5 S in a Hospital

“5 S in hospitals”

THE CHALLENGES IN HEALTHCARE

Technology is altering the profile of healthcare industry with a whirlwind and healthcare delivery systems are moving from a conventional care to the most advanced AI enabled ones. Unfortunately, the basic challenges of cost, quality, and inequity in health services are well intact across demographies. Worldwide healthcare has always been grappled by the challenges of doing more with less and many times quality of service, profitability and sustainability comes in complete conflict with each other. Under pressure to reduce costs and improve quality, many hospitals and healthcare systems adopt approaches to improve their operational processes. Improving the efficiency of processes also depends on eliminating waste in the environment in which the processes are being performed. 5S is one such methodologies that provide a framework for improving efficiency in the hospital environment, right at the hospital floors where people are working.

What is 5S

5S is a structured methodology directed to improve the work environment, it’s a simple and a highly effective technique to a better workplace organization. 5S is the foundation for an efficient and safe workplace, as it ensures quality, productivity and act as a pillar for continuous improvement in a hospital. It organises the workplace from the physical to the functional aspect, therefore, is the fundamental basis for any Kaizen or TQM initiative in a hospital. It’s one of the most cost-effective Lean techniques available, and is the base of all other lean principles, that makes it the perfect starting point for bringing the benefits of lean to your workplace. 5S can improve the work environment and motivate the employees working in the hospital. It includes a set of actions that needs to be conducted systematically with the full cooperation of employees serving the hospital. 5S is a highly participatory activity and improves the quality of work environment and the service components delivered to the clients.

KEY BENEFITS OF 5S

Better workplace organisation, reduction in unwanted items, visual clarity for better communication, less waste (improved efficiency), huge cost saving, improved orderliness, optimal space utilization, improved maintenance, improved Safety, happier and more committed employees, standardisation of work, general cleanliness, improved quality, reduction in complaints from patients and their kins, reduction in lead time and many more.

WHY 5S IN HOSPITALS?

• It does not require the understanding of the difficult terminologies & the concepts
• Enhances teamwork & engagement among employees
• It empowers the employees and gives them a sense of ownership
• It is simple, driven by logic and natural to the human behaviour
• Hospitals have human intensive processes and are very prone to wasteful activities which can be minimised by implementing 5S
• Properly implemented 5S can cut huge on costs and improves the process efficiency

WHAT DOES “5S” STANDS FOR?

It is called 5S based on the five Japanese words starting with “S” and describe the five steps involved in this methodology. The words are:

Seiri — Sort

Seiton — Set in order

Seiso — Shine

Seiketsu — Standardize

Shitsuke- Sustain

1ST S — SEIRI — SORT

Identify the equipments, medical supplies and the resources pertaining to work performed in a particular area and remove the unnecessary stuffs. Sort means separation, hence it is the removal of the unwanted items from the workplace. This is the first step in 5S, without “Sorting”, it is impossible to move on to the next step of putting things in an appropriate order i.e. setting.

How it works:

• Organize the “Big sorting day”
• Start with red tag events
• Engage the owners
• Identify and segregate the unwanted items
• Sort from indoor to outdoor
• Initiate “Reduce, Reuse & Recycle Concept” with “Sort” activities
• Learn from the event

2ND S — SEITON — SET IN ORDER

“Set” is the second step of 5S after Sorting. Its the orderly arrangement of everything. The goal is to put everything in it’s place neatly and organising the workstations for maximum efficiency and productivity. This requires teamwork and involvement of the employees to achieve specific targets. Neat and functional arrangement of all the necessary items on the hospital floors can make everyone’s life easier.

How it works:

• Select the target places for setting
• Break down the areas into sections and clearly label everything
• Expand one by one to other sections
• Use the visualised informations
• Keep future standardisation in mind

3RD S — SEISO — SHINE

The third stage, “Shine” is a highly participatory activity for maintaining the cleanliness at every workplace regardless of the category and the location. All employees in the hospital are allocated a specific territory and is expected to join in the “Shine” activity. Territories having costly equipment and important reports cannot be cleaned up only by the cleaners. Hence, the process owners should have a participative role to take care of their work areas and put their own cleaning efforts. For a 5S System to be successful, the first three “S” should be an integral part of the daily work routine and must be inculcated in the hospital’s culture.

How it works:

• Everyone should participate
• Be ready with the cleaning tools & supplies
• All equipments should be clean
• Heavy equipment maintenance is included
• Special emphasis on hospital waste management system

4TH S— SEIKETSU — STANDARDISE

The “Standardize” stage of 5S is for the development of standards for the initial 3S activities, i.e., Sort, Set and Shine. In this stage, you will set in place the rules and the policies that supports the first three steps. Always remember, 5S system will only work if its followed with discipline and standards. The objective of this step is to make “Sort”, “Set”, and “Shine” as a part of routine work for all the employees in the hospital. Once standards are set, it should be circulated to all the employees through visualisation, sensitisation and regular trainings.

How it works:

• Make 3S a culture
• Visualisation of slogans
• Standardize for safety
• Standardisation of color coding system
• Standardisation of checklists
• Recognition and appreciation by the supervisors
• Training & documentation

5TH S— SHITSUKE- SUSTAIN

All the changes made till now by applying 4S activities need to be sustained. This requires, self-discipline with change in the mindsets and the attitude of the hospital employees. In this step, the self-discipline is instilled by encouraging a quality culture that will sustain the program. Its very likely that over a period of time, a 5S system may become less effective due to slackness of the people. Hence, to sustain a 5S system a continuous improvement culture is a must in the hospital, because 5S is not the final goal of the hospital’s service improvement quest, but is just the starting point of a Kaizen culture.

How it works:

• Employee’s orientation
• Instill self-discipline
• 5S contest, encourage a positive competition
• Hands on training
• Create a culture of continuous improvement

6TH S — SAFETY

Safety is an integral part of each of the original 5S phases.
So the question is, why do we need to add it as an additional step? The reason is the extra focus on the safety issues. Give safety an additional importance and focus in a hospital environment. This additional focus can ensure that we do not neglect the potentially hazardous situations in the hospitals, which may have escaped our initial look while implementing the 5S, where most of the focus is on making the work place more efficient, easier to operate and productive.

How it works:

• Added focus on safety in hospitals, both for the employees and the patients
• Special mention for the areas with more hazardous processes
• Well planned safety measures can highly reduce the risk of accidental events in the hospitals

FEW 5S TOOLS

Color coding, signages, labelling & pictures, numbering & symbols, directions, zoning, alignment, tagging, axis based arrangement, checklists etc.

IMPLEMENTING 5S IN A HOSPITAL — THE LAUNCH

• Educate the employees about the 5S System
• Come up with a plan and seek the management’s approval and support
• Set up 5S zones
• Create a 5S team, educate them and plan the 5S System launch
• Do it in phases, phase 1 and 2 are the “Enablers” & phase 3 and 4 are the actual “Results providers”
• Examine each of the 5S steps to see how it fits into your hospital
• Get all the materials needed for the launch and support of the 5S program
• Develop a culture of 5S & continuous improvement in your hospital
• Benchmark the goals and carry out internal auditing
• Reward and recognise efforts made by the employees
• Foster a healthy competition

5S AUDIT CHECKLIST SAMPLE

ADAPTING THE RIGHT KPIs’

While employing 5S in a hospital, each of the work groups need its own set of KPIs’ for monitoring the progress. These KPIs’ must describe how the group influences productivity across their own work areas. Some of the most common KPIs which are used:

• Productivity
• Lead time
• Number of accidents
• Inventory levels
• Inventory cost
• Searching time
• Equipment breakdown
• Rejection rate
• Rework
• Patient complaints

WRAP UP

5S is an extremely robust approach that hospitals can adopt to promote service excellence in the eyes of their customers. Though it sound really simple and straightforward to implement, but it’s highly toilsome to sustain the results. The management’s task is to inspire new work habits, support positive mindsets and empower individuals to continually improve their workplace. Post 5S implementation, there is improved work efficiency, more discipline in the team to sustain the results and a new wave of enthusiasm on the hospital floors which is directly proportional to the employee satisfaction and a sense of ownership. The happier, the safer and the less fatigued the hospital employees are, the better they will take care of the patients and deliver high quality services. So till the time healthcare is a human intensive industry and not everything is replaced with technology and AI in this space, 5S could be a good start to promote a continuous improvement culture in your hospital:)

All rights reserved by Thinkinghat Consulting LLP, 2018