Kitting reduces setup time

Post date: November 06, 2017 by Grace Bourke

A fundamental principle of lean is to reduce waste—all those things that suck up time and energy but don’t contribute value. For example, taking my camera on hikes was too much effort because of waste: searching for the memory card, the backpack, and the camera that were haphazardly located in three different rooms. Then I realized that these wastes could be eliminated by applying the quick setup technique of a kit.

A kit is a collection of items needed to perform an activity. Many professions use kits for needed supplies and tools – the plumber’s toolbox, a chef’s knives, a doctor’s medical bag. I have a picture-hanging toolbox, which includes hanging wire, wall hooks of various sizes, a hammer, and a level – all the essentials with nothing extraneous, and everything easy to find. A friend plans and kits her dinners for the week: chopped vegetables, measured ingredients, printed recipes. When she gets home after a full day of work and a long commute, everything is ready to go. Sometimes, her teenagers pitch in since everything is prepared and easy to understand. When I worked in a hospital drawing blood, we each had a plastic, portable tray filled with test tubes, cotton balls, alcohol, etc. At a moment’s notice, we would run to the ED, ICU, or labor and delivery and be fully prepared to do our job well. People working with documents or information routinely use kits: a packet of documents to sign for buying a house, a financial report, a leave of absence application. The intention of kits is to have what we need, when we need it, without the waste and frustration of searching. However, a shoebox full of receipts for your accountant is not a kit: it may be missing items or have unnecessary ones, and it’s not easy to find a specific receipt. In the same way, a bicycle with the infamous warning “some assembly required” that is missing a key part or requires an unusually sized Allen wrench is not a good kit.

For my photography kit, I collected what I thought were the essentials: a small backpack, the camera, extra lens, memory card, cleaning wipes, and a bottle of water. With my kit ready to go, I could take it with me on all my hikes. The next day, as I tromped down a dusty trail, a runner pointed out a lynx sitting on a rock. A rare opportunity! With my camera kit, I was prepared. Quickly, easily, and very quietly, I pulled out my camera and took the picture. This picture was possible because I had prepared a camera kit and used it. The next hike didn’t go well: the battery ran out of power. I had neglected to think through the maintenance process. I missed the photographic opportunity of the sun rising over the river canyon. So, the next improvement was to get a second battery; now one battery is always fully charged. It’s been working really well! Sustainability is a key feature of any lean improvement.

Where are some opportunities for kits in healthcare? Recently, a friend shared the pain of watching a fellow nurse going to the supply room five times to get the supplies needed to care for a patient. For one team I worked with, the credentialing process[1] took 18 months; some physicians gave up and chose a different hospital. Talking with a physician who uses an EHR, he mentioned that he frequently has too much information and has to hunt in multiple screens for critical information. Putting these different challenges together, I wonder if we could use kits more. Maybe there’s an opportunity for a visual kit? For the EHR, could we make the information easy to find and reliable, on a single screen that has just what’s needed and nothing extra? That could improve the quality of patient care! Whether at work, at home, or in our communities, do you see opportunities to use a kit to make work easier and reduce waste? Try it! Remember to check-in on how it’s going and adjust if needed to achieve sustainability.

[1] Credentialing is the process through which hospitals verify that a physician has passed medical school and completed the appropriate residencies. They use this information to approve the physician to perform surgeries or other procedures at the hospital.