That Third "S" - By Naida Grunden


Hospital staff members who are conversant with Toyota-based Lean philosophy understand the power of the exercise called 5S. This disciplined approach to organization helps workers transform their often-chaotic work areas into useful spaces, and their tools, equipment and inventory always at the ready. 5S is intended to reduce waste, in the form of time and motion spent looking for things, and error, in the form of supplies that are not perfectly ready for use. 5S is continuous: it never ends. It includes these elements:


1. Sort. Remove everything from the workplace and evaluate what is currently needed. Clutter in the workplace is unsafe, and excess inventory is expensive.

2. Set in order. Arrange needed items so that they are easy to use. Label them so that anyone on the staff can easily find or clean or put them away.

3. Shine. Clean the floors, walls, and equipment. Items are kept in top condition, always ready. In a hospital cleanliness is especially important to staff member and patient alike.

4. Standardize. By integrating the first three steps into everyday work, the continuous restoration of order is built into work routines.

5. Sustain. Because leaders help maintain high morale around cleanliness, the rewards for maintaining order outweigh backsliding to the old way of doing things.


5S in Froedtert Health Operating Rooms

The Operating Rooms at Wisconsin’s Froedtert Hospital, an academic medical center that conducts over 16,000 cases per year, with another 4,000 cases at the adjacent Surgery Center. The team at Froedtert began looking at ways to increase capacity and efficiency of their central core OR space to meet the growing demand over the next few years, until the next scheduled building renewal.

The Froedtert team wanted to reorganize the existing space for optimal use. Doing so, moving equipment around and evaluating each piece, gave them an opportunity to invest in cleaning and maintaining the equipment.

“We decided that the best solution to optimizing our central core was to tear it apart and put it back together again,” said Gary Colpaert, VP of Peri-Operative Services. “And the best way to do that was to conduct a 5S on our central core.”

They wanted to go the extra mile, according to Colpaert. They wanted their ORs and everything in them to be absolutely pristine. They wanted to optimize that third S—that is, Shine.


EquipSystems, for the Optimal Third S—SHINE

The hospital contracted with EquipSystems to conduct a deep, detailed cleaning and where necessary, repair, of every rack, every chair, every OR table—in short, over 1200 pieces of equipment in those rooms.

Froedtert’s 29 ORs are located in two separate areas and to jump-start the effort and demonstrate the depth of their commitment, management actually shut down one location, then the other, while EquipSystems professionals conducted intense, 12-hour shifts for three days until the work was completely done.

Most hospitals’ hard-working, in-house Maintenance Departments constantly work on immediate problems, disrupting or setting behind the cycle of routine cleaning and maintenance. Froedtert saw the benefit of an intensive effort at his hospital likened to “hitting the pause button,” so that everything could be brought to perfect condition immediately.

Once cleaned and fixed, items thought to be at the end of their useful life, like chairs with broken casters, soon looked and worked like new. It was an unanticipated benefit.

“They basically rebuilt many of the pieces of equipment while cleaning everything as they went,” said Colpaert. “The cleaning and repairs extended the life of our equipment, and reduced our overall, anticipated capital outlay.”


Extra Benefit: the Fifth S—SUSTAIN

When it came to restoring total order and cleanliness to the ORs, Froedtert’s management team put its money where its mouth was. Conducting a 5S in conjunction with the work of EquipSystems created ORs that worked better than ever, looked better than ever, and were even cleaner than ever. Leveraging the hard work of the Froedert team’s 5S, EquipSystems helped them create a prototype of what OR equipment maintenance and cleanliness could be. Staff morale is supported by an environment that reflects their high standards of patient care.

Could the hard stop, 5S and deep cleaning help promote the most difficult, fifth S: sustain?

Said Colpaert, “We demonstrated our sense of stewardship by taking care of our assets. It provided a psychological boost for the staff for them to come in and have everything pristine. It shows that we value them, as we value our patients. Also, it instills the desire for everyone to keep the ORs in top shape.”


The Future

Colpaert noted that it took some faith to invite EquipSystems into “one of the most complex environments in the hospital.” He calls EquipSystems “consummate professionals,” and has asked them to come in on a regular schedule to provide the type of maintenance and cleaning that makes everyone proud.

Doing so, he notes, allows the staff to invite patients into that complex environment with even more confidence and pride.