How we created the need for an emergency lane

· January 27, 2015

In my last post, I discussed practices and policies around emergency lanes. Today, during my visit to my client, I realized that we, ourselves, had created the need for them. The good news is, if we created the need, we can also eliminate it.

Let me explain.

The board at my client’s hospital doesn’t resemble your typical kanban board. However, we identified another need. Although it’s in Indonesian, I’ll guide you through it. Here’s how the board looked a couple of weeks ago:

Old Board

  • The board comprises 4 lanes:
    • The top 2 lanes are for larger projects lasting up to 6 months.
    • The lower 2 lanes, labeled “Perbaikan” or “Improvements,” are for smaller tasks targeted for completion within 2 weeks.
  • Each project includes:
    • A brief project description.
    • “Untuk Besok” (Until Tomorrow) section listing tasks to be completed by the next day.
    • “PIC” (Person In Charge) responsible for the project.
    • Current status of the work.
  • For the improvement lanes, we also added:
    • “Kenapa” - WHY are we doing this?
    • “Definisi selesai” - the definition of done.
  • In the bottom right corner, under the “Nanti” (Next) heading, are sticky notes representing tasks that cannot fit on the board currently, serving as our backlog.

The Need for Speed

Recently, we observed the sudden need for a new lane: urgent. Items arose requiring immediate attention – “right now – this can’t possibly wait. It’s an emergency.”

Up until now, we’ve encountered two emergencies: the only food trolley broke down, and parts of the hospital had a foul odor.

The first item was quickly resolved by fixing a wheel, while the second was a genuine emergency. However, this sudden need for emergency items raises the question: why now?

We’ve been using this board structure for about 3 months without any such need arising.

Breaking Down the Work

New Board

As I redesigned the board to include the urgent lane, I realized something significant.

Two items in the “Improvement” lane exceeded our Work In Process limit of 2 weeks. This impeded the flow of work and delayed items from the “Next” section being picked up.

We realized the need to break down our work into smaller chunks to adhere to the 2-week limit. Instead of viewing tasks as one large job, we now break them down into manageable 2-week chunks.

For example:

  • “Cat UGD” (repaint the ER):
    • Plan the project: 1 week.
    • Paint the UGD: 1 week.
    • Replace the door: 1 week.
  • “Perbaikan Parkir” (Improvements for the parking lot):
    • Plan and decide on contractor: 1 week.
    • Parts 1-4 of the parking lot: Each 1 week.


Breaking down tasks not only brings numerous benefits, but it also reduces the need for urgent items. We aim to minimize “Urgent” tasks since they increase WIP temporarily, slow down the process, and divert focus from our primary work.

For instance, during today’s stand-up, approximately 25% of the time was spent on urgent matters. These items existed as urgent due to our tendency to chunk work into large projects.

While emergencies are inevitable, let’s reserve the urgent lane for genuine crises rather than squeezing in tasks due to the waiting period for oversized projects we’ve created.

Remember, how you chunk the work is up to you. You have the power to decide.

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