Thanks @kurtstat.bsky.social for writing about this and @ludictechnologies.bsky.social for tagging me

But few factories successfully transform their productivity by focusing on their cardboard box stock - they look deeply at the interactions of their process bottlenecks, and spend improvement effort there. Those are the things I think it would be great to talk more about.

In the factory analogy hospital beds are the cardboard boxes of parts sitting between the people doing the work. Important to have enough, and by looking closely it's possible to deduce which machines or processes are bottlenecks (the ones with queues of boxes waiting).

While beds are easier to count and measure, I think focussing on the true capacity bottlenecks (surgical time, diagnostic time, clinical decision processes, information sharing, phlebotomy, and pharmacy, among others) would give more insight than measuring beds.

Beds don't treat patients, and doubling their number would in many cases only succeed in doubling patients length of stay. Patients in beds are usually waiting (for the real bottleneck), or healing. With twice the number of beds and no change to the bottleneck capacity, most will wait longer.

That is an excellent article, and it's really valuable to see it laid out from a patient's point of view. I do think the NHS focuses too much on beds, and bed occupancy. As the article hints, the real problems in the writer's case were information flow, and the emergency surgery timetable.

Thanks this is really helpful. I had followed links but not recognised the significance of the gcc-ASAN one. I think the C++ code puts this out of my reach, but it is a learning opportunity! I agree it does look like the maintainer has moved on to other things. Thank you!

Hi, thanks - I just checked rio out but unfortunately it doesn't support xlsb. The recommended workflow of manually re-saving as xlsx in excel won't work for me because I'm batch-processing about 100 separate files. I'm thankful the readxlsb code is still available on github!

I can't read the article, but hopefully they mentioned the improvement context too. I wonder what those in the 1950s would think if we told them that pit stops in 2025 are routinely done in 2 to 3 seconds, not minutes. youtu.be/n_esmAYxE40?...