How to Poka Yoke This?
I received an email from an MBA student in Turkey (this truly is a global lean community). The emailer asked me a question (which I posting here with permission):
I am doing research for my project at school. I noticed that on your website you mentioned that you are involved with medical environment. What kind of things can be poka yokes in a hospital clinic (for records not to encounter forms not to get lost, for patients not to wait too long, for doctors to come to clinic on time, to make sure that viist rooms are clean and front desk staff is notified without having to be told by another nurse etc.)?
I replied that there are many opportunities for poka yokes in healthcare, but ones I could come up with were:
- Surgeons required to write an “X” or “NO” on the left leg if surgery is to be performed on the right leg
- Nurses checking wristband ID's before giving drugs or taking blood
- Scanning bar code wristbands to make sure proper drugs are given to proper patient
The emailer wrote back that they were interested in the the examples they asked about, mainly to the issue of preventing patient records from getting lost.
My response was:
I'm not sure how you truly prevent a patient's papers from being lost using just poka-yoke or visual signs.
“One thing you need to do: have a defined process of who handles the paperwork and where papers go when being handed off to the next person or department. If you have a drop box or location for papers, it needs to be clearly labeled with signs (that's an element of visual management, the lean concept).
Your process needs to be very well defined and standardized — where papers go, who moves them and when, who processes them. That's the lean concept of “standard work.”
I'm trying to think of a true poka yoke. I can't think of one. You need good procedures (standard work), management oversight and audit of the processes, and at some point people need to be taught what the impact is of losing papers. You have to, at some point, count on them to be professionals.”
Does anyone have ideas for a true poka yoke “device”? I hate to rely on asking people to “be careful” but beyond the “standard work” methods that I suggested, I don't know what else to say.