“Staff members sometimes tell us what we’re doing is just common sense housekeeping,” says Niki Rommann, one of the two members of the Kaizen Promotion team in Sun Country Health Region who spend their days traveling from facility to facility working with staff.
“And it is, in a way,” says Rommann. “But it’s not like your annual garage clean-out that has to be done again next year. This is about training staff to organize their workplaces in a way that reduces waste and creates a system that can be maintained for many years afterward.”
“The job is very rewarding when staff says they can find something quicker after we’ve been there or can do the supply ordering for the facility in a very short time”
“Waste,” in Niki’s language, can mean two things. It can be a waste of supplies that are outdated before being used, because too many were ordered. (Until the new Kanban ordering system is in place, staff sometimes order too many supplies for fear of running out. Or, the supplies are hidden by disorganization.) It can also be a waste of time as staff walk and search for supplies that should be easily and quickly available.
As Niki and her colleague Susan Maas have found during their travels so far, there are lots of both kinds of waste to be rooted out. In the 186 spaces they’ve helped to re-organize so far, they’ve found 16,432 expired items, 305 broken items, 1,403 pounds of paper to be recycled, all at a cost of about $23,419. That doesn’t count the extra steps and time saved when supplies are easily found, which can translate into better patient care. Materials still useable are sent to other facilities where they are needed.
Sun Country Health Region has 28 facilities but most have several separate areas needing to be re-organized. A health centre, for instance, can have an emergency room, a nursing area, supply rooms, a maintenance department and administration areas, all of which require separate treatment.
“We work with staff to determine what’s really needed in their workspace.” (Susan Maas)
“Sometimes they’re afraid we’ll walk in and tell them what they need, and take everything else away,” says Rommann. “But we don’t work like that. We train them to organize their own space, and label everything so everyone on staff knows what and where the materials are.”
The colour-coded system being introduced is the same throughout the Region, both for ease of transition for staff members from one facility to another, and to make the re-ordering system uniform and easy to understand. “We take the guesswork out of the system. When everything is labeled and colour-coded, I can be hired into food services anywhere in the Region, and know right away where the cheese should be located,” says Rommann.
When supplies have expired because too many were ordered in the first place, dollars are wasted, and patient care can be jeopardized. A suture, for instance, is only good for a certain amount of time before the thread deteriorates or the sterilization is no longer valid.
The two have found some strange things during their travels. Like a set of dentures on top of a very high cupboard. “They might have been 20 years old or bought last week but we couldn’t find anyone to claim them,” says Maas. “There was no identification on them.”
Or, a very old rape kit that would have jeopardized the case against a rapist. “The seals on the containers had disintegrated, and the legal requirements were outdated. But staff members were afraid to throw it out just in case they needed it one day,” says Moss.
Needed items are sometimes broken and not replaced because no one took it upon themselves to notify the manager, she says.
The huge project is not a rebuke of staff for poor housekeeping, says Rommann. “Sometimes there are issues among co-workers about who is authorized to make changes. Sometimes staff members don’t feel empowered to make the suggestions, even though something has bugged them all their working days. Sometimes, they love the idea of 5sing but don’t know where to start. It’s like learning how to climb a mountain and then being dropped off alone at the base of Mount Everest.”
One facility saved more than four thousand plastic flowers because the residents at one time made and sold them for wedding cars. “Nobody has decorated a wedding car for years but nobody in the facility felt they had the authority to throw them out,” says Maas.
“We provide the region-wide, uniform system and the leadership that makes it possible to make the changes and sustain them. Front-line staff just need to work with us.” (Susan Maas)
“The job is very rewarding when staff says they can find something quicker after we’ve been there or can do the supply ordering for the facility in a very short time,” says Rommann. They both say they’ve also developed a lot more empathy for their co-workers in other departments, and they see first-hand how one department’s work affects all the other departments. “We have more appreciation for what other staff members do,” she says. “This is Lean at its best.”