The Eight Wastes of Health Care

“Jaded Julie, I’ve forgotten something.”

“Of course you have, Curmudge. You’ve spent the past 40 years forgetting most everything you learned in the preceding 20.”

“You are probably right, Julie, but more to the point, we haven’t said much about Lean tools. Several months ago we decided to focus on the Lean culture, and that’s what we have done. Things like the Toyota Way pyramid, leadership, The Flywheel.”

“I recall learning about The Eight Wastes of Health Care. That’s not a tool, but it’s a Lean fundamental that everyone must know. When did we discuss that?”

“It was back in the winter of ’07, Julie. Before my transformation into the Kaizen Curmudgeon. The list was published on the Affinity intranet but not in a blog. Why don’t I name a type of waste, and you can provide some health care examples? Then the blog readers won’t feel neglected.”

“Okay, let’s do it.”

“Waiting:”
“To be seen in the ED
To be admitted to the hospital from the ED
For testing, treatment, or discharge
For laboratory test results”

“Motion:”
“Searching for meds, charts, supplies, patients
Handling paperwork”

“Transportation:”
“Moving patients for testing or treatment
Moving specimens”

“Defects:”
“Wrong patient or procedure
Medication error or omission
Missing information”

“Processing:”
“Unnecessary testing (defensive medicine)
Excessive paperwork”

“Inventory:”
“Pharmacy stock and lab supplies
Paperwork in process”

“Overproduction:”
“Any testing or treatments done at the convenience of the institution rather than the patient”

“Underutilization of Human Resources:”
“Lack of involvement and participation of all members of the workforce”

“Good job, Julie. Did I ever tell you that the Japanese word for waste is muda?”

“You just did, and I am forever in your debt. How did I ever live this past year without knowing that? I must admit that as Japanese words go, muda isn’t too tough. At least it’s easier than genchi genbutsu. By the way, Curmudge, what does genchi genbutsu mean?”

“You know me, Julie; I forgot. We’d better look it up in Liker’s The Toyota Way.”

Affinity’s Kaizen Curmudgeon