Kaizen Event Report-Out Presentation · Kaizen – Definition The word “Kaizen” is a Japanese word that simply means “Change for the Good”! Most importantly, Kaizen is about

Kaizen Event Report-Out Presentation“Right Sizing Linen”

New England Rehab Hospital

November 14-15, 2011

Jeanine’s

Green Belt!

1

Kaizen – Definition

The word “Kaizen” is a

Japanese word that simply

means “Change for the

Good”!

Most importantly, Kaizen is about making change happen with continuous incremental

improvement with empowered teams!

2

3

Kaizen Process

Nov 14 (8-noon):

Training, Discovery

& Analysis

November:

Preparation

3

Nov 14 (noon-4pm):

Solution Brainstorming

Nov 15 (8-noon):

Idea Validation &

Implementation

Nov 16 +:

Result Follow Up

• Floor Staff

– Surveying rooms

• Housekeeping

– Jim, Tom

4

• Kaizen participant managers

– Nurse Manager, EVS, Linen Services

Special Thanks!

• Other

– Pam Cline, Scott (Marketing), Richard (MMC Engineering)

5

• James Mangini, Linen Services

• Clyde Ramsdell, Linen Services

• Petronilo Rodriguez (Pete), EVS Lead Associate

• Jesse Gage, RNT II

• Hannah Maltby , RNT I

• Aline Schultz, RNT II

• Debora Mambuca, Inf Control Practitioner

• Courtney Webb, Physical Therapist

• Wendy Dibrigida, Occupational Therapist

Team Members…

Our Team’s Goal:

• Problem Statement– The proper amount of clean linen is not always available

– Linen is being used for non-linen uses

– Linen inventory levels have never been "right sized“ causing excess

cost for storage or excess complaints for lack of linen

– Patient use area linen storage has never been standardized to

maximize efficiencies and reduce searching/obtaining linen

6

Improve linen costs & implement sustainable systems

Kaizen Overview

• Scope– Clean Linen with NERHP

– “Dock to stock”

– Departments involved are Environmental Services, Nursing and Therapy

• Metrics– Reduce inventory levels from 26,000 lb/month and $14,000/month

– Reduce the # of retrievals thus allowing Nurses to do other things

– Reduce the # of complaints from 50 per week

– Increase patient and staff satisfaction from complaining to proclaiming7

Kaizen Overview

• 3 Teams. 2 hours in the GEMBA.

1. Data & Process (Clyde, Aline,

Courtney)

2. Patient Rooms (James, Wendy,

Hannah “Vanna”)

3. Linen Rooms/Closets (Pete, Jesse,

Debora)

4. Kaizen discovery coordination

(Jeanine, Matt)

8

DiscoveryWhat did we observe?

Wrong size for the job

(opportunity for soiling

more linen$$)

9

Inadequate

quantity,

“stock-out”,

in wrong

place, clutter

Throwing away

excess & not using

the best linen for

the job


10

1. Excess motion: 30 retrievals in

one hour. Etimated 300

retrievals per day * 2 minutes

per retrieval = 10 hours per day.

5 of those hours are waste.

2. Excess delivery time that

inhibits proper response time,

causes complaints, increases

the cart’s “safety hazard” time

and may result in “stock-out’s”

18 delivery

locations

serviced 3

times daily and

6 days per

week


Gym: 2 spots

PT: 2 spots

1st floor: 4 spots

2nd floor: 10 spots

11

Rod is less than

18” below ceiling

(fire hazard)Shower rooms:


No shelving for staging (avoid

infection/soiled linen)

Not every room had a trash

or sharps container (no

standardization)

Mopping with linen

(increasing soiled linen cost)

Inadequate drainage &

curtain containment (causing

a lot of linen to be used on

floor)

Room is too small (causing

staff to bring in a large batch

of linen – waste!)

12

No standard

location to store

linen in each room

Patient rooms:


Used under chairs to

move (preventing floor

scratches, but increasing

soiled linen cost)

No consistency on how much

linen per new patient (2

pillows, 2 pads, warm

blanket in cold season)

Excess is “automatically”

givento each new patient

(and typically stored on

window sill)

13

Crash

Cart

liner/

cover

Spill & condensation

prevention

Under chairs to

move across floors &

prevent scratching


Non-linen uses:

Foot, Ankle,

Knee, Back,

Neck

14

1. Ambulatory

2. Ripped johnny’s

3. Bed bugs

4. Preventing “stock-out’s”

5. Preventing linen from falling off carts

6. Setting up a new patient’s room

7. Changing linen during stay

8. Cleaning a shower room

9. Stocking the 9 2nd floor linen closets

10. Getting “stocked-out linen” (call, page, email

housekeeping, go to another room or floor or area)

No adequate policy or procedure or adherence to a consistent process:

Ambulatory taking linen


• Process mapping

• Waste identification

• Standard Work training

• Affinity diagram

• Priority – Payoff matrix

• Time/Motion study

15

AnalysisWhat tools did we use?

16

AnalysisWhat did our data tell us?

• 30 key issues

• Tools, methods, habits & policies

• 2 Parking Lot ideas

• Linen color & larger bath towels

• 2 future kaizen ideas

• Linen cart swapping, Pin Notebook

• More than $16,000 in annualized inventory cost savings

• Reducing PAR levels, “right sizing” par levels

SolutionsWhat did we validate?

We validated many ideas with staff

• Right number of linen for a new patient & caring for a

patient (under-pad, blankets)

• New process for distributing linen

• New process for managing soiled, heavily soiled & ripped

linen

• Patient related process changes, for example, unoccupied

beds, room transfers, positioning, shower room

SolutionsWhat did we implement?

Training aids:

• Laminated placards:• Window sill

• On bathroom wall

• On patient bulleting board

• Inside each PIN (patient

information notebook)

Door

On window sill

PIN

Pt Bulletin Board


Training aids:• Communication flyer’s:

• Upstream to hospital

liaisons

• Staff handout “What’s

changed” (to each shift,

RN manager & signed)

• On staff bulletin board

“Linen tip of the month”

Bulletin Board

PIN


Adjust inventory:• Updated Par Levels in the computer system

• Maine Med will supply only the PAR level and sorted

• “Right Sized” each

linen storage area

• Labeled shelves in

linen closets/cabinets

with item name and

PAR quantity (not to

exceed #)

• Straightened and

labeled nurse unit

linen carts

BEFORE

AFTER


Linen solutions for non-linen use:• Paper clothing protectors

• Sternal Pillows

• Spill clean up

• Cart Covers

• No personal use of linen

• Water pitcher coasters

• Patient positioning

• Shower & spill clean up

• Teen Johnny’s instead of cutting them


Process changes:• No distributing to patient rooms (except new

patient setup)

• New patient setup with standard linen

• Nurses stock 9 R2 linen closets only to PAR levels

• No using tape on linen

• Use a moist hot pack to avoid burn and excess linen

use

• Heavily soiled & damaged linen have a new bag

• Sorting linen in basement (distributing time will be shorter)


New patient care tools:• Propping/positioning will be done with blanket in a pillow

case

• “Project pads” for mopping floors after patient showers &

general spill clean up

• Bath mat’s for shower floors

• Cart covers for linen carts

• Paper towel use for water pitcher coasters

• Project pad bag for soiled “project pad’s”

• Clean, damaged Navy blue bag

• Future “Alex” machine for ambulatory dispensing

• Towel bars in shower rooms for staging [less] linen

• Teen johnny pants will be in circulation in January

• Linen picture & spec glossary at Nurse station

Kaizen Event Report-Out Presentation · Kaizen – Definition The word “Kaizen” is a Japanese word that simply means “Change for the Good”! Most importantly, Kaizen is about

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