Lean Initiative Turns Enormous Task into Child’s Play

When children have a positive experience in the healthcare setting, it sets the stage for positive interactions with healthcare providers throughout their lives. Often, it is a key contributor to helping them maintain medical compliance, which is critical to achieving the best outcomes.

The staff in Child Life and Integrative Care play a big role in shaping those experiences.

“Young children use play to familiarize, cope and adjust to hospitalization,” says Eileen Clark, clinical director, Child Life and Integrative Care. “Our job is to ensure children are safe and have opportunities to address their unique developmental challenges that hospitalization may emphasize. Children use play as the gateway into addressing fears, normalizing their new environment and coping with the stressors of illness, treatment and extended hospitalizations.”

In other words, she says, children need toys!

The division’s commitment to safety, even more important since Covid-19, means every toy, game, or musical instrument used by patients/families is cleaned between each use. With 638 beds, they clean and process thousands of toys. The toy-cleaning process includes every part of every item. For example, with a Monopoly game, every dollar, property, house and pawn must be properly cleaned and disinfected. Or every Lego in a bucket. The current responsibility for toy-cleaning will become greater with the addition of the new Critical Care building (Location G).

“Knowing we will soon be transitioning to the new building has given us an opportunity to examine our current process for efficiencies, and The Anderson Center’s Lean Collaborative gave us the guidance to properly evaluate our work for improvement,” Clark says.

The new toy-cleaning space in the Critical Care building is a shared space for all toys used by Child Life and Integrative Care, Occupational Therapy/Physical Therapy, and Speech. Their Lean goal was to identify and improve processes to get the toys cleaned and returned for patient use as soon as possible.

They began the Lean process with examining current operations to identify improvement opportunities. During this phase, they discovered challenges with space allocation, volumes of toys, inadequate storage and inefficient cleaning methods. They were able to apply simple, low-cost modifications to the current cleaning room, which included removing shelves, reorganizing supplies, decreasing the amount of spare pieces saved for replacement parts, as well as reducing the time to pick up cleaned toys.

Angie Baker, senior operations specialist, uses the Protexus Electrostatic Sprayer to disinfect a toy.

A Team Effort

Thank you to the following team members who contributed to these improvements:

Angie Baker, Child Life and Integrative Care Keisha Foney, Child Life and Integrative Care Julie Lee, Occupational Therapy/Physical Therapy Abby Mathews, Speech Pathology Cathie Marshall, Child Life and Integrative Care Jeff Steller, Coach, Anderson Center Eileen Clark, Sponsor, Child Life and Integrative Care

Through the Lean Collaborative training, they learned the importance of letting go of past processes, collaborating with other Lean teams in their area, involving all stakeholders and seeking outside guidance (such as from Infection Prevention colleagues). One continual challenge is the products used to clean toys and the impact to the staff members cleaning the toys. The partnership with Infection Prevention and Environmental Services was essential in guiding them towards a safe and effective product.

“The learning process was fun,” says Clark. “We were able to make amazing improvements in our cleaning space, which was easily adapted to new social distancing requirements. We continued the improvements by investigating other storage options and methods to get toys back to the units as soon as possible and finding a new cleaning tool.”

The big win was an introduction to the Protexus Electrostatic Sprayer, she says. “We are in the process of ongoing testing with the sprayer and are thrilled with initial results regarding cleaning times and effective and safe methods for cleaning. We are addressing safety for all—staff and patients!”

The team’s journey took longer than the typical Lean projects because it was multifaceted and included additional steps to ensure they were compliant with the protocol when introducing a new cleaning tool. They submitted the tool to the Equipment and Standards Committee for approval.

“We have persevered because we have seen the Lean process work, and each accomplishment motivated us to explore another phase of improvement,” Clark says.

“One year later, we have our new cleaning tool, and it is amazing to see how processes have improved in our activity centers and playrooms. Our next step is to test its effectiveness against the challenging viruses that require special isolation. Lean is the only way to go!”

The 8-week, hands-on Lean Collaborative continues to be offered virtually during this pandemic. Contact Lean_Collaborative@cchmc.org if you are interested in participating in the next collaborative or would like to learn more.

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