Tuesday, March 25, 2014

Lean comes in small doses

The concept of Kaizen--small, incremental improvements--is at the heart of the Lean philosophy.  But small does not mean meaningless.  Each such change offers the chance to deliver better service to the customer and/or provide better working conditions for the staff.

Thus, when I see examples of Kaizen in action, I smile.  The changes are the result of concerted efforts by people on the front line, supported by their managers.  They represent a thoughtful approach to process improvement, one that goes beyond a simple project and reflects an underlying element of what it means to be a learning organization.

Here are two examples from Jeroen Bosch Ziekenhuis in the Netherlands.  You see below before and after pictures of the nurses work station in the dialysis unit.  The top picture shows a cluttered workspace that interferes with the everyday job of the nurses.

With some simple reorganization and the construction of some inexpensive shelves, items are placed in a manner that allows the work surface to be clean of obstructions.

The next example is elegant in its simplicity.  The walls of the clinic--including connections for electricity and other utilities--were suffering damage from the dialysis chairs when patients leaned back to be comfortable.  By affixing a line to the floor, each chair is assured of being "parked" correctly--far enough from the wall--eliminating the potential for expensive damage and disruption of work flows.


Anonymous said...

The other useful thing about small incremental improvements is that they are often much more practical and easily implemented than huge enthusiastic, 'let's redesign the whole thing' projects which often wind up involving half the hospital staff, endless meetings, disagreements and ultimate failure or abandonment.
I am sure anyone who has worked in a hospital knows exactly of what I speak.

Also, if the small incremental improvement has an unintended consequence it can be much more easily dealt with.

My points above may already be part of the Lean philosophy for all I know, but I am not trained in Lean, which seems to be largely the sustained and willful application of common sense.

nonlocal MD

Paul Levy said...


Don Sharpe said...

Having minimal training in LEAN, I've still been able to accomplish significant improvements in Hospital EMS workspaces. But a person can only go so far without help...
The problems arise when there's no LEAN buy-in from Hospital Admin & Unions, too many of them think it's just 'common sense' or 'simple housekeeping'. It's A Culture.
SaskHealth Quality Summit is going to have Paul Plsek from Virginia Mason speak on May 6/14.
I'll be there. Here's the link: http://qualitysummit.ca/agenda/

Paul Levy said...