More Lean Behind the Scenes
Lean Behind the Scenes: Sterile Processing delivers millions of instruments to University of Utah Health’s procedural teams.
Lean Behind the Scenes: Nutrition Care Services produces and delivers over 300 lunches to inpatients all over our hospital, all at the same time.
you’re looking for them, you can find sharp examples of visual workplace management thoughtfully designed into hundreds of processes at University of Utah Health. But once in a while, you stumble upon an example elegantly simple and worthy of the spotlight. Dr. Dan Vargo’s Frisbee is that example.
“Visual” in this context means more than being able to see it. “Visual” means it’s available at a glance in the flow of the work. Visual workplace elements can be put to into action for multiple purposes. The job of Vargo’s Frisbee is to prompt a specific action, one that in the past was often delivered too late. This tardiness happened for a variety of reasons and Dr. Vargo wanted a reliable method to prevent it.
On his way to designing a solution, Dr. Vargo made two crucial decisions:
- He refused to rely on human recall which offers the lowest level of process reliability. He wanted an intervention that takes into account the human bias for focus on the big critical aspects of work which sometimes allows smaller but non-trivial details to slip. (BTW, the highest level of reliability are automatic forcing functions, but in this case, a visual cue fit the bill.)
- He wanted a method that was respectful to the nurses’ existing workflow. To get this, he asked OR nurses to design the system. He defined the desired outcome and asked them to design the intervention with him.
When designed properly, visual workplace elements nestle into the workflow non-intrusively, respecting the process, and act as a reliable safety net against errors.
The Agency for Healthcare Research and Quality has helpfully defined the Five Rights of Communication, any communication, not just visual. They say five conditions must exist for efficient, reliable communication:
- The right information
- To the right audience
- In the right format
- Through the right channel
- At the right time in workflow
In the video, you can clearly see how Vargo’s Frisbees satisfy all five of these criteria.
Steve Johnson
Sometimes the most impactful change comes from simply asking, “Why are we doing things this way?” Pediatric infectious disease professor Adam Hersh explains the impact of practice inertia on antibiotic treatment in pediatric patients, and how questioning the status quo improved outcomes and reduced cost.
Sterile Processing runs a lean operation, and this video produced by value engineer Steve Johnson and video wizard Charlie Ehlert won a national 2018 Telly Award for shedding light on our system’s unseen infection prevention heroes.
Improvement work isn’t easy, especially when it attempts to address rising health care costs. Solid organ transplant coordinator Sharon Ugolini and her team led award-winning work implementing new protocols for common tests. That led to more than just reduced patient charges, though — ordering appropriate tests increases value and quality, as well.