Through this blog series, I have introduced the basic purpose and goals of the process improvement methodology known as Lean Healthcare. We took a look at Lean’s 5 basic principles and its 7 deadly wastes in an effort to help readers begin to understand the key concepts and tools of Lean thinking and how it relates to Healthcare.
I would like to conclude the Lean Healthcare blog series by taking a look at the “5S” process for Lean Healthcare and how this notion can be a simple, yet powerful method for transforming the physical workspace1 to allow for improved quality of care, safety and cost savings.
5S, is an acronym for “sort, set-in-order, shine, standardize, sustain” and is an integral part of the Lean Healthcare process. 5S is a method that reduces waste in the work environment through better workplace organization, visual communication, and general cleanliness2. In healthcare, it is commonly applied to the busiest of areas such as, nursing stations, physician work areas, operating rooms, triages, registration, supply areas, emergency wards and patient bedsides. Janice Ahlstorm, Partner at Wiplfi’s describes the 5S’ approach in more detail2:
- Sort: Remove those items (unnecessary charts, supplies, meds, equipment, and junk) that are not needed to do the job and keep only the essential items. This will remove clutter, free up floor space, and aid in improving workspace efficiency.
- Set in order: Have a place for everything and everything is kept in its place. Place items in proximity (point of use) to make the caregiver’s job easier. Label and identify the exact location for equipment and supplies to make this easy to maintain.
- Shine: Sorted and straightened areas are easier to keep clean. Shine, another word for “scrubbing and cleaning,” is important to everyone, not to mention making patients and their families feel they are entrusting their lives to an organization that values cleanliness.
- Standardize: It is imperative to standardize regular maintenance and upkeep of the 5S process. It is essential to be deliberate in ongoing efforts and to create guidelines for sort, set in order, and shine.
- Sustain: The true value of the 5S process is to sustain customer/patient and Joint Commission ready approach at all times. Use simple but effective audit processes to accomplish this. Sustaining is the most important “S,” and it requires the most discipline.
Benefits of 5S
5S is perhaps the most easily applicable and adaptable tool of the Lean Methodology and one that can deliver real results impacting both quality of care and the bottom-line quite dramatically3. 5S provides some of the following benefits in healthcare4:
- Shorter patient waiting times
- More patient admissions and diagnoses
- Faster bed turn around
- Improved workplace organization, cleanliness and safety
- Reduced inventory, supply and overhead cost and better use of space
- Increased productivity and more streamlined administration processes
- More efficient patient record and appointment processes
- More efficient and effective delivery of care
- Improved patient and colleague satisfaction
To put the benefits into further perspective, if the 5s were applied to all of America’s Inpatient units* and reduced patient’s length of stay by just 5 minutes, that would amount to approximately 135,985 days of care reduced- based on these figures the amount of lives saved and cost savings would be obscene3.
Putting it All Together
Simply cleaning up the workplace environment in isolation will not achieve the objectives of Lean Healthcare2. The 5S method needs to be implemented in collaboration and understanding of the 5 Basic Lean Principles and the elimination of the 7 Deadly Wastes. It is important to remember that Lean is not simply a set of tools; it is a problem solving approach for continuous improvement2 that requires connecting all the various components in order to be successful and sustainable.
Healthcare providers face unique challenges – as large institutions providing the most intimate of services, they are mandated to balance quality of care with organizational efficiency5. In recent years, Lean Healthcare has emerged as the “how to” of managing change and creating continuous, effective improvements in healthcare6. Through its universally applicable principles, such as the continuous removal of waste and non-value added services/products, built-in quality through the “stop and fix” mentality and root cause problem solving, and ongoing improvement through empowerment and respectful people4, the Lean Healthcare Methodology offers a refreshing alternative to the “quality versus cost” conundrum – fix the broken processes that stand between healthcare workers and their patients, and you can improve the quality of care5, increase operational flexibility, reduce cycle time within processes, efficiently use space, deliver service consistently, reduce lead times, and reduce operating costs2 and so much more. Greater quality of care at a lower cost? Hallelujah for Lean Healthcare!
*Values based on 2005 data.
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