We provide fully integrated facility solutions that ensure the execution of capital projects across markets, offering local presence and global reach to the private and public sectors.
With broad-based expertise across disciplines, we are an unparalleled source for performance-driven facilities built to deliver, from concept to ribbon-cutting.
With a broad range of in-house engineering expertise, we can optimize your current operations or take your new project from concept to completion, providing unrivaled service and results.
Haskell is a global network of experts providing integrated design, engineering, construction and professional services to clients and communities.
Home / News & Insights / What the iPhone Game “Diner Dash” Taught Me about Optimizing Emergency Department Throughput
Like most people, within hours of purchasing my first iPhone, I discovered game apps. Since that time I have spent entirely too much time playing them. One game in particular, Diner Dash, has taught me some valuable lessons about optimizing emergency department throughput.
The basic premise of Diner Dash is that Flo, the proprietress, acquires a run-down diner after leaving the rat race of the business world. If she succeeds at making her first few customers happy with good service and brings in more business, she can upgrade the décor and make a go of her new enterprise.
Flo earns points for good service. As she earns enough points to advance to the next level, the game’s pace picks up: more customers arrive, and more skill is required to keep these customers happy.
Diner Dash is a successful example of gamification to teach not-particularly-interesting-but-necessary life lessons, in this case time management tools. After countless hours playing Diner Dash, I realized that the skills needed to succeed at the game are the same skills my hospital clients need to improve patient flow and plan future space. In fact, I could easily say that playing Diner Dash can teach anyone the general principles of flow important to efficient patient care. Especially in an emergency department.
Flo has a restaurant full of “2 tops”, “3 tops”, and “4 tops”, or the number of seats at a table, and she matches arriving customer party size to table size. A mismatch in party size to available tables causes a lack of space for incoming customers. Also, customers waiting less time may get seated more quickly, making other customers angry and causing the player of Diner Dash to lose points.
This sounds a whole lot like an ED waiting area and triage queue where the Triage RN is trying to determine a patient’s acuity, and may bed a patient that has been in the department for less time, or bed a patient in a space not suited for that patient’s care. In each case there is not appropriate capacity available when it’s needed. And we get angry customers.
We can improve service for customers, or patients, when we can plan for the right number of seats at the right table size ahead of time. A triage nurse can proactively plan “a bed ahead” for placing the next arriving patient in the right bed, based on presentation.
A player wins more points when Flo is directed to take food orders to the cook sooner. If she seats a party, and gets their order in before seating another party, then she has delayed getting orders for the second party. Even though the first party would get their food more quickly, the second and subsequent parties would receive theirs more slowly. The game encourages the player to get Flo to chain together like activities that expedite all customers’ food orders.
In an emergency department, a patient arrives and seeks treatment. Our activities should focus on expediting a patient to a provider and getting orders generated as quickly as possible. If we know it’s going to take a while to get the labs “cooking”, we need to start them sooner.
Flo’s customers get testy and tip less when she doesn’t pay attention to their coffee cups. Players earn more points by directing Flo to visit each table to refill coffee cups in between seating people, taking orders, and delivering their checks.
In an ED, patient rounding offers another touchpoint to answer questions, assure a patient of progress, and see to their immediate needs and safety. A Journal of Emergency Medicine study found that rounding protocols “reduced LWBS by 23.4%, leaving AMA by 22.6%, falls by 58.8%, call light use by 34.7%, and approaches to the nursing station by 39.5%”.
You probably won’t get a tip for rounding, but you will facilitate improved outcomes and patient satisfaction.
Ultimately, serving the most customers attentively in the shortest amount of time produces the most points. In Diner Dash it is just as important to expedite a customer’s paying and leaving as it is to seat waiting customers. If a table isn’t immediately available and a customer has to wait for Flo to clear one in order to be seated, the customer gets angry and she loses some of her tip. In Diner Dash, Flo can’t just add more tables to the floor to seat more customers; she has to make way for new customers by prioritizing the dispatch of those ready to leave.
In an ED, the temptation to add hallway beds for new arriving patients is often couched in the need to ensure patient safety. However, if staff prioritize getting discharged patients ready to go, then beds are more likely to be available when they are needed, and no hallway stretchers are required.
In Diner Dash a player is directed in the game’s play to pay attention to visual cues that indicate what to do next, such as when a customer is ready to order and ready to pay. A customer’s hand purposefully waves a check, and Flo is directed to take care of a payment so that the table can be cleared. For staff taking care of patients, knowing when an order needs to be completed or when a patient is ready to go home often means constantly checking a computer system. And if a nurse is doing many things at once, there often simply isn’t time to even remember to check. Staff are more apt to stay on top of patient flow when they are aided by alerts and visual cues that don’t require they go in search of a patient’s status to know what to do next.
Have you ever tried Diner Dash? If you work in an emergency department you may be apt to see more parallels than I did. What others did you find?
Haskell delivers $2± billion annually in Architecture, Engineering, Construction (AEC) and Consulting solutions to assure certainty of outcome for complex capital projects worldwide. Haskell is a global, fully integrated, single-source design-build and EPC firm with over 2,400 highly specialized, in-house design, construction and administrative professionals across industrial and commercial markets. With 25+ office locations around the globe, Haskell is a trusted partner for global and emerging clients.
The practice whereby a physician operates on patients in 2 overlapping rooms is called a flip room. The physician must be...
The source of many complaints and a great risk for sanitation and safety, temperature and humidity (T&H) control in...
In a project that has been novel on numerous counts, Orlando Health and Haskell partnered to bring the state-of-the-art...
People are innately driven to interact with nature, and biophilic design is an approach that accommodates this desire...
The effects of climate change on healthcare and the effects of healthcare on climate change are inextricably linked. At...
In the year and a half since Jennifer O’Donnell spearheaded its formation and became its first president, the Charlotte,...
After a yearlong effort, the American College of Healthcare Architects (ACHA) has released its VA Task Force 2023 Report,...
Denise Muth was a single mother starting her climb up the construction ranks before anyone had seen a laptop or a cell phone...
It is always interesting to describe what you do as a consultant because your job changes from project to project. I would...
People use that Contact Us link up at the top of the Haskell.com website for all sorts of reasons, but as far as anyone knows,...
Since the release of our first report on upgrading to meet USP 797 and USP 800 requirements, we have received so many requests...
Pharmacy requirements are evolving, and requirements for the physical spaces that pharmacies occupy have tightened...
Taking a holistic approach to projects is a hallmark of Haskell’s work. Nowhere is this more true than in its healthcare...
Early in the planning stages of the Borowy Family Children’s Critical Care Tower Frank Brooks walked through an area in...
Free-Standing Emergency Departments (FSEDs) are, by definition, a community’s link to healthcare when residents need...
The Association of Medical Facility Professionals (AMFP) has formed a chapter in Charlotte, North Carolina, its ninth...
It’s common to hear the phrase “Day in the Life” (DITL) during the activation of a new healthcare space, but what does that...
Scripting, or a standardized response, is part of everyday life. Order a cheeseburger, and the cashier asks if you want...
As the world marks two years of the COVID-19 pandemic, the healthcare operations and construction industries continue...
Medical planners often stay tucked away at their desks, blocking floorplan concepts, creating schematic plans and supporting...
Through a truly collaborative effort that ultimately would span five years and six major phases, Haskell Healthcare recently...
High-quality design has a profound ability to affect our experience and perception of space. In addition to helping providers...
Given that one out of every eight women born today will be diagnosed with breast cancer, scheduling a diagnostic scan or...
Newly named Vice President and Consulting Services Division Leader at Haskell, Kevin Meek might seem far from his roots...
I am often approached by healthcare facilities regarding soiling or staining on their furniture, cracked upholstery,...
We as humans are configured a certain way. We all have the same systems – like circulatory, digestive, nervous – that work...
Aging infrastructure in healthcare facilities represents significant cost and risk, and it has tremendous bearing on...
Post-discharge infections are one of the leading causes of hospital readmissions. Medicare payments typically make...
As recently as 100 years ago, lawyers, notaries, and others were performing the work of engineers despite their lack of...
Population health has changed ambulatory investment. While in the past healthcare systems looked for opportunities...
Concrete slabs contain and continually absorb and emit moisture over time, potentially causing costly problems with...
Haskell’s Healthcare Design Director, for which the company is now recruiting, is a position that embodies two of the concepts...
Centralized care is emerging to reform patient care operations by generating real-time, actionable analytics and proactive...
Virtual reality has come a long way from its original uses in video games and military training exercises. Now this technology...
In the same way that Design-Build project delivery revolutionized the construction industry by enhancing design and...
We have learned a lot from the outbreak of COVID-19, and we will continue to quantify the magnitude of the strain this pandemic...
One of the unintended consequences of the COVID-19 pandemic and extended lockdowns has been unused or ill-used office...
Health systems are seeing changing demands on their existing ambulatory asset portfolio, in both services offered and...
As designers, we often rely on visualization strategies such as 3D modeling, renderings, and video fly-throughs to convey...
Many buildings today are clad with aluminum skins, crisp metal panels in both simple and complex shapes, with limitless...
Telehealth visits, plexiglass partitions, taped-off waiting room chairs, hand sanitizer stations, and masks are just...
The health sector has experienced tremendous disruption in the past year, but one healthcare trend had been gaining steam...
COVID-19 has forced the healthcare world into uncharted territory. Protecting patients from those who are contagious...
To say that 2020 was difficult for hospitals and health systems would be an understatement. COVID-19 wreaked havoc on healthcare,...
Yesterday we had a plan on how to improve our supply chain process. We looked at supplier consolidation, our distribution...
Intensive care units were born out of the development of new technologies to treat the most critical patients. The first...
You don’t necessarily have to be in the healthcare industry to see that COVID-19 has changed the way we approach the delivery...
The COVID-19 pandemic has overwhelmed health systems, and the costs associated with treating these patients have cut...
MTV’s 1981 debut of the Buggles’ “Video Killed the Radio Star” instantly changed how we enjoyed music. We no longer had to...
“Who are the young men we are asking to go into action against such solid odds? You’ve met them, you know. They are the best...
The public health crisis of the past nine months has shone a spotlight on the tireless care that doctors, nurses, and other...
2020 has been a challenging year for all of us. The COVID-19 pandemic has changed our daily lives considerably: healthcare...
With such a profound shift in how to conduct business in a pandemic, determining how to conduct tasks in a sustainable way...
We’ve heard the expression “Hindsight is 20/20,” but that doesn’t mean we have to move forward blindly. Artificial intelligence...
What if we could be proactive about behavioral health rather than reactive? We cannot control people or their behaviors,...
As the coronavirus overwhelmed the New York metropolitan area in March and construction sites shut down en masse, Haskell’s...
When Haskell was founded in 1965, architects couldn’t work in the same organization as construction staff. The American...
Change management, the controlled implementation of required changes within a system, is a phrase that is overused. But...
In my previous blog, I discussed the clash prevention process and how Haskell is using that to advance our designs and deliverables....
The one thing that the current pandemic is teaching us is that technology is going to play a larger part in how healthcare...
We as designers are hands-on, collaborative, and interactive types. We enjoy the opportunity to get together in one room...
It’s 2020, and everything seems to be experiencing a revolution. Articles use popularized clichés like “the new normal...
Since 1892, Haskell has embraced the evolution of documentation methods ranging from 2D pen/pencil and paper and 2D electronic...
Five years ago, Nathan Faloon and his family sought relief from the harsh winters of New England. Hailing from Dover-Foxcroft,...
You walk down a corridor on your way to an operating room. On your left is a scrub sink. You pause and take a quick peek through...
The last few months have brought forth many discussions surrounding the effects of COVID-19, both current and long-lasting....
Read Part 1 to learn more about how to coordinate your response to a pandemic. The COVID-19 pandemic has exposed the vulnerabilities...
The COVID-19 pandemic has elevated the need for the healthcare industry to rethink not only our emergency preparedness...
Architects and designers are immersed in a challenge to create healthier built environments that address the coronavirus...
As cities and states continue to reopen, the thought on everyone’s mind is, “How do we re-enter public spaces and businesses...
The health of humankind is a complex and fragile thing – a fact highlighted by our current world pandemic. So much of who we...
We live in a world of competing priorities. Your spouse wants you home for dinner, your boss wants you in the office putting...
“By failing to prepare, you are preparing to fail.” — Benjamin Franklin COVID-19 will create an expanded need for...
Do you use a smartwatch? Have you ever installed a healthcare, diet, or workout app? Or have you ever put in personal information...
Read Part 1 to learn how a CSC can protect your supply chain during a public health threat or natural disaster. The current...
Let’s imagine for an uncomfortable minute that viral outbreaks become the “new normal.” Yes, a vaccine will probably be...
The healthcare supply chain is complex, and the role it plays in supporting patient care is critical. Around the world,...
Design is a collaborative process. Everyone on the team has a talent and expertise to offer the collective. From our internal...
Back in August I wrote a piece about the future of ICUs and discussed the unlikely potential of the hospital of the future...
While emergency departments and critical care units have been inundated with patients due to the COVID-19 outbreak, many...
As we define our new normal based on our COVID-19 experience, each of our perspectives will begin to shape healthcare design...
You stepped up when the crisis demanded. You were there for your community and your patients. Now it’s time to look toward...
If you had not started making shifts toward comprehensive telehealth before the COVID-19 pandemic shutdown, you have...
As we continue to help clients with their ability to prepare for or deal with patient care surges due to the COVID-19 pandemic,...
The surge of patients caused by COVID-19 will undoubtedly affect how healthcare is delivered once the current situation...
The COVID-19 pandemic has shifted a lot of focus and evaluation to the design of the contemporary hospital patient room....
There is nothing like a sudden and drastic change to make you have major epiphanies, and the social distancing measures...
As part of my job as a construction administrator, I conduct periodic site visits to our projects under construction. The...
It’s been just over five years since my father died due to complications from acute myeloid leukemia. When he was most vulnerable,...
Wearable health technologies are not a new concept. From simple step counters to watches and apps that monitor our activity...
In the same way that it pioneered the Design-Build method of project delivery decades ago, Haskell is distinguishing itself...
Health systems, particularly complex areas such as the emergency and surgical services departments, have long used computer...
Every day we hear about big data, the need to harness it, and the need to analyze it. In doing so, we are promised that big data...
As a healthcare interior designer, I am often asked why design is needed in healthcare. Once I overcome my initial shock...
Say you’re an architect designing a new building of Type I or Type II non-combustible construction. You submit your plans...
Often, the value of an architect is measured by a flashy edifice, a well-thought-out plan, or a functional sequence of movement...
In our last blog post on activation planning, we emphasized that implementing even a single process change in a new building...
Healthcare costs in the United States are the highest in the world, accounting for 17% of our GDP and per capita expenditure...
Attending a conference focused on “patient-centered care” means that every session you go to is based on the patient first....
Trying to juggle work, attempts at a social life, staying physically active, and keeping up with adult tasks (i.e., oil...
111 Riverside Avenue
Jacksonville, FL 32202
© 2024 Haskell. All rights reserved.
We collect basic analytics to improve your experience. No personal data is stored. By continuing to use this site, you acknowledge this. For more details, see our Privacy Policy.