Reducing Motion Waste in Dental Practices Using Lean Six Sigma Principles
Reducing Motion Waste in Dental Practices Using Lean Six Sigma
What is Motion Waste? How’s it affecting your practice?
Lean Six Sigma is a methodology that aims to improve efficiency and quality by eliminating waste and reducing variability in processes. One of the key concepts in Lean Six Sigma is the identification and elimination of the eight types of waste, often remembered by the acronym TIMWOODS: Transportation, Inventory, Motion, Waiting, Overproduction, Overprocessing, Defects, and Skills.
In this article, we will focus on "Motion" waste, which refers to any unnecessary movement of people or equipment that does not add value to the product or service. By reducing motion waste, dental practices can become more efficient, improve employee satisfaction, and enhance the patient experience.
Motion Waste: A Simple Example
To understand motion waste, consider a barista in a coffee shop who has to walk back and forth between the coffee machine, the refrigerator, and the counter multiple times to prepare a single order. This unnecessary motion can be minimized by reorganizing the workspace so that all necessary tools and ingredients are within easy reach. This speeds up the process and reduces physical strain on the barista.
Application in Dental Practices
In dental practices, motion waste can manifest in several ways, such as:
Dental Assistants: Moving back and forth between different rooms to fetch instruments or supplies.
Dentists: Reaching for tools that are not within immediate reach during a procedure.
Patients: Walking long distances between the reception area and treatment rooms.
Tools to Identify and Eliminate Motion Waste
To systematically identify and eliminate motion waste in dental practices, the following tools and steps can be employed:
Gemba Walks: Observing the actual work process in the clinic to identify unnecessary movements.
Process Mapping: Creating a visual representation of the workflow to pinpoint areas where motion waste occurs.
Spaghetti Diagrams: Mapping the movement paths of staff to identify and reduce unnecessary travel distances.
5S Methodology: Organizing the workspace to ensure that all necessary tools and materials are easily accessible.
Let’s go into a little more details.
Gemba Walks
What is a Gemba Walk?
A Gemba Walk is a management practice that involves leaders or managers visiting the actual place where work is performed, known as the "Gemba," to observe processes, engage with employees, and identify opportunities for improvement. The term "Gemba" is derived from the Japanese word meaning "the real place" or "where the action happens." In operations, or manufacturing, departments presents key metrics, challenges and problems using a white board.
Application in a Dental Practice
In a dental practice, a Gemba Walk would involve the practice manager or senior dentist walking through the clinic to observe the workflow of dental assistants, hygienists, and dentists. They would pay attention to how instruments are handled, how patients are moved through the clinic, and how administrative tasks are performed. The goal is to identify inefficiencies, such as unnecessary movements or delays, and to engage with staff to understand their challenges and gather ideas for improvement. In addition, administrative assistant, nurses, and associate dentists can identify and discuss the key challenges they face in their day to day. The idea is for senior leadership to help resolve issues and take away problems that can’t be resolved right away.
Board Equivalent for a Dental Office
In a dental office, the equivalent of a board might be a visual management board or a digital dashboard that tracks key performance indicators (KPIs) such as patient wait times, appointment durations, and staff utilization. This board can be used to highlight areas needing attention and to track the progress of improvement initiatives identified during Gemba Walks.
What is Process Flowchart?
A process flowchart is a visual representation of the steps involved in a process, from start to finish. It's a powerful tool for understanding, analyzing, and improving workflows in various business contexts. Here is an overview on how to create a process flowchart - we will use a separate article to go into details.
How to Create a Process Flowchart
Define the process scope and boundaries.
Identify all steps in the process.
Arrange steps in sequential order.
Use appropriate symbols for each step.
Connect steps with arrows to show flow direction.
Review and refine the flowchart with stakeholders.
Spaghetti Diagrams
What is a Spaghetti Diagram?
I am not making this up - I promise!
A Spaghetti Diagram is a visual representation of the physical movement of people or materials within a workspace. It is called a "spaghetti" diagram because the lines often resemble a tangled mess of spaghetti, highlighting inefficiencies in movement.
How to Create a Spaghetti Diagram
Select a Process: Choose a specific process or task to analyze, such as the preparation of a dental treatment room.
Map the Area: Draw a floor plan of the area where the process occurs.
Track Movements: Observe and record the movements of staff involved in the process over a set period. Use lines to trace their paths on the floor plan.
Analyze the Diagram: Identify areas where movements are excessive or inefficient.
Implement Changes: Rearrange the workspace to minimize unnecessary movements and streamline the process.
5S Methodology
What is 5S?
The 5S methodology is a systematic approach to organizing and maintaining a clean, efficient, and safe workspace. It consists of five steps: Sort, Set in Order, Shine, Standardize, and Sustain.
Simplicity of 5S
Sort: Remove unnecessary items from the workspace.
Set in Order: Arrange necessary items so they are easy to find and use.
Shine: Clean the workspace regularly to maintain order and identify issues.
Standardize: Establish standards for organization and cleanliness.
Sustain: Maintain the improvements through regular audits and continuous practice.
Case Studies
Case Study 1: Improving Registration Process and Service Quality in UAE
Background: A dental clinic in the UAE faced long registration times, leading to patient dissatisfaction.
Issue: The registration process took an average of 15 minutes per patient.
Key Findings: Gemba Walks revealed that the process involved multiple unnecessary steps and excessive movement between the reception and administrative areas.
Implementation: The clinic used Value Stream Mapping and Spaghetti Diagrams to streamline the registration process. They eliminated redundant steps and reorganized the layout to reduce movement.
Benefit: The registration time was reduced from 15 minutes to 5 minutes, improving patient satisfaction and increasing the clinic's capacity to handle more patients.
Case Study 2: Optimizing Dental Chair Side Time in India
Background: A dental practice in India aimed to reduce the time patients spent in the dental chair to improve throughput.
Issue: The average chair side time was 30.5 minutes per patient.
Key Findings: Gemba Walks and Spaghetti Diagrams identified that dental assistants spent significant time fetching instruments and supplies during procedures.
Implementation: The practice implemented the 5S methodology to organize the treatment rooms more efficiently. Instruments and supplies were placed within easy reach, and standardized procedures were established.
Benefit: The average chair side time was reduced to 25.96 minutes per patient, allowing the practice to treat more patients daily and improving overall efficiency.
Conclusion
By systematically identifying and eliminating motion waste, dental practices can achieve significant improvements in efficiency, employee satisfaction, and patient experience. Tools such as Gemba Walks, Spaghetti Diagrams, and the 5S methodology provide practical ways to streamline workflows and enhance the overall performance of the practice. The case studies demonstrate the tangible benefits of applying Lean Six Sigma principles, leading to better operational outcomes and higher quality care for patients.
Sources:
Lean Six Sigma in Dentistry: https://isssp.org/lean-six-sigma-in-dentistry/
Driving Improvement Through Your DSO: The Japanese Methodologies You Should Know: https://www.methodusa.com/resources/lean-six-sigma-dental-inventory-management
Lean Dentistry: a crash course in Kaizen, Six Sigma and Lean Manufacturing for Dental Practices: https://www.dentaleconomics.com/practice/systems/article/14175267/lean-dentistry-a-crash-course-in-kaizen-six-sigma-and-lean-manufacturing-for-dental-practices
