5S

5S is part of the Lean approach to of “visual management,” as a way to show problems and irregularities, so they can be fixed quickly. As such, it is also an aspect of flow, standardized work and the elimination of waste. 5S deals with workplace organization, i.e. exam rooms, pharmacy, lab, surgery, or even the organization of email and information, etc. The workplace is organized to make work easier, clutter is removed, areas are cleaned, and the locations for supplies and movable equipment are labeled. A place for everything and everything in its place (once we figure out the right place!), and in the right amount. It requires the answering of two questions: (1) Do we have all that we need at the gemba, and (2) Do we need all that we have at the Gemba?

The five Ss stand for:

Sort (Seiri)
Go through the work area looking for any old, expired, irrelevant or broken items, and remove them. Throw them away or, at least, get them out of the way (if they are items that are used infrequently or non urgently). Do you really need to keep rabies certificates from 1987? Does anyone even know what a hemocytometer is, let alone still use it? Besides, the latex tubes disintegrated a decade ago!

Straighten (Seiton)
For everything else that remains, organize it. In the exam rooms, for instance, you try to make each exam room similar to the others so that there is continuity from one exam room to the other. Items used more frequently should be placed closer at hand to save time for staff and veterinarians, which can reduce delays for patients and increase office capacity and throughput.

Shine (Seiso)
Clean up the area and have a process for ongoing cleaning and sanitizing (as a form of standardized work). This minimizes contamination and infectious disease. The regular shine process is also the time to check equipment and perform timely maintenance. This keeps the hospital in a state that is a source of pride, with improved quality and safety

Systemize (Seiketsu)
Once the first 3Ss are done, we need to help make this an ongoing system, rather than a onetime activity. Ask if each of the drawers in cabinets, in each of the exam rooms, contain the same supplies and are they arranged in the same way? Systematizing helps prevent confusion and wasted time looking for items. This step provides the method to the madness. Label the drawers, cabinets and even the tops, so everyone knows what is supposed to be there and can easily see if it is not. It is similar to the woodworker who paints silhouettes of his hand tools on the wall to show where they belong, and to quickly, visually highlight when they might be missing.

Sustain (Shitsuke)
Again, 5S is not meant to be a one-time project. It should be an ongoing activity in the practice, to keep things organized, and to be continually improved. Management oversight, 5S audits, and continued improvement are the key to ongoing 5S success.