Tuesday, October 06, 2009

Kaizen Corner -- Visual Systems

Mark Zeidel's Kaizen course continues:

We resume this week with a discussion of Visual Systems. In the effective work place, things are self-explaining, self-ordering, self-regulating and self-improving. We described previously the approaches toward organizing the workplace (5S, which stands for: Sort, Set in Order, Shine, Standardize and Sustain). Our goal is to assure that material and information have been organized to support worker productivity by providing everything needed to get the work done in a predictable place.

Visual Systems help us achieve 5S in the workplace. They are designed to make vital information known, at a glance, to those who need to know it. They tell us what we need to know and what we need to share. There are four types of visual devices that comprise visual systems:

1. Visual Indicator: This provides key information in the workplace, like a street sign or a room number on a patient’s room. The information is useful, but we must seek it out.

2. Visual Signal: This grabs our attention. A traffic light is a visual signal. When it changes from green to yellow we are supposed to notice and slow down (Of course, many Massachusetts drivers regard this transition as a stimulus to accelerate). Many of our clinics use a visual signal such as color coded door labels, to indicate when a patient is in a room and ready to be seen, or when a room needs to be prepared for the next patient.

3. Visual Control: These cues limit or regulate our activities. For example, we do not park in areas with yellow lines or in front of fire hydrants because the visual cues make it clear that we can expect a parking ticket if we do. Similarly in hospital work areas we can make it visually clear that some areas are sterile, thatsharps go into particular containers and the like. If we organize our work space we might have specific, very clearly labeled bins for specific forms; these bins tell us where to put the forms within the work area.

4. Visual Guarantee: This is the most powerful visual device, which actually prevents us from introducing defects into patient care. An example of this sort of device is a forcing function in the
electronic record, which requires that a field be filled out before the computer will move to the next step.

In the factory setting, visual systems alert workers to stoppages in the line, help assure that parts are put in the same place every time, and, in some cases, ensure that parts are snapped into place only in the correct configuration. Try to think about your own work areas. Are there visual cues that might enhance patient care? One thought would be a visual signal on patient rooms that would alert interns and residents that a new admission has arrived, who needs to be evaluated and admitted.

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