The Seven Deadly Wastes: Is Your Organisation Full Of Muda?

Author: Christian Bamber
Posted: Monday 5th September, 2011. 09:42:07

As promised, this week sees a break from strategy as we look at an area that everyone can influence in his or her everyday work, that of wastage.

The elimination of waste is one of the key principles of Lean Systems Thinking, a philosophy and practice developed by the Toyota Production System back in the 1980s. Lean is now a recognised discipline whose ultimate goal is to align everything in the business to deliver increasing customer value. Elimination of waste, or muda as it is known in Lean, is one step towards long-term improvement.

Waste is all around us, every day and everywhere. We all waste our time waiting in queues, waiting in traffic jams, or waiting simply because of poor service. Even at home we can’t escape it – when was the last time you walked into a room expecting to find something you thought was there and then spent the next 20 minutes searching for it? And what about that old vegetable at the bottom of the fridge that’s about to sprout legs and walk out on its own? Again, waste.

So, to define what waste is, the Toyota Production System identified seven forms of waste: transport, waiting, overproduction, defects, inventory, motion, and excess processing. A simple mnemonic to remember these is TWO DIME.

Although Lean was developed within a manufacturing environment, you will see once again how applicable the principles are to service industries and how we can learn from other sectors of the business world. Let’s now examine each of the seven wastes in a veterinary context.

1. Transport

Movement of product or materials between transformational operations is waste. The more you move, the more opportunity there is for something to go wrong as well as the time wasted in moving.

We’re not necessarily just talking about vehicular transport either. Think about the pet as the “product” and how it is transported within your organisation. For example, transporting an animal off the operating theatre table to a recovery room that is at the other end of the building for whatever reason opens up all manner of issues: injury to the carrier, injury to the animal if dropped, and time wastage. Poor layouts are a very common cause of transport waste.

Materials can be equated to drugs, bedding, surgical equipment, consumables etc. therefore consider how these are transported within your practice and between branch practices. Is there unnecessary transport here? Are you experiencing problems that arise as a result of transportation?

With some creative thinking, you are likely to be able to reduce transportation and the problems or time wastage associated with it.

2. Waiting

I am quite sure we can think of many instances of waiting or delay within a veterinary practice environment!

However, waiting comes in many forms. There is the obvious one of client waiting but think about other forms such as a nurse waiting to prep an animal but can’t until the vet is free to tell him or her how much to clip up. Or perhaps a drugs order has not arrived because it was made too late the day before or something has been missed off the order and a client needs to wait another day.

And some practices may have clients waiting for considerable lengths of time in the morning for a vet to be free and yet in the afternoon a vet may be sat idle drinking tea.

There are various causes and solutions to the waiting problem. Client waiting is often due to poor workflow and planning. Of course, things crop up out of the blue and can’t be helped but appointment systems are a step forward to smooth the flow of clients over any given period.

Better communication may help the nurse waiting to prep up the animal on the table and a more efficient and careful ordering process could solve ordering issues. And sometimes it’s as simple as personal time keeping – a vet I once worked with was always late for his afternoon clinic because he would always take a nap at lunchtime and oversleep!

3. Overproduction

A legacy from its manufacturing origins, overproduction refers to producing more product than the customer requires. It causes other wastes like inventory costs, manpower and transport to deal with excess product, in addition to consumption of raw materials.

In a veterinary context what would this look like? Well, there can be overproduction of services. For example, you may have a branch surgery that is open for two hours and you see only a handful of clients over this time.

It’s likely that you could see these clients over the course of a one-hour surgery, thus eliminating an hour of staff cost and overhead wastage, or at least these resources could be reassigned to better use elsewhere.

Perhaps you also offer a large portfolio of services that requires a certain minimum outlay in terms of materials and/or staff time. Are they really being fully used? Could you possibly consolidate the portfolio?

I recently visited a practice that had a boarding facility catering for up to 120 dogs and cats. At the busiest time of year only 20 or so of these kennels were occupied yet many thousands of pounds were being spent on overheads and upkeep of the remaining 100 kennels every year. It may be a tough decision to make but reducing the size of the operation should be a consideration and may even offer opportunities – the space even 50 or 60 kennels occupies is quite considerable and has potential for other uses.

4. Defects

If it isn’t done right the first time, it’s a defect and therefore a waste. Also known as rework because it has to be done again, examples abound. The waste comes in the form of the time to re-do the work and/or the consequences of the defect down the line.

For example, a client is wrongly entered into the appointment system for a day when the specified vet is not there. It’s too late to rebook so the client either has to wait for another vet to become available and get “squeezed in” or to come back another day to see her specified vet.

Either way, we’ve actually created another waste, waiting, and probably have not done too well on the customer satisfaction level either.

Another example: a cat comes in for a blood test and after subduing a particularly fractious patient, blood is taken and placed in the blood tube and the patient sent home and sample sent away. A few days later the test result comes back stating that the it was inconclusive as the blood was placed in the wrong kind of tube. Now the patient has to come back in and the tricky process redone. Waste is everywhere here, particularly waiting and transport.

If the process is looked at, these mistakes could be avoided. The right tube for the test could have been verified beforehand and the correct tubes placed at the ready. Simple really.

So it’s worth trying to pre-empt where mistakes could be made and preventative measures put in place or if defects are occurring with regularity, stop and try to see if there is a pattern to them, and then try to address them.

5. Inventory

Inventory and/or work-in-progress anywhere is non-value-added, even if it is needed. It ties up financial resources and is at risk to damage, obsolescence and spoilage. It can also take up floor space and other resources to manage it.

The obvious inventory equivalent in veterinary practice is stock. Most practices are pretty good at keeping stock levels to a practical minimum through just-in-time ordering systems arranged with their suppliers.

But do be careful about promotional offers such as two-for-ones. They seem like a good deal on the surface but make sure you really need that stock level over a given period and that you will get through it, otherwise you will be offering a two-for-one deal to your clients just to get it off the shelves!

Another way of considering work-in-progress is that every animal under your roof having something done to it is work-in-progress. For example, does an animal tie up financial resources? Yes – it needs heating, lighting, water, bedding and staff time. Is it at risk from damage? Yes – maybe it will get caught up in its kennel or do itself damage trying to escape. Does it take up floor space? Yes. And so on. Now, I’m not saying we should adopt a “turn-‘em-and-burn-‘em” attitude, but we shouldn’t have animals staying unnecessarily.

6. Motion

Any movement of people’s bodies that does not add value to the process is waste. So any walking, twisting, bending, lifting and reaching should be adding value otherwise we should eliminate it.

I’ve always wondered how many miles a vet or nurse walks during the course of a day’s work: probably a lot and probably mostly waste. The classic study is to do a spaghetti diagram where you draw the pattern of a person’s steps onto a plan of the building over a specified time. Guess what it ends up looking like? Yes, a piece of spaghetti.

The point is that we often run around like headless chickens unnecessarily because of poor layout or because someone hasn’t replaced that bottle of antibiotic and we need to go look for it.

Try to look at the flow of steps in a process and design it so that as little motion as possible is required to complete the process. There will be many opportunities out there for improvement.

7. Extra processing

This is defined as any process that does not add value to the product or service.

For example, did the dog that came in for a castration really need to go home with a 5-day course of antibiotics? Unlikely if it was a true sterile procedure.

Or did we really need to place the packet of flea treatment in a plain white plastic bag? Probably not.

And was it really necessary to have a twenty-minute consultation with a client when ten minutes of it was just idle chit-chat? Tricky one this as you could say that it was enhancing customer satisfaction and therefore adding value to the service (although if other clients were waiting as a result, we’re just creating more waste).

So there you have a whistle-stop tour of Lean’s seven wastes. A full-scale Lean programme addresses waste and much more, including customer value, process flow, Lean tools and techniques, and creating a culture of continuous improvement through engaging staff. Although addressing wastage is vastly more effective as part of a full Lean programme, understanding sources of waste will allow you to take some valuable immediate action and I hope this has encouraged you to get rid of your muda.

For more information on how a Lean programme may help you, please contact Approach Strategy.

Christian Bamber is Principal Consultant and Director of Approach Strategy, a consulting firm specialising in strategy services to service industries and not-for-profit organisations. For more information, please contact Approach Strategy at christian@approachstrategy.co.uk. Tel: 01225 722 654 or visit their website www.approachstrategy.co.uk

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