Enabling the visual workplace

In my new role at the Ambulance service, there are some amazing people. One of them is the lovely Adele Markland, who I came to know 10 years ago now, when we first worked together at Bolton FT. We are now starting to develop, our variation of what could be loosely thought of as ‘Productive Ambulance’ (which was never developed as a package in the National productive series) drawing on our shared learning experiences of Productive Ward (which I was involved in when it was a pilot at Royal Liverpool Hospital), Productive Community Services (which Adele was involved in when it was a pilot at Bolton PCT) and of course the Bolton Improving Care System, Lean and QI. So we are starting with one of the base elements of a Lean cell, and also the basis of one of the foundational modules in the productive work kits: 5S … (also known as 6S).

The ‘S’ have now translated through to English, but the original Japanese ‘S’ words are: seiri (organisation); seiton (neatness); seiso (cleaning); seiketsu (standardisation) and shitsuke (discipline). And in healthcare we have added the sixth ‘S’, for safety.

The idea really of 5S is that of having visual workplace, where it is easy to see at a glance if there is something abnormal or out of place, something that could cause a defect, an error, or cause harm. 5S builds on the concept of maintaining standards to ensure that defects are visible to allow easy identification and rapid rectification, by all who work there, staff and leaders alike (Boaden & Furnival, 2016).

We (well Adele mostly) tweeted a lot of tweets about this recently, and it was brilliant, so I don’t want it to get lost in the depths of Twitter, so I am adding it here in my blog site too. You can see the thread here. The thread goes through some of the ‘why 6S?’, what is the aim, how will you know (note the same questions as in the model for improvement) and then starts on the changes. Using the English language 6 ‘S’ words. Sort, Set, Shine, (Safety) Standardise, and Sustain.

If you are wondering ‘why did they get the red tags?’ The red tags are used, usually in the ‘sort’ and ‘set’ stages. When you have excess stock or a piece of equipment you are not sure anyone ever uses but it is there on the shelf anyway, and you aren’t confident you can ‘sort it out and throw it away, or return it to stores’. You can ‘red tag’ it. This stops other team members also performing the ‘sort’ or ‘set’ tasks again on those items unintentionally duplicating the improvement work, and provides a visual trigger to ask about the items before the exercise is complete. These kinds of items can be a bit like that awful picture your great aunt bought you in 2005, that you store under the bed in the spare bedroom because you daren’t throw it away in case she comes to visit. Sometimes you need to keep things for that once in a blue moon or sometimes… more often… we just need to be brave and dispose (appropriately) of long held, but never used stuff. It is a Marie Kondo moment, really.

It is a great thread, explained really well by Adele. Hope you enjoy it!

PS there is a great little interactive group training game for 5S, called the ‘numbers’ games… you can find it online here.


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