Karen Martin, Mark Graban, and Kevin Meyer have been tweeting over the past couple of days about a hospital in New Mexico that — sadly — is putting tape outlines on people’s desks in a misguided implementation of 5S. This nonsense has enraged the nurses who understandably see this as irrelevant to their ability to get their jobs done.
Confusion about how to apply 5S in a knowledge environment is rampant, as these stories of “lean as misguidedly executed” (LAME) attest. I believe that’s because people focus on the easily visible, outward trappings of 5S without understanding the purpose of the tool.
In his book Kitchen Confidential, chef Anthony Bourdain explains the function of a cook’s mise-en-place. His description gets at the heart of 5S better than anything I’ve read by any lean consultant:
Mise-en-place is the religion of all good line cooks. Do not f**k with a line cook’s “meez”—meaning their set-up, their carefully arranged supplies of sea salt, rough-cracked pepper, softened butter, cooking oil, wine, back-ups and so on. As a cook, your station, and its condition, its state of readiness, is an extension of your nervous system—and it is profoundly upsetting if another cook or, God forbid, a waiter—disturbs your precisely and carefully laid-out system. The universe is in order when your station is set up the way you like it: you know where to find everything with your eyes closed, everything you need during the course of the shift is at the ready at arm’s reach, your defenses are deployed. If you let your mise-en-place run down, get dirty and disorganized, you’ll quickly find yourself spinning in place and calling for back-up. I worked with a chef who used to step behind the line to a dirty cook’s station in the middle of the rush to explain why the offending cook was falling behind. He’d press his palm down on the cutting board, which was littered with peppercorns, spattered sauce, bits of parsley, breadcrumbs and the usual flotsam and jetsam that accumulates quickly on a station if not constantly wiped away with a moist side-towel. “You see this” he’d inquire, raising his palm so that the cook could see the bits of dirt and scraps sticking to his chef’s palm, “That’s what the inside of your head looks like now. Work clean!”
Want to know what 5S is and why it’s important, without resorting to all those difficult-to-pronounce Japanese words? It’s mise-en-place. (Of course, I’ve just substituted French for Japanese, so this may not be an improvement.)
Doctors and nurses (mostly) embrace 5S when it comes to the tools of their care-giving trade. Take a look at any surgical tray, and you’ll see that’s true. Physical organization — 5S — is essential to being able to deliver care smoothly and efficiently. Supply closets are perfect examples of places that benefit from 5S. But organizing the stapler and 3-hole punch on the desk? That’s asinine and pointless. No one needs to find the stapler with their eyes closed.
When it comes to the office environment, it’s more important to apply 5S to the information people manage, not the tools they use. The issue isn’t where the stapler sits; the issue is where critical information resides. Can people find it quickly and easily on the file server — or on medical forms?
Making information flow faster, with less waste and greater clarity — that’s how 5S should be applied in the knowledge workplace. The nurses at the Covenant Health System in Texas understand that. They didn’t mess around putting tape outlines on their desks. But they did reduce the amount of time they spent filling out paperwork by 50% by simplifying, standardizing, redesigning, and eliminating all their forms. That’s 5S intelligently applied to a real problem.
Tape outlines around the stapler? Diktats concerning the maximum number of pens a person can have at his desk? Please. They’re not going to get rid of the mental equivalent of peppercorns, spattered sauce, bits of parsley, and breadcrumbs that litter the brains of knowledge workers.
The gemba for a knowledge worker is inside her head. Let’s make sure that the information that goes in there is well-organized and easily accessible.