A few years ago I was discussing plans for an upcoming 5S event with an area supervisor whose department was pretty well run on a daily basis. The supervisor stopped me in the middle of the conversation and asked me the following. “What is 5S? No really, what is 5S and what will it do for me and my staff?” She continued by adding  that her time and the staff’s time was very valuable to the organization, and allocating time for an event would have to be carefully planned and defined before moving forward. She showed me all of the previous 5S training material and even stated each “S” and what all she learned from the events and other lean training. I stopped and thought for a second before responding. It was evident that the department has had some success and the tool 5S was nothing new to them. No one had ever asked me about 5S in that manner before. Most of the leaders I have talked to have heard about 5S before, and they have done an event with little to no success. I asked the supervisor if she had a few minutes to walk on the floor and I would try to show her a better example of how 5S could work. She agreed. On our way to the floor, she quickly stated the 5S (Sort, Set in Order, Shine, Standardize, and Sustain) and noted that for the most part, most of the staff had embraced the 5S tool, but there was a few who always seemed to challenge the system.

Once on the floor, the first thing I asked her to do was to walk me through the system (as it was called) on a very high level. This took less than 10 minutes.  At the end of the process, I then told her that the both of us would spend about 5 minutes observing the process and each of us would write down what waste we saw and ask ourselves what is normal and what is abnormal. After the 5 minutes, we had written down a combination of 20 items we observed and agreed that they added no value or were just simply waste. We then categorized them into the 8 waste categories. Before I could even go into discussing what 5S was and what we as a team should focus on for the event, the supervisor looked at me as if saying “Alex I get it” you don’t even have to say anything. She started pointing out and showing me the current labeling and cleaning processes, some organized shelves and rooms, tape on the floor and racks to mark where items should be or belong, and even a 5S communication board that showed the departments’ accomplishments and score trends. What she said next is what really got me thinking and excited, “We did 5S, well the first three “S’s” very well. However, we really did not set or have a solid foundation to build on.” I asked her what she meant by that. She said, “Well, we did a 5S event and then washed our hands from it so to speak, hoping everyone would follow the new changes and hoped for the best.  Some of the items we wrote down were highlighted during the 5S event. We did a poor job planning the event; in fact we called a meeting and did everything in a conference room. Alex, P for “planning to see” should be the first S and O for “Ownership” should be the last S in 5S. The event should have been clearly planned on: what will be sorted, how things should and will be straightened, how, who, and when to do shining, how to simplify the standards so defects and errors are clearly visible and noticeable, and establish an owner(s) for the new changes to ensure sustainability. If our objective from our first 5S would have focused on improving 5 key things that added value to the process and sustain them, it would have been better than changing 15 things we are not even able to follow or sustain. Five improvements are so much easier to manage and follow-up on than 15 changes. We never established owner(s) in each step of the process and I never gave them the support to become presidents of their process. If each team member, including myself, would just own one improvement and educate the others on it, we would be so much farther along.” I thought she was a little too hard on herself, but it was very clear that she wanted to move the department from good to great. We set a follow-up meeting to come back to the floor at another time to complete the planning. 

I thought about what all she had said and especially the P and O in 5S. I couldn’t have agreed with her more. 

In lean healthcare, caregivers and leaders often relay to me that during a 5S event there’s always a high level of energy and everyone feels that things are really going to change and the improvements will be sustained, just to find out that the new changes must be managed somehow and by someone. Very little time is spent and thought is given in planning the outcome of the event. In fact, I can remember a time or two were I could have done a better job at planning. My sensei once told me that he has spent more than 50 years planning and doing 5S and he is still on the 4th S (standardize). He said that 80 percent of your time should be spent planning, 10 percent should be spent executing, and 10 percent follow-up. You should think about every process as a mini company and every company has a president. This is where the ownership is established so that when one improvement is made, the outcome benefits the company and ultimately the patient as well. 

5S events should be seen and managed as eliminating defects, errors, and confusion, and most importantly be about building a lean culture in your organization, even if it’s just 1 or 5 key improvements at a time. There’s much more than just pretty labeling, tape on the floor, or getting rid of unneeded items. It’s about system thinking, and waste should have no part in it. Cultivate a plan that will set in order ownership in your 5S program that will shine throughout the workplace

This week’s blog was written by Alex Maldonado, an associate with HPP. Alex’s professional experience includes process improvement, operational, and leadership positions in the medical delivery systems and appliance manufacturing industries with Baxter Healthcare and Whirlpool. Alex has had a successful track record in improving results-driven processes with an emphasis in personnel training, project leadership, and operating systems designed to improve customer service and sustainability. He has led the development and implementation of processes to support Lean initiatives that reduce critical path lead-time, reduce expediting costs, capital improvement projects, inventory reduction, and trained and educated staff/employees in Lean Methodology. Alex is well recognized in the following areas: Value Stream Mapping, Hoshin Strategic Planning, Office and Floor 5S, Total Productive Maintenance (TPM), Process Failure Modes and Effect Analysis (PFMEA), Quality Improvements and Mistake Proofing, Six Sigma, Cellular Design, Standardize Work, Pull Systems (kanb an), Equipment Design and Installation (DFLMA), and Safety Programs. He has a B.S. in Industrial Technology Engineering from Mississippi State University and has also completed the Six-Sigma black belt program.

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