“Project Search,” Lean, Cincinnati Children’s, and Respect for People
I had the most amazing morning a few weeks ago when I was in Cincinnati for the TechSolve lean healthcare event. Thanks to a friend of my sister's, I was able to spend a few hours at Cincinnati Children's Hospital and Project Search.
Project Search was started at Cincinnati Children's and is run by the Great Oaks school district, where my sister works. Project Search, which has now spread nationally, is a program that provides a year of job training for young adults with disabilities. More important, it helps provide respect, dignity, and pride in their work, as they are often placed in jobs within the hospital (or other workplaces) upon graduation from the program.
Directly from their website:
In 1995 the American College of Healthcare Executives adopted a policy statement that reads, in part, “…healthcare executives must take the lead in their organizations to increase employment opportunities for qualified persons with disabilities and to advocate on behalf of their employment to other organizations in their communities.”
With this statement as a guiding prinicple, Project SEARCH serves people with disabilities through innovative workforce and career development. Through this process we educate employers about the potential of this underutilized workforce while meeting their human resource needs.
Project SEARCH provides employability skills training and workplace internships for individuals with significant disabilities, particularly youth transitioning from high school to adult life. Project SEARCH originated at Cincinnati Children's and now has program sites throughout the U.S. and the United Kingdom. There are several local programs that serve youth in the Greater Cincinnati area, including one at Cincinnati Children's.
I met with Jennifer, one of the managers of the program. We sat and talked in the hospital cafeteria, the “gemba” in lean terminology, for some of their Project Search workers. I met and talked with two Project Search employees whose job it was to wipe tables and to restock supplies, like napkins, in different zones of the cafeteria. As they explained their work and how they did it, the pride and joy that they exhibited about their work was truly moving.
I couldn't help but think of Dr. W. Edwards Deming and his hope that everyone should have joy and pride in their work. It was certainly there in the Project Search employees.
As we walked through the hospital, we met more employees with various disabilities, all working proudly and independently in different jobs in areas including pathology, emergency, and materials management. I met employees who helped restock supplies through the hospital. One woman was pushing a cart that held boxes of facial tissue that she was restocking in various points throughout the hospital. She smiled and said she was restocking the “booger boxes” and when politely reminded of the proper name for the hygiene stations, the employee said “well booger boxes is easier to say.”
She happily showed me her binder of work instructions – all done in a very nice, visual, and photographic way. Some of the employees can read better than others – her book had checklists and written instructions that she could refer to, if needed, some have to rely more on pictures. This seemed a lot like what we'd call “standardized work” in the Lean approach. Or, it's very similar to the checklists that Dr. Atul Gawande and others have advocated for. The checklist isn't read constantly, but it's there to be used after the fact, sometimes, as a reminder that everything was done properly.
In the emergency department, we met a man whose job it was to restock exam rooms in the clinical area. Now, Cincinnati Children's uses Lean as part of their outstanding quality improvement work. In this case, Project Search was using 5S principles to visually organize the cabinets and storage areas, to make it easy for the Project Search employees to restock the rooms without error.
Of course, it turned out that 5S was incredibly beneficial to the nurses who consumed the supplies!
We also met a few employees from Project Search who use motorized wheelchairs. I was told that the hospital had been considering putting in automated robotic carts to move laboratory specimens around the hospital. Project Search suggested having their wheelchair-bound employees do the same work. A man I met who did this job had his wheelchair decorated with flags of sports teams and I was told that he put Christmas lights on his wheelchair during the holiday season… and the smiles on everyone's faces when they described how the kids and families love seeing him come down the hallway… that was wonderful. There are so many things that people can do that robots can't.
Every single person was so proud of the work they did, not matter how small or simple some of these jobs might seem. They were allowed to work independently, without micromanagement, as the Project Search team has a solid training methodology in place. In fact, it sounded similar to the “Training Within Industry” approach that's now being used in some hospitals. Ah, I'm supposed to follow up with some information for them about this program.
I was moved and inspired by my visit to Project Search and Cincinnati Children's. Not everybody has that same joy and pride in their work. Too many of us get frustrated or discouraged by things that, in the big picture, really aren't big problems. The “can do” spirit of the Project Search employees – making the most of their abilities and doing their jobs with pride… truly inspirational.
If your hospital doesn't already have a Project Search initiative, check out the general program website – maybe this is something that you can bring to your organization. The program is creating great opportunities for disabled people to work independently and productively, bringing a smile to the face of all who are involved – including this lucky visitor.