Comments on: Reducing Interruptions – And Improving Patient Safety http://www.leanblog.org/2009/10/reducing-interruptions-and-improving/ Mark Graban's leanblog.org - Lean Healthcare, Lean Thinking, Lean Manufacturing, Toyota Production System Thu, 09 Feb 2012 22:59:58 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Dan Markovitz http://www.leanblog.org/2009/10/reducing-interruptions-and-improving/#comment-5691 Dan Markovitz Thu, 29 Oct 2009 16:46:48 +0000 http://leanblog.bigbigdesign.net/2009/10/reducing-interruptions-and-improving-patient-safety/#comment-5691 Mark: valid point about the value of standardization. However, since the layout of each floor and each hospital differs, and the nature of the nurses' jobs differs, I wonder if it's possible to standardize that stuff. Probably best to withhold judgment until you go to the gemba!<br /><br />Regarding the root cause of interruptions, my research shows a host of factors: <br />- psychological (need to feel connected) <br />- ignorance (don't understand the cost)<br />- lack of service level agreements (we've trained people to expect instant response, even when it's not necessary)<br /><br />Tim's story points out something very important -- that the deleterious effects of interruptions aren't just on the hospital ward. They're on the shop floor, the warehouse, and (as I often argue) in your office or cubicle. Mark: valid point about the value of standardization. However, since the layout of each floor and each hospital differs, and the nature of the nurses' jobs differs, I wonder if it's possible to standardize that stuff. Probably best to withhold judgment until you go to the gemba!

Regarding the root cause of interruptions, my research shows a host of factors:
- psychological (need to feel connected)
- ignorance (don't understand the cost)
- lack of service level agreements (we've trained people to expect instant response, even when it's not necessary)

Tim's story points out something very important — that the deleterious effects of interruptions aren't just on the hospital ward. They're on the shop floor, the warehouse, and (as I often argue) in your office or cubicle.

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]]> By: Tim McMahon http://www.leanblog.org/2009/10/reducing-interruptions-and-improving/#comment-5690 Tim McMahon Thu, 29 Oct 2009 12:24:34 +0000 http://leanblog.bigbigdesign.net/2009/10/reducing-interruptions-and-improving-patient-safety/#comment-5690 Get points on the effect of interruptions. In one of our factories we stopped interuptions to warehouse where materials were stored by creating a pitch route for pick-up and delivery. This action increased inventory accuracy 10% (observed from cycle counts) and reduced shipping errors by 50%. Simple, stop the interruptions and people could focus on their job thus reducing mistakes. Get points on the effect of interruptions. In one of our factories we stopped interuptions to warehouse where materials were stored by creating a pitch route for pick-up and delivery. This action increased inventory accuracy 10% (observed from cycle counts) and reduced shipping errors by 50%. Simple, stop the interruptions and people could focus on their job thus reducing mistakes.

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]]> By: Mark Graban http://www.leanblog.org/2009/10/reducing-interruptions-and-improving/#comment-5688 Mark Graban Thu, 29 Oct 2009 10:46:05 +0000 http://leanblog.bigbigdesign.net/2009/10/reducing-interruptions-and-improving-patient-safety/#comment-5688 While staff engagement and input is a good thing, of course, I have to ask a question about that last case in Hayward...<br /><br />Each unit decided to have a different visual. Is this confusing to physicians, pharmacists, or others who work in different units? There's got to be a balance between "we want it our way" versus what's good for the system altogether. <br /><br />For example, some cities have standardized the color of patient wristbands so that "Do Not Resuscitate" is the same color in every hospital -- you don't want a mistake being made by a physician who works at two different hospitals in that case!!<br /><br />Maybe the "do not interrupt" visual isn't as risky, having variation. But if I were coaching the team, I'd try to get them to come to a standard consensus approach that would be more consistent. That's my thinking anyway. What do the others think?<br /><br />Is all of this (including covering windows up) getting to the root cause (why do you need to interrupt me?) or is this all a bit of a <br />"workaround" I wonder? While staff engagement and input is a good thing, of course, I have to ask a question about that last case in Hayward…

Each unit decided to have a different visual. Is this confusing to physicians, pharmacists, or others who work in different units? There's got to be a balance between "we want it our way" versus what's good for the system altogether.

For example, some cities have standardized the color of patient wristbands so that "Do Not Resuscitate" is the same color in every hospital — you don't want a mistake being made by a physician who works at two different hospitals in that case!!

Maybe the "do not interrupt" visual isn't as risky, having variation. But if I were coaching the team, I'd try to get them to come to a standard consensus approach that would be more consistent. That's my thinking anyway. What do the others think?

Is all of this (including covering windows up) getting to the root cause (why do you need to interrupt me?) or is this all a bit of a
"workaround" I wonder?

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