Standard Work - Do’s and Don’ts

A couple of weeks ago, a resident at New York Methodist Hospital noticed that the overhead PA system didn't appear to be working properly in a couple of areas in the Emergency Department. He diligently logged that observation in KaiNexus to start the ball rolling on fixing it.

When his supervisor saw the idea in KaiNexus later that day, she started asking around, because she thought it worked just fine. What she discovered was that the PA system wasn't actually the problem. Rather, the issue was that the staff didn't have a standard process for using the system, and as such, sometimes errors were made and announcements couldn't be heard in all necessary areas. She resolved the opportunity for improvement and notifications were sent out telling everyone the correct procedure. That opportunity for improvement is now searchable for anyone in the future who wants to learn the right way to use the PA system.

This seems like a tiny fix, but if you're nurse, doctor, or patient who is waiting longer because someone didn't hear the announcement, it's a big deal. Little opportunities for improvement like this really add up!

Variation in workflow is notorious for resulting in errors like the one identified by the resident at New York Methodist Hospital. Smart organizations like this one empower their staff and leaders to step in, identify, and fix those problems with standardized work.

Standardized work is a term that may be familiar to practitioners of a continuous improvement methodology such as Kaizen, Lean, or Six Sigma. 

Standardized work, sometimes called "standard work," is a written description of the most efficient and effective way known to complete a particular process or task safely with the highest quality outcome.  When a standardized work process is used, variation is reduced and quality, delivery and cost measures (or KPIs) are improved.  The same results are achieved, in the same amount of time, regardless of which employee completes the task. 

The advantages for business are plentiful, but implementing and maintaining standardized work initiatives takes structure and it’s important to get the details right.

4 Steps to Get Started

1. Identify the steps in the work routine that to achieve the highest quality, lowest cost results and can be repeated consistently
2. Document each activity in the process along with the time required to complete each
3. Train other supervisors and employees in how to perform the standardized work
4. Identify and document quality controls or error proofing that will be implemented to eliminate errors or defects

Standardized Work "Do"s

• Engage the people who do the work in the standardized work development process. The documents should not be writen by engineers or outsiders, although they can be involved in the process.
• Document the existing process, but keep in mind opportunities to make improvements, when you identify differences in how the work is done or when somebody thinks of a better way.
• Keep standardized work as simple as possible and break each task down into its smallest component steps.  In order to reduce variation, it is important that task details are not overlooked.
• Document the process to the appropriate level of detail. Not all variation causes problems in safety, quality, and other measures. 
• Make sure that standardized work documentation is easy to understand.  Include diagrams, photos, examples or any other materials that will help visualize the instructions.
• Be sure that your standard work documentation is displayed in the workplace, in easily accessible location and that it is available at hand for those performing the work.
• Provide structure for improving the process.

Standard Work "Don’t"s

• Don't just document the current method without trying to reduce variation or make it better.
• Think about standardized work creation as an event.  It is a living process that should be continually refined and improved over time.
• Change procedures or processes without updating the standardized work.  This is a common trap that negates the advantages of standard work.
• Don't think of standardized work as procedures that are stored in a centralized binder or database. 
• Invent a complex procedure for changing standardized work.  This leads to the above.
• Allow unnecesary variation from the standardized work.  If the standardized work truly defines the best practice it should be performed the same way every time, to the level of detail specified.  If it doesn’t define the best practice, it should be changed.

Whether used together with a continuous improvement methodology or alone, standardized work can be a valuable practice that helps companies create frictionless business processes and achieve superior results.