Doctor-Nurse Interaction – What Hospitals teach us about Lean

Doctor Nurse approach of Feeding an Assembly Line - Lean Production
Doctor Nurse approach of Feeding an Assembly Line - Lean Production

Do you know what lean factories copied from the doctor and nurse interactions during a surgery? Let me show you the doctor nurse principle.

The Doctor Nurse Interaction

What is the Idea of the Doctor Nurse Interaction?

During a surgery most important is to give the doctors the ability to fully concentrate on the surgery. He is the one being in contact with the injured person using his hands and tools. Everything blocking him from being focused has to be eliminated. To fulfill that need, the nurse or assistant stands right next to the doctor. They support the operating doctor with all tools and equipment he needs right when its needed.
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How to implement the Doctor Nurse Principle in your Production?

To switch to the doctor nurse principle on the shop floor some requirements have to be met. Imagine the line operators as being the doctor. They have to focus on the production. As they – in fact – generate the value for the company by assembling the parts which will be sold for money, they have to be placed into a central role.

We call this the line-back approach: First look on the needs of the operators and prepare everything according to them. By implementing the nurse as a line feeding concept he has to take care of all other activities – mostly non-value-adding activities.

The workstations have to be arranged in a way letting the nurse access the operating area without disturbing the operators, i. e. for feeding the line with new material or removing empty boxes.

Doctor Nurse Principle - Lean Production
By separating line-feeding and production in two areas the operators will not be disturbed by refilling parts. The line-feeder (below) can feed the line with material by placing the boxes on the shelves without entering the line.

More than that the doctor-nurse principle is a kind of mindset fertilizing the line-back approach described above. Implementing means to separate value adding and non-value adding tasks. Once non-value adding activities are identified they have to be handled by the nurse first before eliminating them in a following step.

Doctor Nurse Principle – Further Readings:



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