title: Improving value-add work and satisfaction in medical residents training: a resident-led quality improvement project employing the lean method to improve hospital supply usage.
abstract: OBJECTIVE
  Our hospital has a Housestaff Quality Council that fosters education and mentorship of medical residents for quality improvement methodologies. Medical residents on our council identified non-standardised storage rooms as a source of medical resident inefficiency and dissatisfaction. To improve value-add work, medical residents implemented and evaluated a quality improvement project of storage room supplies using the lean method.
  
  
  METHODS
  Using 5S principle and lean methodology, we designed and implemented a standardised supply cart with physician specific supplies. Between April 2014 and April 2015, 40 random observations (20 residents and 20 nurses) both before and after the standardised supply cart implementation were made. The duration time to locate an item was measured in seconds. The paths taken to locate items were drawn as spaghetti diagrams. Nurses served as our control group given that their supplies were not moved in the implementation. Fifty residents were surveyed to assess their satisfaction.
  
  
  RESULTS
  Implementation of the standardised supply cart reduced the time for residents to locate an item per visit from 50.8 to 30.2 s in one unit (p<0.05) and 127 to 28.3 s in the second unit (p<0.05). Mean time savings per day per resident were 5 min. The spaghetti diagrams indicated that finding supplies became more efficient after the intervention for residents. After the intervention, 92% of residents reported finding supplies more rapidly and 86% reported less frustration with finding supplies.
  
  
  CONCLUSIONS
  Residents applied the 5S principles and lean methodology to identify and solve a problem that created inefficiency and dissatisfaction.
authors: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA.|Value Institute, New York Presbyterian Hospital, New York, New York, USA.
authors: Jesse X
authors: JX
authors: Yang
authors: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA.
authors: Tristan D
authors: TD
authors: Hunt
authors: Value Institute, New York Presbyterian Hospital, New York, New York, USA.
authors: Henry H
authors: HH
authors: Ting
authors: Value Institute, New York Presbyterian Hospital, New York, New York, USA.
authors: Dan
authors: D
authors: Henderson
authors: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA.|Value Institute, New York Presbyterian Hospital, New York, New York, USA.
authors: Julia
authors: J
authors: Finkelstein
authors: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA.|Value Institute, New York Presbyterian Hospital, New York, New York, USA.
authors: Karina W
authors: KW
authors: Davidson
mesh_terms: D000046:Academic Medical Centers; D003162:Competency-Based Education; D004865:Equipment and Supplies, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D010549:Personal Satisfaction; D010820:Physicians; D058996:Quality Improvement / Q000458:organization & administration*
keywords: MEDICAL EDUCATION & TRAINING