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© HTS3 2017
Building Leaders – Transforming Hospitals – Improving Care
5 S Your Spring Cleaning
with Lean Tools
© HTS3 2017
• Turnaround
Strategy
• Financial
•Operations
•Corporate
Compliance
• Board
Development
•Regulatory Compliance and Accreditation Preparation
• Lean Process Improvement
•CHNA
•Gaffey Revenue Cycle Management
•CrossTX Population Health Platform
•Optimum Productivity
• Execuitve Recruiting
• Interim Executive Placements
•Mid-level and Specialty Placements
Formerly known as Brim
Healthcare we have a
45 year track record of
delivering superior
clinical & operating
results for our clients.
We believe that the combination of People, Process & Technology transforms healthcare & provides the required
results
Our Company
Our Executive Team
has experience in
managing hospitals
from multi-billion $
healthcare systems to
community hospitals
Our Team Our Mission
Management Placement Consulting Technology
Who We Are
Building Leaders – Transforming Hospitals – Improving Care Page 2
© HTS3 2017 © HTS3 2017
Faith M Jones, MSN, RN, NEA-BC
Director of Care Coordination and Lean Consulting
Faith Jones began her healthcare career in the US Navy over 30 years ago. She
has worked in a variety of roles in clinical practice, education, management,
administration, and consulting. Her knowledge and experience spans various
settings from ambulatory to inpatient to post-acute. In her leadership roles she
has been responsible for operational leadership for all clinical functions
including multiple nursing specialties, pharmacy, laboratory, imaging, nutrition,
therapies, as well as administrative functions related to quality management,
case management, medical staff credentialing, staff education, and corporate
compliance. In her current position she conducts train the trainer workshops to
assist healthcare organization in establishing and advancing a Lean Culture in
their work setting. She is certified as a Lean Instructor, Instructor Trainer, and
holds a Green Belt for Healthcare.
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© HTS3 2017 © HTS3 2017
Instructions for Today’s
Webinar
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• You may type a question in the text box if you have a question during the presentation
• We will try to cover all of your questions –but if we don’t get to them during the webinar we will follow-up with you by e-mail
• You may also send questions after the webinar to Faith Jones (contact information is included at the end of the presentation)
• The webinar will be recorded and the recording will be available on the HealthTechS3 web site
www.healthtechs3.com
HealthTechS3 hopes that the information contained herein will be informative and helpful on industry topics. However, please note that this information is not intended to be definitive. HealthTechS3 and its affiliates expressly disclaim any and all liability, whatsoever, for any such information and for any use made thereof. HealthTechS3 does not and shall not have any authority to develop substantive billing or coding policies for any hospital, clinic or their respective personnel, and any such final responsibility remains exclusively with the hospital, clinic or their respective personnel. HealthTechS3 recommends that hospitals, clinics, their respective personnel, and all other third party recipients of this information consult original source materials and qualified healthcare regulatory counsel for specific guidance in healthcare reimbursement and regulatory matters.
© HTS3 2017 © HTS3 2017
Today we are going to talk about:
• The concepts of sort, straighten, shine, standardize, and sustain
• The importance of engagement and validation in the process
• The impact of culture on the Lean Journey
The Agenda
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© HTS3 2017 © HTS3 2017 6
Spring Cleaning Time
• At home or at work
• Be observant/ Talk to
People – ASK:
– Do you see people looking
for things?
– Do you look for the same
thing over and over?
– Are you moving things to
get to the items you need?
Do You Need to 5S?
© HTS3 2017 © HTS3 2017
Why Use the 5S Method
• A simple tool used in conjunction with Lean
Principles
• Takes human “memory” factor out of the
equation
• Visual
• Reproducible
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© HTS3 2017 © HTS3 2017
What is 5S
1. Sort
2. Straighten
3. Shine
4. Standardize
5. Sustain
A simple method for creating a clean, safe,
orderly, high performance work environment.
https://www.cisco-eagle.com/blog/2013/11/05/the-5s-process-visualization/
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© HTS3 2017 © HTS3 2017
Sort
Japanese: Seiri
Sort
Clearing
Classify
Sort and identify necessary items to perform
process (work) and eliminate all other items from work area.
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© HTS3 2017 © HTS3 2017
Sort Process
Step 1: Identification of unneeded items
• Define “unneeded”
• Thorough Inspection
Step 2: Take responsibility for disposition of
unneeded items
• Item Disposition
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© HTS3 2017 © HTS3 2017
Define Necessary
Team based definition
Is it needed for this work/activity?
• Frequency of use
• Time parameters (per week, per month)
If NOT needed, is it…
• Obsolete, defective, trash
• Immediately remove
• Unknown use – red tag
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© HTS3 2017
Where to look for ITEMS
https://www.isixsigma.com/tools-templates/5s/ease-5s-sort-process-defining-necessary-criteria/ Page 12
© HTS3 2017
What to do with ITEMS
https://www.isixsigma.com/tools-templates/5s/ease-5s-sort-process-defining-necessary-criteria/ Page 13
© HTS3 2017
Red Tag Items – The What ifs?
Red Tag – simple tag placed on items you
believe are unneeded
Red Tag Quarantine – location to hold red
tagged items for evaluation
Steps:
1. Tag
2. Quarantine
3. Evaluate
4. Take Action
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© HTS3 2017
Red Tag Tips • Involve ALL people involved in work from
the start
• People doing the work should do
tagging
• Have Red Tags available where work
occurs
• NOT just at a tagging event
• Do NOT remove red tags without
evaluation & discussion with people doing
the work
• Keep Quarantine Area Public
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© HTS3 2017 © HTS3 2017
Straighten
Japanese: Seiton
Straighten
Simplify
Set in Order
Configure
Organizing remaining needed items for work
and arranging them in efficient manner that
best supports the work.
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© HTS3 2017
Straighten
Benefits of Straightened Items
1. Easy Access
2. Searching eliminated (or reduced)
3. Mistakes by misplaced items reduced
4. Accidents avoided - safety
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© HTS3 2017
Straighten Tips
• Use labels
• Use custom signs
• Use color coding
• VISUAL SIGNALS!!!
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© HTS3 2017
Straighten Tips
Use tool shadow boards
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© HTS3 2017
Straighten Tips
Open shelves
Transparent Containers
Clearly labeled
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© HTS3 2017
Straighten Tips
• Involve ALL people involved in work
from the start
• People doing the work should set
locations
• Do NOT “set and forget” – revisit
• Measure improvements – pat on the
back
• Ergonomics and safety
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© HTS3 2017 © HTS3 2017
Shine
Japanese: Seiso
Sweep
Scrub
Shine
Clean & Check
Clean area, tools, machines and other
equipment to “nearly new” status. Future
non-conformities will stand out & be easily
identifiable (and resolved).
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© HTS3 2017
Shine Benefits
Opportunities for improvement more obvious
Better customer perception
Better working environment
Increased safety
Increased efficiency
Facilitates standardization
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© HTS3 2017 © HTS3 2017
Shine Process
Step 1: Initial Cleaning
• Make Clean (and pretty)
• Clean area, tools, equipment, etc.
• Reduce/eliminate potential dirtiness
• Inspect & Repair (damage/problems)
• Fix NOW – immediate response
• Create Repair/Maintenance
Schedule
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© HTS3 2017 © HTS3 2017
Shine Process
Step 2: Keep Clean
• Define & Document Cleaning Process
• Who cleans
• What is cleaned
• When to clean
• How to clean
Provide tools required
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© HTS3 2017 © HTS3 2017
Initial Cleaning List
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© HTS3 2017
Shine Tips
People doing the work/cleaning should
develop the custom cleaning
checklist/process
• Meant to help in the cleaning NOT as a
management report card
Problems frequently are hidden by dirt, grease
and clutter.
• Immediate response to opportunity
• Management support to encourage
flagging & resources to resolve issues
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© HTS3 2017 © HTS3 2017
Standardize
Japanese: Seiketsu
Standardize
Stabilize
Conformity
A process structure (who, what, where, when,
how) to ensure that every employee
understands and adheres to the standard
created in S1, S2, & S3.
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© HTS3 2017 © HTS3 2017
How to Standardize
Document standard workflow
• Standard Operating Procedures (SOP)
• Ideal picture of area
Standardize labeling
signage, etc.
Perform 5S Audits
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© HTS3 2017
5S Audit
Independent Audit of 5S Areas
Goal: Capture Current State
Take Color Photos
Create custom audit sheets (entire team)
Simple scoring system
Objective, fair & reasonable
Visual
Conduct Audits.
Identify opportunities for improvement
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© HTS3 2017
Standardization Benefits
Incorporates improvements into workflow
Sustains Sort, Straighten & Shine improvements
Increases accountability
Prevents back-sliding
Builds 5S into process
Continuous improvement
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© HTS3 2017
Standardize Tips
Management MUST Support
Standardization for improvements to be
sustained
• “Go to Gemba” DAILY (~30 mins/day)
• Build time into work day schedules for
cleaning & organization to occur
• Provide resources for cleaning,
signage, etc.
• Encourage employees to
continuously improve definition of
cleanliness and update checklist to
assist them in maintaining their
standard.
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© HTS3 2017 © HTS3 2017
Sustain
Japanese: Shitsuke
Self-Discipline
Customs & Practice
Sustain
Involves training and disciple to ensure the
work from the sorting, straightening, shining
and standardizing is sustained
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© HTS3 2017
Sustain
Self-Discipline
Customs Practices
CULTURE
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© HTS3 2017 © HTS3 2017
I. Continuous Improvement
• Form a long term vision and meet challenges with courage and creativity
• Always driving for innovation and evolution
• Go to the source to find the facts to make correct decisions, build consensus and achieve goals
II. Respect for People
• Make every effort to understand each other, take responsibility and do the best to build mutual trust
• Stimulate personal and professional growth, share development opportunities, and maximize individual and team performance
The Toyota Way
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© HTS3 2017 © HTS3 2017
Sustain
Engagement - Validation
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© HTS3 2017 © HTS3 2017
Ownership vs Consensus
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© HTS3 2017 © HTS3 2017
How to Sustain
Connect the Dots
• Safety
• Values
• Efficiency
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Remember the Vision
• Visuals
• Before and After
• Patient Centered
© HTS3 2017
Patient Centered
WHY is it Important?
Relate the improvements to the patient
Tune in to WIIFM - What is in it for me?
Identify and communicate:
• Safety
• Efficiencies
• Decreased Frustration
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© HTS3 2017
Sustainability Tips
Self Discipline = Accountability
• Everyone must understand the 5S
process and incorporate sustaining it
into every day work
• Everyone in the workplace should treat
the area/environment as if it was their
home
• Check up - “Go to Gemba” DAILY
• Don’t assume anything – provide
guidelines that were agreed upon – in
written or visual format .
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© HTS3 2017
Outcome
• When fully implemented, the 5S process increases morale, creates positive impressions on customers, and increase efficiency and organization.
• 5S is a whole culture which increases production, improves quality, reduces cost, makes delivery on time, improves safety and improves morale.
• 5S is not a list of action items, but is an integrated concept of actions, conditions, and culture.
https://www.isixsigma.com/tools-templates/5s/practical-approach-successful-practice-5s/ Page 41
© HTS3 2017 © HTS3 2017
Upcoming Events
Building Leaders – Transforming Hospitals – Improving Care
Visit our Website to Register http://www.healthtechs3.com/webinars/
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© HTS3 2017 © HTS3 2017
THANK YOU!
Faith M Jones, MSN, RN, NEA-BC
HealthTechS3
Building Leaders – Transforming Hospitals – Improving Care Page 43
