The application of a "6S Lean" initiative to improve workflow for emergency eye examination rooms

Can J Ophthalmol. 2017 Oct;52(5):435-440. doi: 10.1016/j.jcjo.2017.02.017. Epub 2017 Apr 15.


Background: Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment.

Objective: The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital.

Methods: With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms. This model, considering 8 waste categories, was then used to recommend and implement changes to the examination rooms and to workplace protocols to enhance efficiency and safety.

Results: Eye examination rooms were improved with regards to setup, organization of supplies, inventory control, and maintenance. All targets were achieved, and the 5S audit checklist score increased by 33 points from 44 to 77.

Conclusions: Implementation of the 6S methodology is a simple approach that removes inefficiencies from the workplace. The ophthalmology clinic removed waste from all 8 waste categories, increased audit results, mitigated patient and resident safety risks, and ultimately redirected resident time back to patient care delivery.

MeSH terms

  • Checklist
  • Efficiency, Organizational*
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / organization & administration*
  • Eye Diseases / diagnosis
  • Health Care Costs
  • Humans
  • Ophthalmology / economics
  • Ophthalmology / organization & administration*
  • Patient Safety
  • Physical Examination*
  • Quality Improvement / organization & administration*
  • Safety Management
  • Time Factors
  • Workflow*