McDonald's Made-to-Order System and Patient-Focused Care

Introduction: An Unlikely Comparison

To improve consumer relationships and gain a competitive advantage, a company may address any number of areas: process design, distribution channels, branding, advertising strategies, or the core product or service it offers. Because McDonald's and hospitals provide such different services, one might assume they would adopt very different strategies when dealing with organizational waste. After all, McDonald's sells burgers while hospitals are responsible for the lives and well-being of their patients. McDonald's is a commercial venture offering a service consumers expect to be fast and easy, while patients expect more personalized attention from healthcare organizations.

However, when both types of institutions reformed problematic and costly lags in service delivery, they arrived at a remarkably similar discovery. Both found that placing consumers in the driver's seat — making individual needs, rather than predetermined standard operating procedures, the central priority — can be the most effective way to implement meaningful change.

McDonald's Push Model and Its Breakdown

McDonald's has long ruled as the dominant force in the fast food industry and has become virtually synonymous with the quick-service burger. However, with shifting consumer demand for different types of cuisine, "McDonald's original, much-vaunted food-prep system eventually broke down" (McGinn, 2001). Originally, McDonald's speed depended on swift, accurate forecasting of when and where customers would want its products. Burgers were pre-assembled based on expected demand at a given time of day, then kept warm under heated lamps. Unfortunately, as demand grew harder to predict and the menu grew more complex — in response to competitor offerings and a demand for slightly healthier choices — burgers began to get cold and quality declined.

McDonald's had perfected what is known as a "push" model of process design, whereby predetermined benchmarks set productivity goals. This model became increasingly problematic as variability increased. Given McDonald's brand identity, in which sameness was a selling point, customers receiving food of questionable quality was not merely an inconvenience — it contradicted the very premise of fast food, which promised that a burger in one part of the country would taste identical to one sold anywhere else in the world.

The reliance on demand forecasting also made it difficult to add new menu items, such as bacon burgers or new chicken sandwiches, because new choices made historical data unreliable. Additionally, because burgers were dressed with toppings before customers ordered them, anyone who wanted to deviate from the standard configuration had to place a special order, which took considerably longer. The food itself suffered: even when burgers did not go cold, the heat lamps wilted ingredients such as lettuce and tomatoes (McGinn, 2001). Varying market tastes across different regions made distribution more complex, and customization became a greater necessity than before.

The Shift to a Made-to-Order Pull System

In response, McDonald's learned from its competition and created a made-to-order system in which ingredients were prepared and staged, but sandwiches were not assembled until a customer actually placed an order. This allowed for greater product variation, prevented quality decline throughout the day, and enabled more flexibility across different regional markets. Because food no longer rested for extended periods under heat lamps, quality improved. And because individual customization was built into the system rather than treated as an exception, the time required to serve each customer actually decreased rather than increased.

McDonald's had shifted to a "pull" system — a model originally associated with Burger King, the architects of the slogan promising customers it would be done "your way." McDonald's was notably quiet about borrowing its rival's processing innovation. From a philosophical standpoint, however, the company could frame the change as simply putting its customers first and treating them as individuals rather than as projected statistics plotted on a demand curve.

Conclusion: Putting the Customer First

In patient-focused care, everyone benefits: patients receive more personalized care that targets their specific needs, and the hospital reduces costs. In McDonald's new system, there is less food wastage, customers enjoy greater menu flexibility and the ability to customize their orders, and food quality improves because it spends less time resting under heat lamps. Whether the greater convenience for consumers and increased profitability for McDonald's constitute an unambiguous good may be a matter of debate in the health care profession, but both PFC hospitals and McDonald's redesigned process model demonstrate the economic and organizational value of responding to actual consumer demand rather than merely anticipating it.

References

Clouten, K., & Weber, R. (February 1994). Patient-focused care… playing to win. FindArticles.

Myers, S. M. (July–August 1998). Patient-focused care: What managers should know. Nursing Economics, 16(4).

McGinn, D. (May 1, 2001). McDonald's case study: Burger time. Jungle Magazine.