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Rumbidzayi Zinyuke
Health Buzz
In mid-1950s, Japanese manufacturers adopted a model that sought to ensure continuous improvement in their operations for better environment and safety standards.
The model, known as the Kaizen 5s or the Continuous Quality Improvement (CQI) model was very successful in that sector for organising and standardising the workplace and was later introduced to other sectors, eventually finding its way to the health sector.
Not only did the model get attention as a potential solution for improving government health-care services in low and middle-income countries, it helped hospitals work with what they had to improve on that care.
Like other countries in Africa, Zimbabwe adopted the model in 2017 and since then, health facilities that are using it can attest to how well it has worked in improving health outcomes.
The implementation of the Kaizen framework in health facilities in the country is being funded under the Health Sector Development Support Additional Financing V, which is co-financed by the Government and the World Bank.
Cordaid Zimbabwe, through support from the Ministry of Health and Child Care (MoHCC) and the Japan International Cooperation Agency (JAICA), are the project implementers.
According to Uzumba Maramba Pfungwe district medical officer Dr Gladman Mbonani, most districts in Mashonaland East province had implemented the model and this has resulted in significant improvement in the quality of care being offered.
“We have been using the Kaisen 5s model like other districts in the province. We adopted a quality control team at the hospital and we are implementing that model in all departments in the hospital. The best so far is the laundry department,” he said.
Many people may think that the laundry department has no bearing in the health outcomes at a health institution.
But studies have shown that contaminated textiles and fabrics in healthcare facilities can be a source of infections.
Global healthcare standards mandate health facilities prioritise laundry services as they serve a great purpose in avoiding any setback caused by an infection passed through the hospital clothing or linens.
Mutawatawa district hospital matron Winnie Murigo, who heads the quality control team said: “Our laundry department was the first department where we introduced the 5s model, then we moved to OPD and then the Kitchen where work is still in progress. For the laundry, our dirty linen from each department is sorted separately so that we do not mix the dirty linen. So when we put the laundry in the machine, it goes in separately and it is also separated on the lines.”
What also stands out at this hospital is that everything is clearly marked. Labels for dirty laundry from maternity, outpatients, or the male ward are stuck to the walls. Even the laundry baskets are labelled.
The waiting areas are marked with colour coded labels.
The green area is for patients with minor injuries who can wait for service, yellow is for patients who are urgent but can also wait while red is for emergency patients who cannot wait.
This means that health workers can prioritise patients and ensure that the critical ones are attended to first. Those in need of services such as prescription refills do not need to wait in line with those who want other services so patients are served faster.
The kitchen area has also reorganised itself and aligned its operations to ensure maximum utilisation of resources and reduction of wastage as they know how much food is needed at any given time.
The catering team has been trained to enhance service delivery to staff and patients and to put emphasis on the quality aspect.
So if all departments implement this model, there is bound to be less time wasted on finding where equipment and other things are located and more time dedicated to giving patients care.
For this to be effective, every department implements five key steps that demands that they Sort, Set-up, Shine, Standardise, and sustain operations.
The 5s program focuses on having visual order, organisation, cleanliness and standardisation for improved profitability, efficiency, service and safety.
The first ‘S’ is Sort
Under this step, all items, equipment, and work materials should be neatly arranged and all unnecessary objects should be removed. The objective is to reduce clutter and make it easier to locate the resources needed for work.
This ensures that only necessary tools and equipment and supplies are present in the work area. All working, walking, and standing areas are also freed from trip hazards
Set
After everything is sorted, the next step would be to set everything in order. This means that all items, equipment, and work materials are placed in optimal locations. The objective is to maximise accessibility, free up space, and prevent accidents from occurring by removing unnecessary obstacles.
Tools and equipment are clearly identified and placed in a sensible location while paperwork and other documents are properly compiled, labelled, and have clear identified locations away from work surfaces.
Areas requiring personal protective equipment (PPE) are also clearly marked through safety signs and emergency equipment are prominently displayed and unobstructed for easy access.
When this happens, nurses are then able to improve the flow of work eliminating wasted steps to get necessary medical equipment and supplies, and increasing time spent with patients.
Shine
Once things have been set in order, they should be cleaned.
The workspace including all tools, equipment, and machinery, should be cleaned on a regular basis. The objective is to make the workspace safe, waste-free, and conducive to productivity.
It ensures that everything is kept clean as much as possible, in their correct location where they are easily accessible.
Standardise
This happens so that the processes for sorting, setting and cleanliness are standardised and implemented across all departments and work areas.
The objective is for all the departments to maintain consistency and enhance the benefits of practicing the first three steps.
Under this step, all tools, equipment or documents are stored neatly in their designated areas after use, equipment maintenance records are easily accessible and clearly state when the last maintenance occurred. Product waste are consistently and regularly cleaned and disposed of and preventive measures are implemented to ensure the workplace adheres to the 5s guidelines.
Sustain/Self-discipline
After all is said and done, the institution should have the initiative to continuously and consistently practice the 5s model.
In health facilities, this is done to maximise the institution’s potential by removing all obstacles to productivity that are within their control.
At the end of the day, the facilities will benefit more from the model through reduced costs, improved efficiency and a safer working space. This will definitely bring better health outcomes for the patients and help the facility to achieve its objective of providing quality health care for all in line with the Government’s National Development Strategy (NDS1).
Because improved health care is ideal for improved productivity and development.
Online Reporter