You 5S'd Our Fridge

You 5S’d our fridge!

By now you may have heard Saskatchewan’s healthcare system is starting on an exciting Lean journey.  

Its all about creating value for the customer.  In healthcare, that means relooking at everything we do through the eyes of our patients.  The foundation of lean is eliminating anything and everything that does not add value to the customer/patient. If any step in a process does not add value for the patient, you are creating waste.  

We are in early days here, learning a completely different way to approach our work, whether it be as healthcare workers, administrators, system leaders or architects. We are also learning new words (want to poka-yoke a process, anyone?) concepts, tools, and approaches. If you walk around hospitals, clinics, and offices in Saskatchewan right now you might overhear conversations being held using this new language.  Sometimes this new language makes it home.

The other day I came home from the gym and headed straight to our fridge, expecting the usual shuffling of OJ, cranberry juice, costco-sized sweet chili garlic sauce, yogurt and a collection of stacked containers of leftovers to get to the milk I was craving.  I was amazed to find a clean, organized, spacious fridge.  “You 5S’d our fridge!” I blurted out, before realizing the right thing to say to my husband was a HUGE thank you! 

5S is a workplace organization tool that creates an efficient environment or process. Most often 5S is used to talk about transforming a cluttered workspace into a clean and organized place to work.   5S entails five disciplines all which start with S that together are used to transform a messy process or workspace into one that is streamlined. 

So without knowing it (he’s a natural at this), the five steps my husband used to create the beautiful fridge you see here were: 

Sort: Frequently used items (defined as at least one use every 2 days) were separated from those items used less frequently.  Anything not needed was tossed. 

Store: Standard locations for everything were defined with everyday staples kept in the upstairs fridge while everything else was moved to our underutilized basement fridge (which also underwent a thorough 5S).

Shine: Everything was cleaned, and all family members agreed to keep shining on a daily basis. (It is so much easier to do this when the sort and store steps have been completed for you!)

Standardize: Everyone needs to follow the new principles the same way. 

Sustain: Develop a system to make sure the gains of the first four S’s aren’t lost.  This is the hard part, but so far, we have sustained the gains!

5S is one of the key activities used across our province as part of Saskatchewan’s Releasing Time to Care Program that aims to improve the patient’s experience by focusing on the processes used by the care team. 

These two pictures clearly demonstrate the potential gains from applying 5S to a nursing unit storage room: 

So just as it is now easier and faster to find what I need in my kitchen (along with a whole host of other benefits such as inventory reduction combined with less food spoilage since we can see what we have and don’t have), nursing units across our province have reduced waste in their daily work by reorganizing their workspace and process using 5S.  

What other lean principles have traveled home with you? I wonder what a sensei’s house looks like! 

Need another reason to do the surgical checklist?

Today I bumped into the mom of one of my son’s friends.  She had recently had surgery, knew I worked in some of our city’s operating rooms, and had a question for me about her experience: “Are things always like that?”  My heart sank as I asked, “like what?” anticipating a complaint about the amount she spent at the hospital that day, or perhaps the confusion of the process.  

Instead, she said “Do the workers in the Operating Room always introduce themselves?  Do they always check so thoroughly that I’m the right person having the right surgery? I never knew how many people were on my team!”

Oh, you cannot imagine my relief when I realized she was asking about the Checklist!  I happily explained we have been working on implementing the surgical checklist for over 18 months.  And that it is “mandatory” in all operating rooms in Saskatchewan since March, 2011.  And that I’m VERY proud to say that our current performance is 96.2% across Operating Rooms in Saskatoon Health Region.  Not just the main ORs but also our Labour and Delivery operating theatres, our Women's Health Centre, and our surgical suites in our rural regional hospital.   And just to brag a little more, we strive for perfect care with our checklists: to be compliant in our health region means we do all of the three components (checklist, which is done 99.4% of the time, timeout (99.4%), and debrief (97.2%)) with the attending surgeon, anesthesiologist, an operating room RN, and, most importantly, the patient.

She shared with me she had been in an operating room once before and remembered feeling overwhelmed by the process, the number of strangers in the room, and the feeling of not knowing what was going to happen.  But this time, she said, was completely different.  She felt calm, safe, and confident.  She really liked knowing why each person was in the room, and that they, too, had a first name.  She felt she was part of the team, and was in fact the most important person in the room.  

This person underwent what we in the medical profession would call “minor surgery” (ask the patient, there is no such thing as “minor” surgery). Very simple, not a lot of steps, no need for preoperative antibiotics, VTE prophylaxis or special instruments.  The sort of case where you might wonder whether the implementation of a surgical checklist would have a large impact.  But for this patient, using the checklist made the difference between feeling overwhelmed and scared, and feeling calm and in control.  

That’s reason enough for us to make sure we really, truly, with heart and commitment, do the surgical checklist.  For every patient, every procedure, every time.