Today, I'm sharing a 10-minute video that was shared by the Five Hills Health Region within the Saskatchewan health system. In the video, Heather, the director of women's health unit and pediatrics, describes their kanban system for managing supplies and materials. They started in November 2013 with this approach.
Note: This is not a post about the “kanban” method of work visualization and planning that's been written about by people including David Anderson and Jim Benson. This is about what I'd call the original meaning (and continued meaning) of kanban as a materials management and/or production scheduling method (see Toyota's website). The use of the word kanban in areas like software development causes some confusion…
Back to the video, Heather smartly engaged the knowledge of nurses and unit clerks in the design of this approach and the organization of the supplies. They spent one full dedicated week to do the initial setup of the system, which seems realistic to me based on my past experience in setting up a kanban system. An approach like this also requires some pre-work to try to collect data on the normal and “worst case” usage for each item.
The video shows a very typical two-bin kanban system that works great. It's far more effective and less time consuming, I'd say, than the more typical hospital “par level” system (an approach that requires a lot of counting).
They've utilized color coded bins to make it easier for staff:
Each item is clearly labeled:
And there is a bar-code label on the side of each bin:
Materials management comes up every weekday to scan empty bins. The “AA05” refers to the shelf location of the bin, which is also clearly labeled on the shelf and “it's easy to locate what you need.”
When a bin is empty, it gets placed into the large grey bin container (something that's easy for staff to do):
And then the second bin that still has supplies in it gets pulled forward.
Heather talks about how they tried to estimate demand for items, but they also had to account for peaks in usage. Early on, they “did run out of some supplies,” which isn't unusual in the start up of a kanban system. The key, then, is to adjust kanban levels accordingly because the goal is to NOT run out.
In my work, I like to err on the side of having a little too much inventory at first. Otherwise, if there are stock outs and missing supplies, people lose faith in the kanban system. Over time, you can adjust the inventory levels down if it seems like bins for certain items aren't having to be restocked very often.
They have a clipboard that's used for communication about items that have run out, been discontinued, etc. or if they have questions about what items are really being used:
Some bins might be removed if an item has been discontinued (and there's communication to staff):
They also kept track of training each staff member on the kanban system, which “takes five minutes, it's easy.” It's important to make sure everybody gets that training.
Some items have associated kanban cards, maybe because they don't fit neatly into two bins or maybe because the quantity needed doesn't justify two full bins:
When inventory gets down to a certain non-zero level, the card gets placed in the holder on the wall:
Thanks to the Five Hills region for sharing this nice overview of a working kanban system.
As I wrote about in Lean Hospitals, a kanban system can be very effective at achieving both:
- Increasing the availability of supplies, while
- Reducing overall inventory costs
Have you utilized kanban? What have been the results? Is your organization still clinging to the outdated par level approach?
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