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Implementing VQM in Auckland Regional Dental Service

What is Visual Quality Management (VQM)?

Visual Quality Management is a 6 step methodology for achieving a consistently tidy, efficient and effective work environment.

Step 1: Safety

When undertaking quality improvement the safety of our patients, their family/whanau and our staff is our number one priority.

Step 2: Sorting

Separating the things you need from those you don't need.
Sorting through items in the work area and removing what is not essential.
Removing clutter.

Step 3: Setting In Order, Straightening, Simplifying

Organising the workplace in such a way that things are EASY to see, EASY to get and EASY to return.
A motto often used is "a place for everything and everything in its place".

Step 4: Sweeping, Shining, Systematic Cleaning

As the name says, it means to wash, dust, sweep, and clean everything.

Step 5: Standardising

Putting standards in place to make sure that everything is kept where its supposed to.

Step 6: Sustaining

No matter how well you do on the previous steps, if you don't sustain the gain, you move slowly back to square one. It is important to put a plan in place to make sure that doesn't happen.

Auckland Regional Dental Service

The Auckland Regional Dental Service (ARDS) is responsible for providing free dental care for all children up to the age of 18 that live in the Auckland region from Wellsford to Waiuku. The service covers over 270,000 children and has:

365 staff
41 permanent community clinics mostly located in schools
21 transportable dental units (TDUs) which move from school to school
an additional 18 mobile vans that go to schools that don’t have a permanent clinic or are unable to accommodate a TDU

Transportable dental unit

Permanent community dental clinic

Mobile dental van

What are we trying to achieve?

Value: Better, Best, Brilliant Although our dental clinics are standardised in design they are organised differently and have clutter, waste and inappropriate stock levels. This leads to unsafe work environment for patients and staff.

The aim of this project is to:

reduce waste
optimise productivity through maintaining an orderly workplace
use visual cues to achieve more consistent appealing results
create a clean, organised, standardised and visual workplace

What did we find?

Waste of:

time searching for items, equipment and supplies
time moving items, equipment and supplies to where they are needed

E.g. ARDS clinic storeroom

What we found - before
Before

What we found - after
After

Waste of:

inventory from overstocking of items, equipment and supplies
space for storage of unnecessary items, supplies and equipment

Excess stock in TDU

E.g. Excess stock from a two chair TDU

What have we done?

We trained all staff members (365) on VQM methodology.
All permanent community clinics and TDUs undertook VQM, i.e. we sorted, simplified, shined, standardised and this is being sustained through an ongoing audit process.
We managed the movement and circulation of overstocked items.
We disposed of extra, unwanted and outdated items , e.g. expired supplies, old forms and broken equipment.

What we did - before
Before