In my last blog post, we took a deeper dive into understanding the 5 Basic Lean Principles of the Lean Methodology and how incorporating these principles can help healthcare organizations achieve smooth process flows, while concentrating only on those activities that add value and eliminate activities or “waste” that do not provide any value.
In this blog I would like to focus on the specific “7 Deadly Wastes” of the Lean Methodology and how they impact healthcare organizations.
The “7 Deadly Wastes” of Lean:
Waste elimination is one of the most effective ways to increase the profitability of any business1. The Lean Methodology focuses on “7 deadly wastes.” Taiichi Ohno (developer of Toyota Production System) suggests that these account for up to 95% of all costs in non-Lean environments2.
The 7 wastes or “muda” as it is referred to in Japan, provide a systematic way to categorize problems and identify improvement priorities. When assessing a process, looking for the 7 Deadly Wastes helps healthcare organizations find more opportunities to streamline the flow of work and provide continuous process improvement3.
For simplicity’s sake, Healthcare Professional Partners created the table below to help define and illustrate the 7 Deadly Wastes, with specific healthcare examples4:
|
Waste “Muda“ |
Definition |
Examples |
Causes |
Countermeasures |
|
Defects (Rework)
|
Work that contains errors or lacks something of value |
Medication errors Rework Variation in outcomes Incorrect charges/billing Surgical errors |
Lack of understanding of what is “defect free” Lack of specification in work processes |
System redesigns that support workers in doing their good work by clear specification of activities of work, clear expectations of outcomes and safe environment for problem solving in the course of work Clear definition/ understanding of what is “defect free” Single, clearly understood method of addressing “defect free” right now |
|
Over-production
|
Redundant work |
Duplicate charting Multiple forms with same information Copies of reports sent automatically
|
Misinterpretation of regulations Poor communication between departments, offices No clear specification of who needs what Computer systems not linked |
Clear interpretation of regulations System (electronic or paper) of information traveling with patient that eliminates redundancy |
|
Waiting |
Idle time created when people, information, equipment or materials are not at hand
|
Waiting for other workers at meetings, surgeries, procedures, reports Patients waiting for appointments, MD visits, procedures |
Poor understanding of the time required to do a task Poor accountability for delivering on time Compounding delays Unresponsiveness of scheduling systems to demand of work |
“Right now” scheduling Fewer meetings; work done in small focus groups Matching capabilities to demand for services, supplies |
|
Transporting
|
Required relocation/delivery of patient, materials or supplies to complete a task |
Delivery of medication from central pharmacy Staff travel to a remote storage room to retrieve supplies Delivery of surgical pack to OR |
Non-standardized supply location Supplies to complete one task located in multiple locations |
Conduct 5-S workplace organization to standardize location of supplies near the point of work Examine staff location as related to commonly used supply storage locations |
|
Inventory
|
More materials on hand than are required to do the work |
Overstocked medications on units Overstocked supplies on units and in warehouses |
Supply/demand not well understood Outdated supplies not deleted Personal preferences catered, duplicated |
Supply exactly what is needed; no more, no less Keep supply availability current Understand personal preferences and orchestrate “like” items use |
|
Motion
|
Movement of people that does not add value |
Looking for information Looking for materials and people Materials, tools located far from the work
|
Inconsistent information systems (includes communication) Materials stocking that does not match the demand Scheduling that creates work-arounds and re-work |
IT systems that match the demand of work Reliable communication systems Fluid materials availability that meet the current demand Consistent scheduling that meets the demand
|
|
Excess Processing
|
Activities that do not add value from the patient/customers perspective |
Clarifying orders Redundant information gathering/charting Missing medications Regulatory paperwork |
Work area layout that does not promote continuous flow Complex flow of medication delivery from pharmacy Multiple/complex forms |
Work area re-designs to create continuous flow Simplified/consistent delivery systems for meds/materials/information Forms that document only essential information
|
Understanding and eliminating the 7 Deadly Wastes can help to achieve improvement in healthcare by enabling the organization, and its staff, to examine their own workplace and eliminate wasteful activities. In return the organization will reduce cost, increase profits and most importantly improve the patient experience.
Stay tuned for my next blog, as I conclude the Lean Healthcare series by providing readers with a better understanding of the “5S’s of the Lean Methodology,” an effective tool to help improve the physical work environment and increase patient satisfaction.
Resources for this blog post:
