Quality Update: a quality approach puts midtown ir in 5S order
By Sam Marie Engle
The Interventional Radiology team at Emory University Hospital Midtown is improving efficiency and performance with a newly reorganized supply area, thanks to help from the Emory Radiology Quality team.
“We’ve grown so much so quickly, with an increasingly demanding patient care load, we felt we outgrew our supply area,” explains IR Supervisor Lisa Kemp-McClure. “We couldn’t expand the supply area, so we needed help reorganizing the space we had.”
To jumpstart the process Ms. Kemp-McClure contacted Susan Reich, Emory Radiology’s enterprise manager of quality. They met to assess the current state and gather data on supply usage. Together with fellow Lean facilitator Pratik Rachh, who is Radiology’s quality program manager, and Deja Williams from the Lean Promotion Office, Ms. Reich led the IR Midtown team—Traci Miller, IR tech II, Timisha Gonzalez, IR tech III, and IR Supervisor Kemp-McClure—through the 5S process.
The Process of Getting 5S Organized
Ms. Reich started by explaining how Lean 5S workplace organization optimizes flow and eliminates waste. Its five stages/principles are Sort, Set in Order, Shine, Standardize, and Sustain. The core values of Lean are respect for people, continuous improvement, and elimination of waste in work processes. Respect for people includes engaging those closest to the work to help design solutions, which is why the IR team was fully engaged in redesigning the space. The Quality team helped the IR team analyze its workflows and determine how best to maximize the 400 square-foot supply area. A survey posted in the supply room allowed IR staff to submit in-the-moment comments and ideas for improvement.
To reduce item retrieval time, a major concern, the IR team used Lean thinking to carefully consider the placement of more than 300 items, ensuring commonly used items were stored closer to the supply room entrance or in cabinets added just outside exam rooms. The Quality team then leveraged Lean design to right-size storage bins on shelving, employ hanging wall fixtures, and standardize visual labeling with Kanban cards for inventory management. Items are organized in a way that makes sense to and supports efficiency in the workflow.
When sorting supplies, the IR team found expired items and many items that were overstocked. Setting the correct par levels was essential to optimizing space utilization and to reducing the risk of lesser-used items expiring. The Kanban cards for each type of item—each type has its own ID number—in the supply area contain information about the item’s location, the minimum reorder threshold, the maximum on-hand target, and the current quantity. The Kanban cards are placed in between inventory to trigger when an item should be reordered. Now everyone on the IR team knows what to reorder and when, plus the status of the order. Team members utilize first-in-first-out when restocking supplies: newer supplies are placed behind the older to ensure older supplies are consumed first.
5S Organization: An Essential Component of High-Quality Patient Care
The project began as an idea in September. By mid-October the IR team was learning Lean 5S and Kanban basics from the Quality team. The bulk of the analytical and organizational work took place in November and December. Ms. Kemp-McClure says they’re now completing Stage 4: Standardize. Here, they are using the new supply organization system and assessing how it is helping improve workflow efficiency. Any bottlenecks or areas that need adjusting are now identified as part of ongoing audits. Issues are flagged and reported at Tier 1 huddle so the team can brainstorm solutions. Rather than seeing the supply area as simply a place to store things, the IR team now sees supply storage/management as an essential component of delivering high-quality clinical care.
“When things are organized in a way that really makes sense, that you easily can see and understand, it makes you feel good, makes you proud of your work,” says Ms. Kemp-McClure. “Being involved in developing and implementing the solutions is pretty awesome. The Quality team made it fun and made sure we didn’t miss a thing.”
Lean Across Radiology
The IR Midtown project is the third large-scale dedicated 5s project the Quality team has facilitated since implementing EmPower 2 years ago. Several smaller 5s projects have been completed as part of rapid-improvement events.
“The 5S philosophy of ‘a place for everything and everything in its place’ helps eliminate wasted time, wasted space, and wasted inventory,” says Ms. Reich. “Implementing 5S not only improves work productivity, resulting in lower costs and higher efficiencies, it also demonstrates respect for our patients and staff.”
A culture of continuous improvement requires a problem-solving mindset and engagement from everyone. The Quality team incorporates Lean training into every event to ensure staff have the knowledge and tools they need to successfully facilitate their own future improvement efforts. The benefits extend beyond the workplace, Ms. Reich says.
“When leading teams, I often tell them to be careful: once you put on your Lean glasses, it’s hard to take them off. You’re going to start seeing waste in processes everywhere, but fear not; now you have the skills to make improvements on your own. The Quality team’s goal is to create an army of problem solvers, with the ultimate goal of continuously improving how we deliver care for our patients.”
“We’ve grown so much so quickly, with an increasingly demanding patient care load, we felt we outgrew our supply area,” explains IR Supervisor Lisa Kemp-McClure. “We couldn’t expand the supply area, so we needed help reorganizing the space we had.”
To jumpstart the process Ms. Kemp-McClure contacted Susan Reich, Emory Radiology’s enterprise manager of quality. They met to assess the current state and gather data on supply usage. Together with fellow Lean facilitator Pratik Rachh, who is Radiology’s quality program manager, and Deja Williams from the Lean Promotion Office, Ms. Reich led the IR Midtown team—Traci Miller, IR tech II, Timisha Gonzalez, IR tech III, and IR Supervisor Kemp-McClure—through the 5S process.
The Process of Getting 5S Organized
Ms. Reich started by explaining how Lean 5S workplace organization optimizes flow and eliminates waste. Its five stages/principles are Sort, Set in Order, Shine, Standardize, and Sustain. The core values of Lean are respect for people, continuous improvement, and elimination of waste in work processes. Respect for people includes engaging those closest to the work to help design solutions, which is why the IR team was fully engaged in redesigning the space. The Quality team helped the IR team analyze its workflows and determine how best to maximize the 400 square-foot supply area. A survey posted in the supply room allowed IR staff to submit in-the-moment comments and ideas for improvement.
To reduce item retrieval time, a major concern, the IR team used Lean thinking to carefully consider the placement of more than 300 items, ensuring commonly used items were stored closer to the supply room entrance or in cabinets added just outside exam rooms. The Quality team then leveraged Lean design to right-size storage bins on shelving, employ hanging wall fixtures, and standardize visual labeling with Kanban cards for inventory management. Items are organized in a way that makes sense to and supports efficiency in the workflow.
When sorting supplies, the IR team found expired items and many items that were overstocked. Setting the correct par levels was essential to optimizing space utilization and to reducing the risk of lesser-used items expiring. The Kanban cards for each type of item—each type has its own ID number—in the supply area contain information about the item’s location, the minimum reorder threshold, the maximum on-hand target, and the current quantity. The Kanban cards are placed in between inventory to trigger when an item should be reordered. Now everyone on the IR team knows what to reorder and when, plus the status of the order. Team members utilize first-in-first-out when restocking supplies: newer supplies are placed behind the older to ensure older supplies are consumed first.
5S Organization: An Essential Component of High-Quality Patient Care
The project began as an idea in September. By mid-October the IR team was learning Lean 5S and Kanban basics from the Quality team. The bulk of the analytical and organizational work took place in November and December. Ms. Kemp-McClure says they’re now completing Stage 4: Standardize. Here, they are using the new supply organization system and assessing how it is helping improve workflow efficiency. Any bottlenecks or areas that need adjusting are now identified as part of ongoing audits. Issues are flagged and reported at Tier 1 huddle so the team can brainstorm solutions. Rather than seeing the supply area as simply a place to store things, the IR team now sees supply storage/management as an essential component of delivering high-quality clinical care.
“When things are organized in a way that really makes sense, that you easily can see and understand, it makes you feel good, makes you proud of your work,” says Ms. Kemp-McClure. “Being involved in developing and implementing the solutions is pretty awesome. The Quality team made it fun and made sure we didn’t miss a thing.”
Lean Across Radiology
The IR Midtown project is the third large-scale dedicated 5s project the Quality team has facilitated since implementing EmPower 2 years ago. Several smaller 5s projects have been completed as part of rapid-improvement events.
“The 5S philosophy of ‘a place for everything and everything in its place’ helps eliminate wasted time, wasted space, and wasted inventory,” says Ms. Reich. “Implementing 5S not only improves work productivity, resulting in lower costs and higher efficiencies, it also demonstrates respect for our patients and staff.”
A culture of continuous improvement requires a problem-solving mindset and engagement from everyone. The Quality team incorporates Lean training into every event to ensure staff have the knowledge and tools they need to successfully facilitate their own future improvement efforts. The benefits extend beyond the workplace, Ms. Reich says.
“When leading teams, I often tell them to be careful: once you put on your Lean glasses, it’s hard to take them off. You’re going to start seeing waste in processes everywhere, but fear not; now you have the skills to make improvements on your own. The Quality team’s goal is to create an army of problem solvers, with the ultimate goal of continuously improving how we deliver care for our patients.”