5S Basic Manual - JICA

1 Republic of Malawi Ministry of Health 5s basic Manual 1st Edition January 2014 5s basic Manual Table of contents Acronyms .. iiii Introduction .. 1111 1. Background .. 1111 2. 1111 Part I .. 3333 Phases and steps for 5S implementation .. 3333 1. Four phases of 5S implementation process .. 3333 2. Ten Steps for 5S installation .. 6666 Part II .. 7777 Implementation steps of 5S activities .. 7777 Preparatory Phase (Step 1, 2 and 3) .. 7777 Step 1: Decision making to install 5S .. 7777 Introductory Phase (Step 4 and 5) .. 15151515 Step 441: Training for S14S3 15151515 Step 442: Practice Sort, Set and Shine activities.

2 16161616 Step 5: Feedback of achievement of 5S activities .. 19191919 Implementation Phase (Step 6 9) .. 21212121 Step 6: Formulate QIST and WIT .. 21212121 Step 7: Internal training .. 24242424 Step 841: Formulate action plan of WIT activities .. 25252525 Step 842: Practice Standardize activity .. 26262626 Step 9: Internal supportive supervision .. 27272727 Maintenance Phase (Step 10) .. 28282828 Step 10: Brush up practice Sustain activity .. 28282828 Practical tools and methods for 5S activities .. 30303030 2. 5S tools .. 30303030 Red tag .. 30303030 Alignment.

3 31313131 Numbering / Alphabetical Cording .. 31313131 Safety signs .. 32323232 Color coding .. 32323232 Signboards / Mapping .. 33333333 Labeling .. 33333333 Symbols .. 34343434 X4Y Axis .. 34343434 Zoning .. 35353535 3. Effective way for sharing information on 5S activities: 5S Corner .. 35353535 4. 5S tools for enhancement of visual control .. 36363636 Part IV .. 39393939 Supportive supervision of 5S activities .. 39393939 1. Monitoring and Evaluation under Supportive Supervision .. 39393939 (1) Monitoring and Evaluation .. 39393939 (2) Supportive Supervision.

4 39393939 2. Internal Supportive Supervision .. 40404040 (1) Supportive Supervision by 40404040 (2) Methodology .. 40404040 (3) Implementing steps for the 41414141 (4) Monitoring by WIT .. 42424242 3. External Supportive Supervision .. 43434343 (1) Structure .. 43434343 (2) 44444444 Annex 1 Situation Analysis Check sheet .. 45454545 Annex 2 Form of Action Plan .. 47474747 Annex 3 Monitoring and Evaluation Check Sheet .. 50505050 Annex 4 Monitoring and Evaluation Check Sheet (Criteria) .. 57575757 i ACRONYMS CQI Continuous Quality Improvement (KAIZEN)

5 DHMT District Health Management Team DHO District Health Officer HMT Hospital Management Team IPC Infection Prevention Control ISO International Organization for Standardization JICA Japan Overseas Cooperation Agency M&E Monitoring and Evaluation MOH Ministry of Health MT Management Team OPD Outpatient Department PDCA Cycle Plan Do Check and Act Cycle QA Quality Assurance QAP Quality Assurance Program QATWG Quality

6 Assurance Technical Working Group QC Quality Control QIST Quality Improvement Support Team SOP Standard Operational Procedures SWAPs Sector Wide Approach Programs TQM Total Quality Management TOT Training for Trainers WIT Work Improvement Team 1 Introduction 1.

7 Background Since the establishment of a healthcare services quality improvement workshop in 2004, the Ministry of Health (MOH) has been striving for the improvement under the initiative of chiefs of relevant agencies. Several Quality Assurance Programs (QAPs) are introduced to the health sector in Malawi. To overcome the situation, MOH has established Quality Assurance Technical Working Group (QATWG) recommended by Sector Wide Approach Programs (SWAPs) and integration of the Quality Assurance (QA) has been going on. However, quality improvement in the health sector in Malawi is hindered by poor facilities, lack of equipment, lack of qualified human resources and weak management.

8 Meanwhile, Japan International Cooperation Agency (JICA), has made efforts to strategically familiarize to African countries including Malawi, Japanese style quality management methodology 5S8 KAIZEN8 Total Quality Management (TQM) that was commenced in 2000 at a maternal hospital in Sri Lanka by one genius director and formulated by the director and technical advisors from Japan. 5S8 KAIZEN was selected as one of the core targets for harmonization of QA by QATWG. 2. Definitions 5S: It is to implement Sort (S1): to eliminate what is unnecessary, Set (S2): to align in the position easy to use, Shine (S3): to make things clean without trash or dust, and Standardize (S4): to maintain S1 to S3, and Sustain (S5): to voluntarily continue S1 to S4.

9 Its original purpose is to delete the defect from finished goods with defect or dirt, and later utilized in the various purposes such as improving the work environment, organizational revitalization and management system improvement. KAIZEN: In most cases, indicating Continuous Quality Improvement (CQI) activities by Quality Control (QC) circles, but it also includes KAIZEN recommendations and field improvement activities (GEMBA KAIZEN). It is generally conducted through PDCA cycle, so that it can be called problem solving through participation by service providers. TOYOTA production method (such as automation and Kanban8placard 2method, etc.)

10 Fits in this category. TQM: It is sometimes defined as the implementation of QC circle activities across the organization; it is essential approach aiming at comprehensive quality management that utilizes capacity throughout the organization at maximum (aggregation of systemized methods). Constraint theory and Six Sigma are one of TQM approaches, and International Organization for Standardization (ISO) implementation is one example of its practice. Implementing these three management methods in phases is a characteristic of 5S8 KAIZEN8 TQM approach , and within this approach, each step is defined as follows.