Provide a summary of your organization
BronxCare is one of the biggest voluntary, non-profit organization and teaching facility offering health care services to the citizens of south and central Bronx. Statistically, it is the largest facility offering outpatient services to the residents of New York City, with more than a million visits every year. It also has Emergency Rooms(ER) responding to more than 139,000 visits annually. The facility is an engine for positive change due to the fact that more than $300 million has been infused into the Bronx economy. This incorporates a 60,000 square feet modern health and fitness center for their outpatient, another 56,000 square feet life recovery facility for chemical dependency services, and other significant projects aimed at improving the health services around the Bronx.
Provide context regarding the events and any industry
As one of the directors at Wound Care Center and Non-invasive Vascular Laboratory, my goal is to help improve service quality and the overall patient experiences. These facilities majors in providing quality care for chronic, disabling, painful, and non-healing wounds. The Non-invasive Vascular Laboratory services also play a critical part when it comes to the diagnosis and treatment of some chronic vascular infections. At the facility, health care practitioners use advanced minimally invasive endovascular approaches and laser surgery to manage arterial and venous disorders. Based on previous cases, the strategies have been effective. Patients have been able to embark on their daily activities within a short timeline.
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What was the goal of the Gemba?
"Gemba" originated from Japan and is used to mean "the actual place". It is normal in an organization when a complex issue comes up; those involved often lose sight of the main task. The real-world issue that affects an organization's profits and consumer experience can change to be a more theoretical abstraction, reduction in data reports and endless discourse about an issue without finding a sustainable solution. This is when Gemba Walk comes in to help organization leaders understand and implement a viable solution.
Gemba Walk is a lean management concept where the managers pay a regular visit to the production line interacting with the employees rather than undertaking the management duties within the boundaries of the office (Gesinger, 2016). Gemba Walk management concept is essential in the achievement of the company's set goals and objectives. Besides the Gemba Walk, there is a need to incorporate the management concept to improve the production of quality goods and service. With this, the managers and the organization leadership can easily observe and monitor the actual work progress, gain knowledge, as well as interact with the employees concerning the production line. This leads to the exploration of opportunities that will ensure continuous improvement in the production of goods and services in the company. The goal of the Gemba walk was to see proper waste disposal at the Wound Care Center and Vascular Lab. Proper waste disposal, particularly the red bag waste, is vital in a health care facility. Red waste includes items soaked with blood, bandages, gauze, specimen cups, and contaminated fluid items, among other equipment used in wound management and treatment (Patan & Mathur, 2015). There are strict government laws and regulation to ensure proper handling and disposal of biohazards waste.
What did you observe during your Gemba? Who were the individuals you spoke with? Who are they, and what are their responsibilities? What did you learn from the people who work in the environment you observed?
During my Gemba Walk, there were numerous issues I noted with the waste disposal system. As part of the ethical and service standards in the healthcare sector, medical waste should be appropriately managed and disposed. This is supported by the federal, national, and local governing agencies mandated to manage the healthcare sector. It was evident that tracking, storing, and management of medical waste proved difficult for the management at Wound Care Center and Vascular Lab. According to the world health organization (WHO), only 10-15 per cent of collected waste is the actual infectious waste used in any facility. This means that about 85 per cent of collected waste is non-hazardous. The 15 per cent of the collected waste contains infections, radioactive, and toxic materials.
The Wound Care Center and Vascular Lab need restructure their waste disposal methods while at the same time operating within the set government guidelines for the management of biohazardous waste. Healthcare facilities are obligated to dispose of biohazardous waste in full compliance with FDA guidelines. However, the medical professionals in Wound Care Centers and Vascular Lab facilities carelessly dispose of all kinds of waste that have been used in a patient into the red biohazard bag without scrutinizing whether or not the items genuinely pose a risk. Also, wound care centres fail to accommodate a separate disposal bin in treatment rooms. This means that every type of waste ends up in the biohazard bag. Often the red bags are found to contain used wound dressings, adult diapers, tubes, and device packaging (Pandey et al., 2016). This produces an enormous volume of excess waste. I believe that this has been caused by limited sensitization on the need sort wastes and proper waste management systems in the health care facilities. The high turnover rate also contributes to improper waste management. New healthcare practitioners often take a significant amount of time to cope up with waste management systems put in place.
Provide a preliminary analysis of your observations
Wound Care Centers and Vascular Labs are in desperate need for efficient waste management systems and programs. The increased medical waste makes it necessary for the organization to come up with disposal programs in order to enhance proper patient care. The primary wastes in the hospital include sharp objects used in medical operations and the “Red Bag”. The management and disposal of the “Red Bag” is controlled by strict laws and regulations set by the federal, national and local governments. The management and disposal of the red bag material is always costly for the healthcare facilities hence the need for proper handling and final disposal once filled (Patan & Mathur, 2015). Proper management of the “red bag” can, to a large extent, improve on the services provided, reduce the costs incurred in disposal, and protect the patients from getting further health problems. The primary objective of Gemba Walk was to promote safe disposal of waste at the Wound Care Center and Vascular Lab . I believe that when a proper waste management system is implemented, “Red Bag” waste can significantly help reduce and improve patient care, reduce pollution and costs.
List two short-term and one long-term executable project ideas
Several ways can be used to minimize the red bag waste and improve the services offered. Continuous staff training on the containment of the red bag and how they should dispose of wastes such as used needles will ensure proper waste disposal and limit possible health risks to the healthcare practitioners too. This means that only the required items are put into the red bag (Kumar et al., 2017). The solution to this problem is utilizing education and CME training courses aimed at helping staff put processes in place that will help ensure better compliance. To cut down on waste, medical facilities should provide a large garbage disposal bins and a smaller biohazard disposal container available only to the medical personnel. All staff needs to undergo proper and continuous training on what materials present actual biohazards and which materials require no special handling. Additionally, waste segregation prior to disposal will also play a fundamental role in ensuring proper waste is placed at the correct bin. It costs less to sort the waste as compared to the amount used in the management of the wastes.
How is your employer responding to your project?
The chairman of the department of surgery showed interest in my project. We both agreed that by reducing the red bag waste, it would make Wound Care Center and Vascular Lab services more affordable and efficient. Patients can be assured of safety and recovery. At the same time, less expenditure on waste management would mean extra funds that can be utilized to employ more nurses to help realize the organizational goal of quality and sufficient care services. It has also been noted that going "green" is sustainably the best move that hospitals could ever take. It is cheaper to go green as hospitals will be able to spend less on the purchase of health equipment since products containing mercury and PVC are widely being scraped from the market. Cutting down on packaging helps save resources and reduce hospital waste, which, results in a lot of saving. It is also beneficial as it creates a friendly environment by cutting down on health hazards hence maintaining a healthy community. It is essential to take care of the environment in a way that will favour our health and well-being. Therefore, hospitals talking the frontline towards embracing the “green” concept is very crucial for a better living for the existing and future generation.
