I’ve heard of hospital improvements focusing on issues ranging from emergency room time to distribution of medicine to hand-washing. Now our friends at the Lean Healthcare Exchange have described one I’ve never heard of before, and it is a wonderful example of how lean methods can be used to attack an everyday, ordinary and almost invisible problem to produce significant benefits.
The challenge: Increasing the cleanliness and availability of wheelchairs.
The blog article notes the importance of wheelchairs in a hospital, and how often people are frustrated when looking for one. Further, dirty wheelchairs can spread disease.
Wheelchairs are used by multiple clinical departments, outpatients, volunteers, families and even visitors. Often like a grocery cart, wheelchairs are picked up in one location and dropped off somewhere totally different. Until recent increased awareness to prevent the spread of infections, wheelchairs and grocery carts were often not cleaned between uses. ..
Only 1% of staff felt wheelchairs were always available when they were needed. Audits found that only 69% of the designated locations had the available par levels of wheelchairs. More importantly to the patient and despite intense emphasis on infection prevention practices, observations of wheelchair use found that only 7% were actually cleaned between use. The event team took cultures from a sample of wheelchairs and found 4 out of 10 positive for bacterial growth.
As with so many lean improvements, the steps taken to improve the situation were simple and basic.
The wheelchair team modified previous visual markings for wheelchairs by placing pictures at eye level showing staff members cleaning wheelchairs and the number of wheelchairs to be placed in each location. They also ensured cleaning wipes were stocked in each wheelchair location with cards for replenishment. Standard work was implemented for volunteers to round and ensure wheelchairs were up to PAR.
The results were dramatic.
Observation 60 days following the event found cleaning of wheelchairs was carried out 75% of the time. Time spent by staff searching for wheelchairs was decreased by 50%. The time saved gives back almost two 8 hour shifts per month for staff to spend in value-added direct patient care. Clinical staff at this facility are no longer wishing for a clean wheelchair, they know exactly where to find one and have the supplies immediately available to provide patients with clean and safe transportation.
I’ll bet it never occurred to many people at that hospital that anything could be done to improve wheelchair availability.
What about your company? Do you live with annoying problems every day that you simply assume cannot be solved?