Waste

Waste

Waste is everywhere in the workplace. There are some very obvious wastes and some very subtle ones, but we know that all of them have a detrimental effect on service delivery and quality. We wouldn’t walk past a safety issue or poor delivery of care and do nothing, so we must not allow waste to go unidentified and unaddressed.

We must commit to ‘seeing’ and eliminating or reducing the waste that we know is in our systems as a primary way of improving quality. However, there are some obstacles to this: 

  • we can be too quick to rationalise the waste - “that’s because of how we do things around here”
  • we can be too passive in accepting it - “that’s how it is around here, what can I do about it?”
  • the waste is insulating us from a much bigger problem that we don’t want to, or can’t deal with

The last of these reveals a truth about waste - that small wastes can hide much bigger wastes. But it is the much bigger waste that we really want to address as that is where the greatest opportunity for quality improvement lays.

In Lean Thinking, waste is conceptualised into 8 categories and is a way of helping us to ‘see’ waste more clearly. This then leads us to be able to think about ways of reducing or eliminating it. The 8 waste categories are:

Defects
Overproduction
Transportation
Waiting

Inventory
Motion
Over-processing
Non-Utilised Talent

(see below for further explanation)

Being able to ‘see’ the waste in our activity and processes is the starting point. We can achieve this through being in the workplace – literally where the work happens – and directly observing the activity, or through analysis of process maps or work activity. 

We should all be looking out for the 8 wastes and when - not if - we find them, shine a spotlight on them and design better ways of doing the work to reduce or eliminate them. We can use the full range of Quality Improvement tools and techniques to help us do this and test our solutions using Plan Do Study Act (PDSA) cycles.

This simple activity – waste identification and elimination – is an incredibly powerful Quality Improvement technique. There will already be many examples of this across the organisation, but you can read about one here.

Although the article doesn’t explicitly talk about ‘waste identification and elimination’, you should be able to spot a number of the 8 wastes that were present before the improvements were introduced (see if you can spot; motion, waiting, over-production, and non-utilised talent). You will definitely see the improvements to quality, service delivery and service user satisfaction that making these simple changes brought about.

I know that we can (and do) all see waste in our work. Let’s make that commitment to reducing or eliminating it and improving the quality of all of our services.

If you have any comments or would like to know more about waste reduction and elimination, please e-mail me eddie.short@hpft.nhs.uk

Eddie Short
Continuous Improvement Lead