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Background Lean management aims to improve the performance of a company through the involvement of employees. It makes it possible to find the ideal conditions of functioning by optimising staff, equipment and sites, to add value with the least waste possible. The sterilisation activity is a production activity, which can be managed by lean management. Purpose The objectives are to schedule and optimize the recomposition flow, to redistribute resources, to pool skills and to prioritise emergencies. Material and methods A management engineer was assigned to help the sterilisation unit’s team to implement this project. After observation of the sterilisation activity and analysis of production data of the different surgical specialties resulting from the traceability software of the unit, an exercise in setting up a new organisation was carried out with all the agents. An interest in the use of Kanban to smooth the flow was demonstrated during these exercises. Results A redevelopment of the conditioning area was produced to limit movements. Islands of recomposition previously specific to a surgical unit, were redefined. The configuration of the conditioning area made it possible to create three production lines. To create three equivalent flows, the specialties were grouped according to their volumetrics and the complexity of the operating trays (OT). Each of the three resulting flows contained two blocks, and represented an activity of 2500 OT/month. Kanban labels were deposited on the OT in the washing zone, so the OT were handled in the conditioning area in order of arrival, according to the ‘First-In, First-Out’ principle. The restitution delay of the OT to surgical specialties decreased from 44 hours to 30 hours. The percentage of OT returned within the contractual deadlines increased from 72% to 85%. Conclusion The reorganisation of the sterilisation unit began on 16 July 2018. We can conclude that there was an improvement in productivity in terms of scheduling, fluidity and availability, reduction in the production pressure, redefinition of the true urgency, development of the concept of self-help and an increase in versatility through training. The project was presented to the general management of the University Hospital Centre in September 2018. A re-evaluation in 6 months is planned. References and/or acknowledgements https://ejhp.bmj.com/content/20/3/168 No conflict of interest. |
