There are core building blocks to a Lean approach, including value, waste and value streams. 5S is another core technique. I’ve written about the development of 5S in a previous post. There are variations of the words used, but 5S involves:
Sort – separate the necessary from the unnecessary
Set in Order – put items in the best place for work to flow
Shine – clean and tidy the workplace, and keep it organised.
Standardise – agree the standard work to maintain the arrangement
Sustain – keep it going over time
I worked with a colleague to support a clinical team in Lean work, and they made significant changes to their service, in order to improve flow. We met with the team again, as they were preparing for a 60 day report out. The team would feed back on their progress since their initial Rapid Process Improvement Workshop report out, and a previous thirty day report out. One of the issues they discussed was their progress on 5S. There had been work on a store area, and on some office space, but one team member commented that a particular office ‘doesn’t need 5S, as it’s already tidy’.
This rang a warning bell for me that either my initial teaching to the team had not been adequate, of that memory of the teaching had faded in the two months since the original work. 5S is not tidiness for its own sake. A workplace can be tidy, without being well organised. The point of 5S, after all, is to improve flow and decrease waste.
Waste relates to 5S in several ways. It is easy to hold more stock of items than you need, and so tie up money in unnecessary stock. This is very common where staff want to err ‘on the safe side’, particularly if they are not confident in re-supply arrangements. Making decisions on what to keep can also seem more trouble than it is worth – making no decision, and therefore keeping an item, can be seen as less likely to produce blame than removing an item that another staff member later needs. 5S also helps to reduce waste by decreasing time spent looking for supplies, time walking from place to place, and time grouping items together needed for a particular task. Thomas Jackson’s book on 5S in health care has some good examples of the use of 5S.
A tidy office does not mean that it automatically contains the items that are needed to do the job. This is why 5S goes hand in hand with understanding flow, and the supplies needed to undertake necessary tasks. When a team understands what they need to undertake the tasks, they can also identify items used together, and so which items should be stored together. This has the benefit of helping with set up reduction (the time taken to clear away the last materials needed, and to ready the room or area for the next task, including locating supplies).
A careful review will confirm which items are needed rarely, but urgently, and so require to be stored in an accessible place; which are needed from time to time but not urgently, and so can be stored further away or obtained as required, and which are needed so frequently that they may need to be stored in several areas, for example beside beds or in client rooms. As this only becomes clear when tasks are well understood, there is a crucial link to identifying value streams, waste and standard work.
The final piece of this puzzle is agreeing staff roles. A room may be tidy, but often only one or two people keep it that way. A 5S process requires that everyone understands what is expected of them, the standard is clear, and the work agreed. A team may agree, for example, that the person who uses the room or area should ensure that materials are returned to the correct place and the area tided so that is ready for the next person.
The impression that 5S was only about a room looking tidy was disappointing, as it meant that I had failed to convey the nature of 5S. I will review my coaching materials to try to avoid this happening again. 5S is a building block of Lean processes, and it is important that coaches provide the knowledge and skills to use it to its best advantage.