Thursday, November 20, 2008

Farr better



Another wonderful application of Lean process improvements on one of our floors, done in conjunction with our BIDMC SPIRIT program. A seemingly simple reorganization of the supply closet. It always seems to prompt the question, why didn't we do this before? Well, the answer is that people are so busy doing work-arounds and getting by that they don't have time to get better. (By the way, the title of this post is a play on words: The work was done on the 5th floor of our Farr building.)

A note from our Lean guru, Alice Lee:

I know there was a comment in your blog asking if RNs should be organizing a supply room. Well, they are among the primary users of the supply room and know best what items need to be co-located, what items can be retired, what additional items need to be added, what the correct par level is (after analyzing usage trends). There is a true sense of ownership with full participation at all levels so the work is sustained.

The RNs and PCTs as well as MDs go in the supply room many times a day and waste many, many minutes a day searching for things, not finding them even if they are, there due to the disorganization and overstock of so many items.

We have a place for everything now that makes sense and locates the most frequently used items at eye level. As we transform each unit, the nurse manager and medical director marvels at how much of a crowd pleaser this is with the staff. Morale boost!

I know there have been comments also about whether the rapid improvement approach is the right one. Most of the work is actually parsed and distributed throughout a month in preparation for the 2 day concentrated effort to make the physical changes needed. It is hard work that is fun and builds a closer team. It brings people together that may have had an adversarial relationship previously (Unit staff & distribution staff). This is not unlike the ED and Lab working together to solve the hemolysis problem.

2 comments:

Anonymous said...

Looks great! it is amazing how much of a difference a little organization can make.

We are looking at doing the same thing on a few nursing units at my hospital. What is the plan to sustain the improvments? How are you planning to keep it from just going back to the way it was?

Alice Lee said...

Anon,
1) The unit staff are very incented to keep it organized for flow as are the distribution par stockers. This makes work much easier for both.
2) Because the people who use and stock the supply rooms make up the teams on each unit, there is also a sense of ownership and pride which also helps sustain the improvements.
3) The team leaders (usually the nurse manager) for each unit do a daily 'audit' and provides immediate feedback to their par stocker. They work together to continuously improve the flow in the supply rooms. It is a partnership.

We transformed our first supply room and med room a year ago and it has been sustained for the above reasons.