In Part 2 of this series, we’ll move on to the next mini-epoch, A.C. — After Computers. Once computers were on the scene, innovations came quickly. And we’ll revisit the first part of the A.C. mini-epoch from word processors up through the modern spreadsheet!

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Mark Sessoms

I'm supposedly a helluva industrial engineer since my alma mater is Georgia Tech. But what I really enjoy is continuous process improvement, in any and everything! I've been tackling scheduling practices in dialysis since 2003. Five years later, the stars aligned and ScheduleWise was born...

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