One of the essential elements of the foundation for an effective Lean Healthcare transformation is the implementation of a Workplace Organization or 5S system. In my role as coach and facilitator I am often asked by leaders why their 5S initiatives are failing. My first, internal, response is “why don’t you ask your staff”?
Of course, I sanitize this terse response before putting it back to the questioner. But, the message is always the same. The key to improvement in 5S performance, like any metric, lies with the staff. Go to the Gemba and ask them.
Assuming that all the pieces of a 5S program are in place, including a healthy audit system that yields quantifiable, actionable 5S results, leaders are ideally prepared to address 5S performance in the same manner that they might any of the other initiatives they are charged with.
Leaders often make the mistake of assuming that failure to follow 5S standards is simply, at worst, an issue of non-compliance on the part of the staff or, at best, an issue of lack of training to the standard. But, the root cause of failing to follow standards is almost always more complex. Getting to the root cause requires a disciplined approach to problem solving. The ideal tool to use when seeking to improve 5S performance is the A3.
In one recent case at a Lean Healthcare facility, a leader noticed a downward trend in one her department’s 5S score. She scheduled a stand-up meeting with some members of her staff to address the issue. She chose to use an A3 approach. She used the data from the department’s recent 5S audits to explain the issue and the background. After some problem analysis, the team was able to hone in on one source of the point deductions but they still weren’t at the root cause. They had learned that a consistent problem area is the improper storage of blood pressure cuffs on the headwall. The standard was for these cuffs to be stored in casework in the exam room. Further problem analysis, using the “5 Why” tool revealed that the some staff members had begun to store the cuffs on the headwall to avoid congestion. (The casework is on the opposite side of the exam room, where another member of the team is often blocking access to the cuffs while using the computer to chart at the same time vitals are being taken.) As a countermeasure, the team decided to change the standard so that cuffs are now stored on the headwall. Appropriate storage, with labeling, has been added. This change has been communicated throughout the staff and the team is no longer having points deducted on its 5S audit. In this case the audit findings pointed to a need to improve the standard.
When 5S performance, as measured by audit results, fall below the acceptable level, employing an A3 approach will help to point the staff to the true root cause and a solid countermeasure. Nearly every failure to follow a 5S standard should elicit this type of problem solving approach. Shortly, the failures to follow standards will fall away. You can be reasonably sure that if your staff is failing to follow standards, it due to a hidden issue that can often be addressed at little or no expense.
This week’s blog was written by Jeff Wilson. Throughout Jeff’s career, he has delivered and applied progressive management and process improvement tools to help organizations reach new levels of performance. The industries span from healthcare to manufacturing, financial consulting and accounting. He has developed Lean transformation plans, facilitated Kaizen events and developed training materials for numerous client companies. Jeff has a Bachelors Degree in Economics from Western Kentucky University. He also holds a Certified in Production and Inventory Management (CPIM) designation.
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