LeanHealthcare_ContinuousFlowOne of the problems with having lean eyes is that it can infect your family.  If you point out waste enough while you are out and about, your spouse and children start to see it.  My wife sent me the picture below from a McDonald’s restroom recently with the caption, “Check out these Lean sinks.”  She also said that the hand dryers are extremely fast and the restroom was much cleaner than other McDonald’s restrooms.  Drying my hands at McDonald’s has been a point of dissatisfaction for me, as most locations have very slow hand dryers which really don’t work.  I usually end up using napkins from the counter to dry my hands.

This is “continuous flow” — no pun intended. The soap dispenser, water faucet, and hand dryer are right next to each other, and all are located right over the sink.  You may say, “Well, that looks cool, but so what?”  Let’s look at the business case problems or opportunities this touch-less design addresses:

  • Safety: no slipping due to water on the floor
  • Health: no touching the faucet, soap dispenser or hand dryer
  • Satisfaction: cleanliness of the sink area and floor as your hands are dried in the sink (no water on the floor or outside the sink, and no soap on the floor or counter); no bumping into other customers moving from the sink to the paper towel dispenser or separate hand dryer; no paper towels on the floor or overflowing trashcans
  • Cost: no paper towels (material and labor cost to replenish towel dispensers or remove used paper towels); less time spent cleaning the restroom since there is no water on the floor or outside of the sinks
  • Time: hand-washing time is shorter because you don’t have to travel to a separate location, or wait in line to dry your hands.

Now there are other solutions that solve one or more of these problems, but not all of them. It is also important that the dryer cycle time be very short and effective, the dryers be waterproof (to prevent the risk of being electrocuted with the faucet next to it), and that these combination sink units are not cost prohibitive. I am sure McDonald’s performed an extensive cost-benefit analysis and tested the new design before installing it.

Continuous Flow (also called one-by-one processing, or no batching) means no delays occur once a value-added process is started. In order for this to be achieved, the causes of the delays must be eliminated.  It appears McDonald’s has found a hand-washing solution which does just that.

Even if you can’t achieve continuous flow in a process today, every step closer to it results in improved outcomes. This is because you can’t get closer to continuous flow without addressing the root causes of the delays, which are waste.  I believe all of the benefits listed above are needed in Healthcare.  You may be surprised what you can see and the ideas you come up with when you have lean eyes!


Today’s blog was written by Dwayne Keller.

Dwayne has more than 20 years of experience in performance improvement and Lean-focused executive leadership positions. He has led a variety of project types, including Lean implementation, strategy deployment and Lean facility design, ensuring that all work is connected to the organization’s business case.  His breadth of experience combined with a deep understanding of lean allows Dwayne to effectively mentor client leadership teams through the lean transformation process. Dwayne was previously with Medical Reimbursements of America where he served as executive vice president of operations. Healthcare executive teams visit MRA to learn about the Lean revenue cycle management system that Dwayne implemented.

He is an executive faculty member and instructor for Belmont University’s Lean Healthcare Certificate Program. Dwayne holds Master’s and Bachelor’s degrees in Mechanical Engineering from Bucknell University, and a MBA from Clemson University.

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