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Raising the Bar in Rehab

Lean and Physical Therapy

Published March 27, 2014 5:20 PM by Lisa Mueller

When I worked at the hospital, there were times when I needed to grab linens for my patients during our physical therapy sessions. Gowns, towels and even bed sheets were frequently changed. The hospital floors each stored linens in a slightly different manner to fit the best workflow for their staff -- some linens were kept in cupboards outside each room, some in centrally located carts, and some in the patient's room. I remember a handful of times where I spent easily 5-10 minutes walking around the hospital floor, opening cabinets and peaking behind doors to find the linen storage, and to find linens that were stocked.

It wasn't until I started at my current facility that I learned about the concepts of "lean" and "continuous improvement." What is lean? Well, I'm not an expert, but my understanding is that lean assesses workflows to make them more efficient. One example I've been told is rearranging equipment (such as fax machines or copiers) to a location where it's more accessible. Instead of walking 9 seconds to the machine and 9 seconds back to your workstation, arranging desks and the machine so the average walking time is 4 seconds, gaining 5 seconds per fax transaction, that over time will become time to be spent with patients.

Looking back at my experience in the hospital, I recognize the linen storage wasn't the most resourceful. Why weren't cupboards labeled, or signage posted to find linens? Did other staff spend as much time as I did looking for supplies, and how much cumulative time was spent away from patient care in tracking down items? It would be interesting to see a "before" and "after" to demonstrate how changes to simple things such as adding a label to a cupboard equates to improved staff morale (having the tools to do your job, feeling empowered to find what you need) as well as increased patient time.

This makes me wonder if lean or continuous improvement processes will become common language in physical therapy. If you were to open a clinic today, would you consider the lean perspective in how you set up your practice? What has your experience been in continuous improvement?

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