Archiwum dla miesiąca: July 2015

Order and arrangement at the workplace

Maybe the header doesn’t persuade to get to know the 5S method however, everyday safety and ease of work strongly depends on it. There are lots of activities in a hospital since everone strive to make his or her work done properly. As more patients stay in, it gets more and more difficult to maintain decent workplace. If we consider medical services process from the angle of used supplies, we can simply notice that any arrangement, setup or configuration becomes a repetitive obstacle and preserving workplace ergonomics, adjustment of medical equipment and distance to stocks located in storage facilities isn’t as simple as it should be. The more workplace is arranged and ordered the more we’re able to notice issues elswehere. 5S method has its origins in Japan and is associated as a continuous improvement tool. Widely used in various branches including healthcare.

What to do first?
Method name indicates number of stages that must be followed in order to make it most efficient. Each stage unveils its various meaning.

1S-SEIRI

Selection – it stands for tools selection so that one can perform an action and a perfectly valid process. It is important to remove unnecessary objects. Define frequency for hardware, objects and tools use. If there is any equipment used ver rarely it is likely to place it in a storage facility in order to gain extra space to work.

Another stage is called 2S-SEITON

Systematics – it determines where to place hardware and objects. Each area should be described and pictured because visualization facilitates any kind of work. Convenience and frequency of use are here top-notch factors – the more we use an item the more close it should be located. Thanks to S2 SEITON each item has its own fixed spot and we level time spoiled on looking for it. Furthermore, it gets straightforward to evaluate shortages and execute quick supplies. Another significant component is to outline pathways, doors, room for medical equipment. Particularly important in preparing emergency equipment including specific medications and items (secured dose and amount). If items of a set lay down unordered in a drawer it’s hard to guess if there is something missing. However, using dividers or a shadow boards makes it organized and easy to identify (shadow board is a map of item shapes e.g. shapes cut in a special foam hanged on a wall always display the missing item if it’s not there).

Shadow board is great solution for tool management at workplace. It allows define status of tools and quantity  promptly. Shadow board  serves for cleaning kit but also for:

• drugs and syringes
• surgical instruments
• emergency tray
• other technical tools

Shadow board allows for keeping order according to 5S methodology. This is visual tool, thanks to medical staff don’t waste time for looking for things. It allows to complete activity in safety way. Clinical processes are specific, because that it is important  to use intelligent and relatively cheap solution. Shadow board is tool created to everyday control of emergency tray. Just one look and it is known if tray is completed or not.

3S-SEISO

Clean-up – it’s not only about cleaning up. Systematic cleanup according to hygiene schedule helps to maintain appropriate hygiene along with safety expansion. Cleaning up also means to control in order to identify broken equipment, damaged items, any defected or nonessential conditions that doesn’t fit regulated standard. Criteria of control are composed by ourselves. A person responsible for cleaning up is also assigned to evaluate actual condition and record any aberrations. There’s always a clean-up personnel in a hospital – ward nurses perform activities having enormous impact on clinical process safety. Accurate assessment using 5S method can easily eliminate risky situations which have been always a possible risk to medical personnel or patients e.g. leaking tap in patients bathroom… maybe it’s not a big deal but suppose water drains on the floor and our patient falls. It may cause grievous bodily harm or even death. After getting such a result in our 5S evaluation process a quick preventive reaction is necessary. Each staff member should be responsible for his or her spot.

4S-SEIKETSU

Harmonization – it pertains to above mentioned stages. We define the rules, form standards and maintain both. It is obliged to follow certain duties, schedule and sanitation safety plan. Both law requirements and internal procedures are being developed and this is why it is so important to fit new rules and improve them.

5S-SHITSUKE

Self-discipline – reassures to abide above mentioned stages. It is essential to introduce an evaluation system as an everyday routine. 5S audit should be performed by determined clean-up personnel that’s responsible for order in a workplace. Best results can be acquired when 5S isn’t just required from 1st degree personnel but from all employees including executives. The easiest way is to begin with the first degree personnel, and ending with executives.

PROS?

– safety improvements
– shortening the distance coverage of Staff
– increased staff knowledge
– arrangement among medical records
– appropriate workspace management e.g. storage facility for medications, dressings or equipment items. All above mentioned advantages relate to entities financial liquidity and lower the risk of having medications or equipment with expired date which in fact are producing losses of a hospital
– simple and quick evaluation of occuring action
– higher efficiency and productivity of provided services

5S audit

Methodology 5S is the beginning of long way to improvement with lean healthcare approach in medical unit. There is no patient safety management without well equipped infrastructure and without defined duties and responsibilities at every workplace. 5S implementation is not easy task, but its maintenance is more difficult. It is difficult to convince employees to work according to new rules and standards. Acquisition of new information and change the habits is hard and long term process, but using Kaizen philosophy is easier to  reach goals. How after 5S implementation, keep this system in the hospital?

Methodology 5S consist of 5 steps, which are described above. How to conduct daily 5S audits?

It is worth to design checklist in which defined employees will be conduct assessment. Forms should be adequate to each workplace, department and hospital wards. Other aspect will be checked by cleaner, other by technician and medical caretaker.

5S audit form should be divided on 5 parts (5 steps):

• sort
• set in order
• shine
• standardize
• sustain

and days of week, we want to conduct assessment.

Each stage contains questions and aspects which should be followed every day.

Sort is checking workplace if there is no unnecessary things, machines and equipment which could make work more difficult.

Set in order means systematic lay down equipment and other things on defined place. Each machine, wheelchair, USG machine, EKG have own address, so that it is possible to keep order. Things that are used most common are located on hand, in the nearest place.

Shine is everyday activity in each patient room, hospital ward, ward kitchen and warehouses, also it is infrastructure which is used less often.

Standardize allows for conducting 5S audit according to checklist. It is also linked with documentation results of assessment.

Sustain- this point suggests employee take care of own workplace, proposing improvements and observing own surrounding. When problem appears, medical staff or other employee find some lost drug, should inform supervisor and protect place so patient and employee will be safe.