This is how the room looked before starting 5S, and after:
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| After 5S |
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| Before |
As you will see from the new photo, there
is less equipment in the room. I have used visual controls to assign space for
each item on the floor, as well as labels on the wall with the name of the
equipment. Equipment was allocated space according to frequency of use and
grouped as much as possible by service to make it simple.
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Small does not necessarily mean easy.
This storage room is quite small, and starting here seemed like a great idea
(and still is). But once I have started organizing the room, I realized that
this couldn’t be done independently. I had to take into account the rest of the
storage space in the OR, the hallways, the nooks and crannies where equipment
can be moved to in order to keep my space free. Also, extra facts had to be
accounted for: the new beds we just received, trying to find extra space for
more supplies we just ordered etc.
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Moving one piece of equipment is like opening Pandora’s box. Once I tagged the equipment by frequency of use, I discovered some
vintage pieces. Some equipment has not been used in 6 years! The decision to
take it out was easy to take. But actually doing it raised new challenges:
clinicians found it hard to part with the old friends (“Just in case”), plus I
was told, “Once it is removed, you cannot have it back” (?). Still, effort was put
to have some pieces removed, while protecting the ones that had to stay. And of
course, I had to personally do it (with a lot of persuasion to be helped by one
technician).
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The equipment fairy does exist!? As the
saying goes: The lack of sense of accountability in healthcare is a huge issue.
And I did find out that when unassigned equipment would suddenly appear in the
room, nobody seemed to have put it there!? I would ask nurses, attendants,
everyone, just to find out what I can do to simplify everyone’s work and find a
solution, but the answer was always the same: “People just put things there”.
Unfortunately, I have not met these ‘people’, and as I believe in fairies, I
assume they are the culprits.
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Don’t block the aisle is the most difficult task. Storage space in the OR is like square footage in Manhattan: you
see an empty spot (i.e. aisle), you put something right there. After asking
everyone for suggestions for solutions on how to stop this, I was told to have
a ‘warning’ type of sign posted. So I printed a sign and taped it right on the
floor (it can be seen in the picture). It seems to work, except some days. It’s
instant gratification: just drop it right there. It does not matter how you
will get to the rest of the equipment later. Or, it goes with the previous
point about fairies.
My next steps:
- As I see it right now, I have
completed a PDSA cycle, and I am restarting a new cycle with a new plan. My
greatest challenge so far is the sustaining part. I still have to regularly
check the room and take out extra equipment. I am happy to say that it seems
there are less instances though, and there are actually days in a row when the
room stays as organized. I plan to educate more about the purpose of this
project, including the housekeeping staff (who have been noticed to put
equipment in so they can clean the hallway). Also, I plan to create a schedule
and ask for accountability in maintaining the room organized.
Initially, the strategy was to
organize the room, institute a rule (Tag on the wall, within taped space on the
floor) and apply it to the rest of storage space. I now realize I have to
reconsider. This will require more time, and that first you need is to have
this space become standard work. More to be done on standardizing before
expanding.
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I am not giving up. Regardless
of the fact that I am being called a dreamer, I think change is possible. I
need more people on my team, and I need to do more aggressive recruiting.
Until next time!
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