The Equipment Room Challenge

Remember my previous post about attempting a 5S organization of the OR equipment room?
This is how the room looked before starting 5S, and after:

After 5S

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.

Here are the lessons I have learned so far:

5S for OR Equipment Room

Before picture:

This is one of our equipment room. On the day I took this picture, the room was completely full with equipment, tables, chairs, suction units. It was simply impossible to find an item or retrieve it;  there was no space left for accessing any item in the room.

This seems to be a common occurrence in hospitals: equipment is replaced, and old equipment is not removed from the unit, but placed in a corner. The hallways accumulate more and more items, and transporting a patient turns into an adventure. Patients are always amazed by the amount of items that seem to invade every square foot of space, and also by our ability to steer the stretchers around all these obstacles.

There is a definite need for improvement here. So, I decided to start small, with one room of equipment at one end of the hallway. By using the 5S Lean tool, these are the steps taken for starting this improvement project:

Space Organization in the OR

OK, so I have decided to start a small, easy and much needed quality improvement project on my unit. As many of you know, clutter is one of the biggest issue on surgical floors. Equipment is stored everywhere, on hallways, around corners, behind doors. Tables, chairs, props, accessories...the list goes on an on. Space is at a premium, and no matter where you turn, you incessantly see a piece of equipment. Many times when transporting patients to their theatre, they are amazed by the amount of carts, equipment and supplies on the hallways.

Why targeting this area for improvement?

Here are some areas of opportunity where we can make a difference:
1. Delays: when there is a pull for a piece for equipment, the nursing attendant goes to look for that piece, retrieves it and transports it to the theatre. At the moment, there is no standard placement for equipment, so staff inevitably spend precious time looking for it, then 'digging' it out from in-between other items, and finally transport it. This search = delay = patient/surgical team waiting = OR $$

2. Inventory: OR equipment is expensive. We like to remind each other to be careful with handling it, caring for it. But when it comes to storage, we forget about that. Many pieces of expensive equipment (i.e. laser machines, endoscopic units etc) are stored chaotically between more often used equipment, and end up being moved improperly, getting hit and damaged. This carelessness costs money and creates frustration for staff who have to go around it to retrieve some needed accessory.

3. Motion. This relates to both 1 and 2. Staff perform an incredible amount of unnecessary movement by looking for equipment, trying to relocate or move equipment and transport it where needed. By not having standard, designated places for equipment staff end up tired and frustrated, and are always in a frenzy when they should be able to know and easily retrieve any piece of equipment easily.

Stay tuned for the next phase: Using 5S to organize the equipment room