How Poor Ergonomics Can Lead to Waste in the Hospital

Taiichi Ono, the former chief engineer of Toyota wrote that “moving is not necessarily working”. Your workers may appear busy but they may not be productive (i.e. no added value from their activities). Ergonomics is the study of workplace design. It has to do with the working conditions of an organization, especially the design of the work space, equipment and furniture in order to help workers work more efficiently, effectively, comfortably and safely. This results in being more productive. Poor ergonomics therefore means poor work conditions and poor design of the workplace.

Unnecessary movement of machines or manpower within your hospital process is counterproductive. This usually happens when your work space is poorly designed. To fully understand poor ergonomics as a source of waste, let us consider a clinical scenario.

Dr. Kola is in the OR performing a C-section. He has already extracted a 4.5 kg male neonate. In the process, there was a deep tear extending from the anterior part of the lower uterine segment towards the posterior surface of the urinary bladder. In an attempt to close the uterus beginning at the “angle of sorrow”, the suture snaps. The scrub nurse is so jittery that he drops the replacement on the floor. That happens to be the last Chromic 2 suture available in the OR. (Dr. Kola’s practice is to keep all materials and drugs in his office to reduce pilferage. He only supplies what is needed per time. His office is a fair distance from the OR). So, the circulating nurse has to get the office keys from Dr. Kola’s pocket, runs to his office, and fumbles at the lock before gaining access to the office-cum-store. The nurse returns 7 minutes later with a pack of the coveted Chromic 2 sutures. In the process, the patient losses a considerable amount of blood and have to be transfused on the ward.

This is a poor design of the workplace and work conditions. It is quite fortunate that the patient did not lose her life in the process.

Dr. Kola’s problem can be easily resolved by decentralizing his storage system and securing the items with locks. He could situate a mini-store in the immediate theater vicinity. This is a better design and will reduce the incidences of unnecessary motion without jeopardizing the safety of hospital materials (and patients, of course!). 

Other examples of poor ergonomics are situating the Out Patient Department (OPD) far from the laboratory or placing the pharmacy at the hospital entrance while the OPD is at the middle of the complex.

To reduce wastage from unnecessary motion, carefully and economically design your work space. Manpower, machines and materials should be arranged in such a way as to minimize motion. This will save time and energy. Plan and constantly re-plan your hospital layout to achieve better ergonomics. Having workers run around in an uncoordinated manner during emergencies because of poor workplace design does not portray order and efficiency. Rather, it reflects hysteria and panic resulting from poor planning.

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