Supporting staff to improve waste in everyday work – ELFT’s Learn and Apply Series

 20th May 2022

Have you ever looked around your place of work and considered that there are lots of opportunities to improve the value we provide to our service users by removing waste in our system? The concept of waste is defined by the Institute for Healthcare Improvement as “resources expended in money, time and/or personnel, that do not add value for the patient, family or community”[1]. Waste reduction is a key element of the programme of work that supports us to Improve Value, one of ELFT’s four strategic objectives.

Identifying and tackling waste has the potential to:

• Improve quality of care
• Release time for staff to focus on what matters
• Increase efficiency
• Reduce costs

In April 2022, 39 members of staff took up the challenge of trying to reduce waste in their area by joining two 30-minute workshops over a week, designed to help them learn about applying the ‘8 Wastes tool’. The workshops were designed and delivered in partnership with the Financial Viability Team and aimed to equip staff from across the Trust with the knowledge and skills needed to identify and understand waste in their place of work.

Part of the Learn and Apply series, the first workshop introduced the ‘8 Wastes Tool’.  This tool originates from Japanese car production in the 1950s but has been widely adopted across the world and in healthcare. It categorises different types of process waste; the bits of a process that do not add value for staff, service users or those we serve. Taking the first letters of each of the 8 wastes forms the DOWNTIME acronym; to help you remember these, think of downtime as that bit of the week or the month when you might have a little time to consider whether your processes are efficient. The wastes are described below in figure one.

The tool is simple and easy to use, with the ability to be applied to any system or environment. A local food outlet can often be a great place to identify some of the 8 wastes in action. The next time you are in line somewhere ordering food or drink, see if you notice any of the following:

• Customers being served their food or drink but no clean tables to sit at
• Not enough staff available to process orders but too many staff preparing them
• Being given several napkins with your order when all you need is one
• Wrong orders being returned to the kitchen
• Large quantities of food being thrown away due to overproduction

Shifting attention to their workplace, participants then used a Mentimeter survey to share common wastes they experienced in their teams. Can you spot anything from the examples shared below that happen where you work?

Between the first and second workshop, attendees were given the challenge of going on a ‘waste walk,’ using the 8 Wastes DOWNTIME tool to see if they could identify a waste issue at work they wanted to improve.

Returning for the second workshop, we were delighted to hear that several participants had been able to identify waste in their area and some had already started taking steps to reduce it!

In the short video below, hear from Adetoro Jiboye – an administrator from our BCHS (Beds Community Health Services) Primary Care at home service, and James Johnson – Admin Manager for BCHS, about their experience of using the 8 Wastes tool and their ideas for improvement.

Why not have a go at using the 8 Wastes tool in your workplace and see what you find? If you identify a waste that you want to reduce, you can contact your local Improvement Advisor for support in how you might use QI to help. Share any success or learning with the QI Team and contact the Trust’s Financial Viability Team via sarah.barnett6@nhs.net , if you feel your ideas for waste reduction can lead to reduced costs.

[1] Bueno  B, Leo  JD, Macfie  H IHI Leadership Alliance. In: Trillion dollar Checkbook: reduce waste and cost in the US health care system. Boston: IHI, 2019