This is another experience to come out of my visit to hospital. I couldn’t help notice how much effort had gone into 5S and visual management on one of the wards. Good news I thought as I’d heard a lot about how it is being used to improve effectiveness in hospitals.
5S (sort, set, shine, standardise, sustain) is a method for organising the workplace which has evolved from Japanese manufacturing techniques. It is now being widely applied to all sorts of activities, including public services, as part of an overall continuous improvement, Kaizen type approach. Also linked to this are visual management or control techniques which deliberately use visual signs or symbols to help improve a process.
Lots of people are into using these approaches as methods of improving process outcomes. A quick look at You Tube will get you an extract from Family Guy illustrating the need for 5s in hospitals, whilst some more serious videos give a good explanation of what 5s is all about, in straightforward terms.

The gist is, if you can see where things are and what needs doing, you’ll get the job done more efficiently, rather than wasting time looking for things. All good news and just the sort of approach that I wanted to see as a patient. The application of these approaches in hospitals has had many benefits, and there is plenty of evidence to prove it.
One of the things that interested me though was the longevity of these initiatives. Once the enthusiasts have left to evangelise elsewhere what happens? Well I might have got an answer from my stay on the ward. One of the successes of the 5S approach was the use of background sheets for hand sanitiser dispensers. These were a different colour to the hand sanitiser gel and allowed you to see if the translucent dispenser was empty. They also had a nice big “clean your hands” slogan prominently displayed. A really good visual management initiative in the fight against hospital acquired infections.
This specific application however relies upon the background sheet and the dispenser being positioned with the dispenser on top of the background sheet. But this is not what I saw during my stay. The background sheet and dispenser sat adjacent to each other. Completely not what was intended. No obvious reason why, maybe they had got new dispensers and this is how the maintenance people had fixed them? Whatever the reason, it wasn’t doing what was intended, and nobody seemed to notice. A great visual management initiative that seemed to have run into the sand.
So, what’s the PONT?
1. Things like 5S and visual management are good improvement techniques but they need people to own them.
2. Once the evangelists have gone away things can lose momentum.
3. For practices like this to succeed, everyone has to understand and believe. I suspect whoever placed the dispenser next to the background sheet, not on top of it, neither believed or understood.
Sanitising you hands isn’t a recent invention. If you are interested, there are thousands of pictures of hand sanitiser dispensers on Flickr. People do have diverse interests!

Was it Lady Macbeth who started the hand sanitizing cult? Think the 5S approach could work well for recruitment : get em in, polish em up a bit, clone and then keep replicating them. Oh hang on…maybe it’s already in application in quite a lot of places…
I must admit to being a bit ignorant on Macbeth.
However, I do know lots of random geeky science stuff.
This bloke was good news for hand sanitisation.
Ignaz Philipp Semmelweis (July 1, 1818 – August 13, 1865) was a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the “savior of mothers”, Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics.
http://en.wikipedia.org/wiki/Ignaz_Semmelweis
Not much loved by other medics early on, but proved right in the end.
The significance of hand washing is the stuff of legend. Take Pontus Pilate for starters and the ritual significance simple sanitisation has acquired around meals and prayers. Souls and sins are, variously washed and anyone who’s ever been to Varanasi will wonder at the magic ascribed to the water of the river Ganges. Do you know, there’s more than science to this stuff!
All this has helped confirm how ignorant I am. One of my kids knew all about Lady Macbeth and “out damn spot”. Apparently there’s a ‘Macbeth hand washing syndrome’ according to the Times. http://www.timesonline.co.uk/tol/life_and_style/health/features/article638886.ece
In my defence all I’ll say is I’m a Merchant of Venice sort of guy (and still very ignorant).
The point about the power of rituals and stories having a deeper meaning and significance is very right. Dave Snowden has lots to say about this. I’ll try and have a look at this in another post.
As it’s the end of Glastonbury weekend I thought I’d mention I’ve seen a couple of pictures of the hand santiser stations at Glasto. Whatever happened to the unwashed hippies?

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