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Tuesday, July 27, 2010

Book Review: Clinical 5S for Healthcare

Clinical 5S For HealthcareI recently had the opportunity to review the latest publication by ENNA called “Clinical 5S for Healthcare.” This book is authored by Akio Takahara, a leading expert on Lean Healthcare and 5S for the medical field.

The book opens by explaining one of the critical challenges that face hospitals is the chronic occurrence of accidents. Medical accidents are strongly related to the overall workplace environment of the hospital and misunderstandings by humans. The author defines “human error” as follows:
“Human error is essentially a human malfunction that occurs in the process of understanding, decision-making, and carrying out an action. Humans continue to suffer from such failures no matter how much attention is given to trying to not make any mistakes.”
Clinical 5S is the foundation for promoting medical safety and improving operational effectiveness. Implementing 5S allows you to:
Reduce human errors
Prevent patient accidents
Eliminate the waste of searching
Better utilize available work space
Increase patient and colleague satisfaction
The first half of the book explains the true meaning of, and practical methodologies for, 5S implementation. There are several chapters on the procedures and key points to implement 5S in a healthcare setting. Visual management is highlighted in the section on standardize as an effective way to maintain the previous S’s. I certainly agree with this assessment. Four important aspects of visual management are:
“Visualization” allows you to see the condition of work
“Clarification” helps us draw appropriate judgments
“Marking” allows us to identify items
“Sharing Rules” creates a sharing environment
The author claims that the rationale for failing to sustain can be classified by these four causes:
No rules to follow – Manager’s responsibility
Rules not understood – Frontline leader’s responsibility
Unreasonable rules – Manager’s responsibility
Unwillingness to follow rules – Your responsibility
I believe there is more to sustaining than rules but the author is right by saying sustaining is everyone’s responsibility. In my experience people will commit themselves when the reward to do it is greater than that of departing from it.

The second half of the book illustrates a series of case studies of actual 5S implementations that have taken place at Takeda General Hospital under Mr. Takahara’s direction. The best part of this section is the lessons learned from the experience of implementing 5S.

The book has nearly 100 illustrations and photos to help you understand Clinical 5S. However I found a number of the photographs to be hard to see in the black and white format. There are also a several templates in the back of the book used at Takeda General Hospital.

Clinical 5S provides a great introduction and overview of implementing 5S. Unfortunately, it misses the opportunity to present a comprehensive system of maintaining 5S after the initial year. Commitment doesn’t happen on its own. You must create the conditions to make sustaining possible. This generally includes: awareness, enough time, structured activities, management support, rewards and recognition, and employee excitement and satisfaction.

The element of continuously improvement seems to be lost in sustaining 5S. The process of sustaining is in part a review of the ideal state and the current state. This gap in the two states provides for more improvement. It is from this improvement that we convert from reactionary thinking to preventative thinking. Given the premise of the book is to use 5S as a philosophy to reduce errors it would have been beneficial to make this link.

Ultimately, I enjoyed this book and found it to be a practical guide to implementing 5S. Clinical 5S is obviously written for healthcare but certainly could apply to similar institutions. This book is a good place to start for healthcare professionals looking to reduce errors by making their workplace less susceptible to causing mistakes and confusion.

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