3rd EARC 2012 GEMBA KAIZEN 3rd EAST AFRICAN REGIONAL HEALTHCARE ENGINEERING CONFERENCE & EXHIBITION (EARC 2012) DATE: 31st Oct-2nd Nov 2012. VENUE: ROMBO GREENVIEW HOTEL, SHEKILANGO ROAD- DAR ES SALAAM. THEME: IMPROVED HEALTH TECHNOLOGY MANAGEMENT FOR QUALITY HEALTHCARE DELIVERY IN EAST AFRICA. SUB THEME: QUALITY ASSURANCE & QUALITY CONTROL AUTHOR :PETER MATOKE PRESENTED BY : HERMAN MMASAVA KAIZEN

Definitions Gemba and kaizen are Japanese words; 3rd EARC 2012 Definitions Gemba and kaizen are Japanese words; Gemba means "real place" or “workplace”. Kaizen means "improvement" or "change for the better."

3rd EARC 2012 Kaizen History The kaizen method has been established as an outcome of various activities undertaken for improving the productivity and quality of Japanese products after mid 1940s, as Japanese manufacturers( e.g Toyota) were urgently trying to catch up with the standards of American and European manufacturers. KAIZEN

3rd EARC 2012 Kaizen History Initially, efforts were made to learn from western management systems, particularly the statistical quality control methods. Through this process, the western management strategy was combined with Japanese management methodologies and gradually developed into the kaizen system. KAIZEN

3rd EARC 2012 Kaizen History Kaizen does not prescribe for a particular model since as it empowers creation of the system to the workers in Gemba. On top of 5S, each company selects and combines various production and quality control tools . Some tools originate from the western management system. KAIZEN

KAIZEN Guru 3rd EARC 2012 Known as KAIZEN Guru, Sensei Masaaki Imai is the founder Chairman of Kaizen Institute Worldwide. Has been a pioneer and leader in spreading Kaizen Philosophy all over the world. Author of Ground breaking Books KAIZEN - The Key to Japan’s competitive success and GEMBAKAIZEN- A common sense low cost approach to Management Sensei Masaaki Imai Founder & Chairman Kaizen Institute

Quality Control tools Quality Control Circles (QCC), 3rd EARC 2012 Quality Control tools Quality Control Circles (QCC), a Just–In-Time System, Total Productive Maintenance (TPM), Total Quality Control (TQC), Total Quality Management (TQM), etc.

First Step towards Continuous Improvement 3rd EARC 2012 First Step towards Continuous Improvement The aim of 5S is to create an atmosphere to keep a clean, organized, safe and efficient workplace for everyone. The foundation for the practice of 5S, comes from a Japanese program derived from these words, seiri, seiton, seiso, seiketsu and shitsuke. The 5S’s are a conventional approach towards maintaining and improving the work place. The following words have been chosen for the 5S acronym’s translated into various symbols and words by each language globally. Sort Sanitize (Safety) Sweep Straighten Sustain

Meaning of the 5S’s Sort Straighten Sweep 3rd EARC 2012 Meaning of the 5S’s Sort Examine everything at the workplace & identify what is needed and what can be discarded Straighten Organizing the way things are put away with efficiency, quality, and safety in mind. Need to decide where and how things should be put away and what rules should be obeyed to insure that it is maintained. Sweep (Scrubbing clean) Sweeping, scrubbing and cleaning of the building, machines, fixtures & tools so that all areas of the workplace are neat & tidy. This leads to early detection of mechanical problems before they become major breakdowns. Machines cry!

Meaning of the 5S’s Sanitize Sustain 3rd EARC 2012 Meaning of the 5S’s Sanitize (Safety) Insuring that each workplace is properly designed for safety. This is to protect every member from the dangers during the performance of their assigned tasks. Sustain (Standardize) Developing the practice necessary to continually participate in the 5S process. This requires that each of the S’s become a personal habit. This is the most difficult of the 5S’s, but it is the most important factor in achieving long term success. Establishing routines and procedures for maintaining and improving on the first four (S’s), incorporating visual management tools.

Basic Rules for Change Management 3rd EARC 2012 Basic Rules for Change Management Keep an open mind to change No such thing as a dumb question or idea Avoid spending money (Capital expense should be a last resort) Maintain a positive attitude Don’t’ make excuses & question current practices Think about how to do it, NOT why it can’t be done Just do it!! Have Fun!!!

Values, Standards, Judgements 3rd EARC 2012 Iceberg Knowledge and Skills Visible behaviours Sea level Values, Standards, Judgements Motives, Ethics, Beliefs Attitude Invisible

MATHARI HOSPITAL KENYA ~AMENITY WARD JULY 2007 3rd EARC 2012 MATHARI HOSPITAL KENYA ~AMENITY WARD JULY 2007

5S Committee Members Med. Supt Hospital Administrator 3rd EARC 2012 5S Committee Members Med. Supt Hospital Administrator Snr Nursing officer Laboratory officer Public Health officer Medical Engineering Public works In charges of units

Staff clinic Records before 5S, 2007 3rd EARC 2012 Staff clinic Records before 5S, 2007

3rd EARC 2012 Items in a drug cupboard before 5S, 2007

3rd EARC 2012 Waste, unclassified, before 5S

3rd EARC 2012 Wasted space from breakdown, before 5s, 2007

3rd EARC 2012 Unclassified items mixed up before 5S, 2007

3rd EARC 2012 Patients urinal before 5S, 2007

3rd EARC 2012 Patients toilet before 5S, 2007

3rd EARC 2012 Junk yard before 5S, 2007

3rd EARC 2012 Junk yard before 5S, 2007

3rd EARC 2012 Mathari Hospital, July 2008 Since Implementation of 5S was started in January 2008 Great Job!!

July 2008- Customer care desk 3rd EARC 2012 July 2008- Customer care desk

3rd EARC 2012 July 2008-Clean Compound

Wd 8m July 2008:Both staff & Patients Happy 3rd EARC 2012 Wd 8m July 2008:Both staff & Patients Happy

3rd EARC 2012 July 2008 Motivated Staff

July 2008: Undergoing Renovations 3rd EARC 2012 July 2008: Undergoing Renovations

July 2008. Clean Patients Bowls 3rd EARC 2012 July 2008. Clean Patients Bowls

3rd EARC 2012 July 2008 Clean Bathrooms

3rd EARC 2012 July 2008 Clean Toilets

3rd EARC 2012 New filling system

Clean work environment 3rd EARC 2012 Clean work environment

3rd EARC 2012 Easier filling System

Our strengths in 5S Implementation 3rd EARC 2012 Our strengths in 5S Implementation JICA support- financial & technical 5 of our members got intense training in Sri Lanka Very supportive administration Hospital staff responsive

Our weaknesses/Challenges 3rd EARC 2012 Our weaknesses/Challenges Old dilapidated buildings Bureaucratic procedures in procurement and disposal of equipment Few staff-overworked Nature of our patients (mentally disturbed) Staff transfers/turnover

3rd EARC 2012 Way Forward Kaizen is a must to those who want to improve the work place. Once successfully implemented, we hope to roll it out to other public hospitals Memorial hospital has already started Kenya Association of manufacturers introducing to members

Thanks for your attention. May the LORD bless you 3rd EARC 2012 Thanks for your attention. May the LORD bless you