Can we find a cure for the EHR (electronic health record) through lean optimization and the 5S? The EHR is a digital version of a patient’s paper chart. It contains the medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results. The system can be challenging for most users. A survey conduct by the American Medical Association in 2015 indicated that 34% of respondents were either satisfied or very satisfied with their EHR. This is a significant drop from the same survey conducted in 2010 which showed 61% of respondents were satisfied or very satisfied.
Lean Optimization using the 5S
Unfortunately, there is a great deal of waste associated with a hospital’s EHR system. Clinicians have several complaints that demand some attention. First, there are just too many buttons cluttering the screen. Secondly, they feel that placing orders and documenting actions takes too long. Lastly, using the ‘InBasket’ with secure communications is difficult and cumbersome.
This situation is perfect for the application of the 5S tool. The concept of using Sort, Set, Shine, Standardize and Sustain is ideal for this problem:
- Sort – Removing unnecessary items, simplifying to keep value-add items only.
- Set – Organize items in the right order to maximize efficiency and minimize wasted time.
- Shine – Make the workspace clean and appealing to the eye.
- Standardize – Implement best practices for all individuals, maintain standards, and consistency.
- Sustain – Create and develop practices that are ongoing and encourage compliance.
Changing the Landscape
If you consider the millions of mouse clicks and hours spent in front of screens navigating the frustrations of EHR, lean optimization is in demand to bring relief to the users of the EHR system. Frankly, the system must change to ensure it achieves the goals that were established. In a recent survey from the American Journal of Emergency Medicine, a study found that ER physicians spent 44% of their time on duty entering data into the EHR. It goes without saying that most people would prefer to have our ER physicians and other clinicians spending a great deal more of their time with patient care, than struggling with the cumbersome nature of the EHR.
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