Dr. Samples has formal training in LEAN for Healthcare through the Center for Executive Education, College of Business Administration, University of Tennessee
Introducing the first steps of LEAN always brings a question or story to mind to illustrate a point.
Have you ever noticed what happens when a new construction project starts somewhere and you walk by it every day? At first, you notice the construction and the disruption that occurs because of it; however, within a short time you walk by the site and you stop noticing the mess or the disruption. The same is true in our work environments.
Over the span of 38 years in pharmacy, I have worked in, managed, and inspected hundreds of pharmacies, and it always amazes me how blind the staff is to their disorganized and sometimes cluttered pharmacy operation, much like the construction site example.
That brings us to one of the first steps of preparing to implement LEAN processes in a pharmacy environment, the 6 S’s.
- Sort (Seiri) – often called “red tagging,” where items and materials not needed for work are removed. I was recently in a pharmacy in which there were completely empty shelving units close to the staff, while clutter and tight spaces were in other production areas. The pharmacy also had an entire shelving unit devoted to old CPUs, which should have been destroyed/recycled a long time ago. The key to “red tagging” is to set up processes so that your pharmacy does not keep or horde unnecessary waste in a fast-paced operation.
- Set in Order (Seiton) – this step deals with organizing tools, equipment, and other items by grouping them based on their function. For example, placing labels in accessible areas so that staff can easily reach them when needed. In pharmacy, this means foundation logistics/supply work to ensure everything has a place and that place is properly identified/labeled. It also means thinking through your plan-o-gram to ensure that you have all the items you need within six feet in either direction of your work “center” location so your team can perform 85-90% of their tasks. That is, when your staff is filling prescriptions, ideally they’d be able to perform 90% of all their work and not have to move more than six feet from their workstation.
- Shine (Seiso) – includes activities like cleaning the workplace, maintaining its pleasant appearance, and using preventive steps to keep workspaces tidy and clean. This may seem strange to mention this to a healthcare operation, but unfortunately this is often overlooked, and it can have a huge impact on patient and staff perception. This becomes second nature when this task is performed on a daily basis.
- Standardize (Seiketsu) – the method of establishing a new workplace norm by providing visual reminders, setting expectations of workers’ responsibilities, and conducting routine inspections and regular site checks. If it’s important to the leadership, it will be important to the staff.
- Sustain (Shitsuke) – depending on the environment, the long-term goal and most challenging step of the 6S method is when your pharmacy consistently applies standardized procedures until they become habitual. It’s especially challenging in an environment where leadership/management changes on a relatively routine basis and requires extra effort and diligence to ensure success.
- Safety – this additional step (not originally included in the 5 S’s of LEAN) focuses on identifying hazards and setting preventive controls to keep staff safe during work operations. The use of a safety checklist to identify hazards is key to maintaining a safe workspace and appropriately documenting policies/procedures and training.
In summary, you don’t have to be an expert in LEAN principles and processes to implement the 6 S’s. I can assure you that when you implement these principles, your staff’s attitude, your processes and your patients’ perceptions will all improve. So, what are you waiting for? Get onboard with LEAN and transform your pharmacy into a smooth running, prideful operation.