South Florida Hospital News
Tuesday September 17, 2019

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June 2008 - Volume 4 - Issue 12




Use Lean Thinking to Help with Your Hurricane Readiness

In times of crisis, the need for standardization and speed are greatly magnified. Examples of this are things like different radios by emergency response personnel, or different types of equipment or medication set-up on crash carts, which may cause user errors. Preparing for a hurricane is one of the most stressful exercises we go through outside of our day-to-day routines in Florida. By applying some of the principles of lean thinking (principles and methods based on the Toyota Production System), both preparation and actual response can be significantly improved. Accuracy and speed are enhanced when the principles of Standard Work and Visual Management are applied. This can greatly reduce or eliminate errors in judgment, especially under the stress of an emergency response situation.

Standard Work means everyone will execute tasks and services in a consistent manner to ensure accuracy and speed in delivering the work. Preparation of supplies and tools using the exact model of equipment, type of supplies, and material presentation in the form of kits that are "ready to go" will enable care givers to spend less time searching and more time providing care. It is not enough to simply define and assemble the tools and materials for Standard Work. Proper and refresher training must be visually tracked and done so that personnel that are not typically in the job function can perform the required work with ease. The concept of quick change-over comes in to play here. How quickly can a technician, nurse or doctor switch from one type of care to another, when enabled by the right tools and process. The best way to gain effectiveness is to have repetition using the tools in the environment that people are expected to work in. Utilizing Visual Management indicators in the environment, following the lean 5S system of Sort, Set-In-Order, Shine, Standardize and Sustain will provide for an intuitive workplace, which will save valuable seconds at critical times.

Simple things like labels, signage, pin stripe tape, color coding and shadow box storage combine to form a powerful system for making work intuitive, and surfacing workplace abnormalities so they can be corrected real time.

No one wants to find out that they have run out of gloves or sutures when they need them, or that the procedures cart was not re-stocked between uses.

Another powerful use of Visual Management is in the use of a production control board for staff to communicate. This allows everyone to see what the current "patient demand" is and where the resources are best applied at any given time to meet the demand. Some pre-work to agree on key terms and definitions, and how the "work-flow" will be processed is required up front. Who will update the board, what criteria is being used, where it will be located and how often staff should "check in" are all things to determine before it is applied in practice.

Although creation of a true lean environment takes time, these are several simple concepts that are easily implemented with powerful improvements in accuracy and speed. A true lean culture would have an environment that is ready to serve at all times, with standard work consistently followed, yet continuously improved on by the users of the process.

Roger Chen and John Tjahjadi are lean practitioners in healthcare. Roger can be reached at or (772) 341-9428. John can be reached at or (262) 527-7974.
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