Review all of the work that you have dedicated for your Gemba and data collection.
Select one short-term executable project supported by the Gemba and data collection.
Create a 1- to 2-page SBAR Proposal.
Note: Be mindful of the proper protocols required to submit SBARs at your place of employment. Be sure to follow up with your employer to ensure that your SBAR has been received.
Running head: THE GEMBA WALK
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The Gemba Walk
Debra Saunders
MHA/598
02/10/2020
Ed Paluch
THE GEMBA WALK
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The Gemba Walk
The Gemba walk is an essential aspect of continuous and quality improvement in an
organization. It involves a manager of the organization going to places where the real work
happens to observe how work gets done, ask questions he/she may have, and learn from them
(Gesinger, 2016). The Gemba helps the manager understand the events that take place in an
organization and understand how to get the employees involved in improving the performance of
the organization. The manager can identify potential opportunities, wastes, and ask questions
with the best interest of the customers or clients of the organization. The Gemba walk is also
essential in assessing the safety of the organization for the employees and customers as well, and
in the process, identify the safety hazards that may be present in the organization. The
organization in this paper is a healthcare facility. The employees in the organization include
nurses, physicians, and laboratory technicians, among other personnel. The healthcare facility
provides a wide range of healthcare services, some of which include surgical procedures,
administration of drugs routinely, routine checkups and blood tests, MRI scans, among other
medical procedures that are common in hospitals.
My Gemba observations included the fact that some departments had more than one
individual with the same set of skills working on the same case. This appeared to me as a waste
of resources as the individuals could be distributed to work on other cases of the same nature to
minimize wastage and improve efficiency (Mann, 2017). Another observation I made was that I
noticed some nurses were not using the protective gear efficiently when handling patients. This
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could lead to the development of further infections, which poses a risk to the health of the
patient. The sanitation of the hospital was not up to the required standard endangering the safety
of patients. Also, I observed that there was an ongoing conflict between some employees who
were supposed to be working together, pushing them to work individually when the particular
project was supposed to be done in a group. This acted as a barrier to achieving the
developmental goals of the organization, which could lead to poor performance in the
organization. I also observed several opportunities from the ideas some of the employees had on
how to improve the quality of healthcare provision in the organization.
The goal of the Gemba was to assess the activities of the organization in terms of how the
employees carry out their speculated duties and how they relate with their patients. It was aimed
at understanding what the employees think and the possible suggestions they may have on
initiatives that could improve the quality of services provided at the healthcare facilities. I
wanted to assess the safety of the employees and establish whether there were any wastes in
terms of production and skill. In observing how my team works, I wanted to understand what is
needed to improve productivity in the organization. Understanding the experiences of the
healthcare providers in the delivery of healthcare to the patients was essential in figuring out
ways to improve the organization with suggestions from the people who do the work on the
ground.
During the Gemba, I observed several opportunities. One, to manage the waste which in
this case included several physicians with the same set of skills working on the same case when
the other patients with the same case were in line waiting, I saw an opportunity to reduce waiting
time for the patients by setting up another office for one other physician so that we can reduce
time wastage and have the patients see the physician within the shortest possible waiting thus
THE GEMBA WALK
improving the quality of service delivery. Another opportunity I saw was from the division that
existed between healthcare providers who were supposed to be working together on a quality
improvement project, and I saw an opportunity to establish a proper conflict resolution platform
in which conflicts get solved as soon as possible to ensure that teamwork gets promoted and
delivery of healthcare gets improved. In other words, I saw an opportunity to unite the
employees through proper conflict resolution channels for efficient and quality service delivery
in the healthcare organization and satisfactory care to the patients.
To decrease inefficiencies, I observed that I would need to take regular Gemba walks to
follow up on how the employees are carrying out their stipulated duties as expected and, after
which, address the issues identified accordingly. To reduce waste, I will ensure that there is a
division of labor and that every employee has a duty to carry out within their work hours to
minimize idleness. To improve a product, in this case, to improve the quality of healthcare, the
opportunity I saw is to listen to the suggestions made by employees, deliberate on them, and
follow up on their institution if agreed upon as possible improvement initiatives that are quality.
The key take away from the Gemba walk of the healthcare organization includes the importance
of one on one interactions with employees, workplace conflict resolution and its importance,
waste management, occupational safety and safety hazards, quality improvement initiatives and
employer-employee positive interaction.
The individuals I spoke with during my Gemba walk include the heads of departments,
for instance the head surgeon, who is in charge of directing surgical procedures as well as
carrying out the complex ones, who explained to me what goes on in his department in terms of
procedures. He further explained to me the problems his department faces in terms of
occupational safety as well as the availability of waste. He explained that his department was
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THE GEMBA WALK
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overcrowded with several surgeons working on the same cases. He suggested another surgical
department be opened to minimize congestion and reduce waste as there is sufficient skillset
available to manage an extra department and reduce the congestion and time consumed by
patients waiting in line for their turn for procedures. Another individual I spoke with was the
head of the nursing department, who is in charge of managing the operations of nurses and
ensuring that they carry out their duties effectively, who expressed his concerns on the
occupational safety of nurses and the risk of such to the welfare of patients. He suggested that
nurses need to be provided with training on how to maintain safety at the workplace by learning
how to use the safety gear properly.
Also, I spoke to the patients who expressed their concerns about certain aspects of
healthcare delivery in the organization by stating areas where the service was satisfactory and
areas where it was not. Some of the patients gave their opinions as to how the healthcare delivery
should be carried out giving me an opportunity, as the administrator, to think about their
opinions and consult the board of directors to establish the possible ways to meet the needs of the
patients as well as the needs of the employees. Generally, the Gemba walk provides ways to
improve the quality of healthcare delivery in the organization by meeting the individual needs of
both the employees and the patients. Patients are an essential part of the healthcare facility as
they are the ones responsible for building or destroying the reputation of the hospital from the
reviews they give. Therefore, their opinion as to whether the services offered by the hospital are
satisfactory or not should be taken seriously by the hospital administration. Their opinions
should be considered to ensure that the services provided to them are satisfactory.
Apart from the observations I made, there are several lessons I learned from the
individuals who work in the healthcare facility. First, I learned that the success of an
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organization is highly dependent on how satisfied and comfortable the employees are. There is a
higher chance of success if the employees feel safe in the work environment. Also, the patients
have to be satisfied with the quality of services being offered so that they can present good
reviews to the public. Second, I learned that when managers interact face to face with employees,
trust gets built, which encourages the development of innovative ideas as they will trust their
managers to consider their ideas. Interaction is a show of interest in the welfare of the
employees, and as such, there is open communication among them, providing a platform for the
presentation of ideas and suggestions for quality improvement initiatives. Lastly, the lesson I
learned was that conflict among employees reduces performance.
My interview/evaluation sheet will be composed of the names and position the
interviewees to hold in the organization, the ratings as to how the physicians, nurses and patients
think of the quality of healthcare provision in the organization in terms of whether it is
satisfactory and whether the working environment is satisfactory for the employees. Another
aspect will be as to whether the individuals I interviewed think the healthcare facility has safety
measures that are sufficient to protect the employees as well as patients from possible infectioncausing germs. The evaluation form will also entail an evaluation as to how the people I
interviewed to rate the rate of waste in terms of personnel in healthcare provision as well as in
other sectors of the organization. Apart from those ratings, it will also include questions as to
whether the people I interviewed would recommend someone to seek employment in the
organization in the case of the employees, and for the patients, whether they would recommend
someone to seek medical treatment in the healthcare organization.
The two short-term executable project ideas for the organization that I got from
interacting with the employees include training of nurses on how to apply safety measures in the
THE GEMBA WALK
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appropriate way and educating the employees on workplace conflict management measures. The
long term executable ideas include establishing another surgical department to manage waste and
improve performance, enhancing patient satisfaction, and improve patient outcomes. Another
long term executable idea would be setting up goals to improve the quality of care by putting the
interests of patients first. For instance, upgrading the equipment for use in treatment and
observation of certain medical conditions could build trust in the patients as their welfare will be
taken care of.
My employer is responding to my project by appreciating the fact that I took the time to
walk through the various activities going on in the organization and establishing areas that need
attention. As such, the organization was able to figure the quality improvement initiatives that
are essential in ensuring the success of the organization as well as improving the relations
between employers and employees, employees and patients as well as the relationship between
the manager and the employees. This paved the way for self-expression, presenting the various
problems, ideas, and solutions that the people in the organization initially kept to themselves.
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References
Gesinger, S. (2016). Experiential learning: using Gemba walks to connect with employees.
Professional Safety, 61(02), 33-36.
Mann, D. (2017). Creating a lean culture: tools to sustain lean conversions. Productivity Press.
Running head: THE GEMBA WALK
1
THE GEMBA WALK
Debra Saunders
MHA/598
02/17/2020
Ed Paluch
THE GEMBA WALK
2
With the quest to improve workplace standards, building more workrooms, use of better
methods in solving departmental conflicts, and providing better infrastructure to the employees,
my employer positively welcomed the Gemba Walk project. Apart from the long term schemes,
the short term proposals were also well received since they were vital strategies in ensuring
better service delivery. My employer instantly formulated some short term proposals like conflict
solution plans, organizing training programs for nurses and physicians on proper handling of
safety gears (Carter et al., 2016). He decided to establish an enabling for all health care
practitioners, more so building the nurse-physician relationship. Teamwork and nurse-physician
being one of the most noteworthy challenges that health care amenities face; such a move would
enable nurses to have a better perception of their roles and ensure they are satisfied with their
jobs.
The use of Gemba walk guidelines regarding employers keeping close contact with their
working environment there was the need to ensure that the necessary information regarding
patients’ satisfaction on the kind of services provided at the health care facility was
communicated to the administration (Carter et al., 2016). This fact served an integral part in
better service delivery. All these positive measures stipulated in the Gemba project did not
dictate my employer to have a second thought in implementing most of the short term project
since his key target was on ensuring the health facility attained prosperity.
My experiences with the Gemba walk project were nothing short of exceptional. I
acquired vital knowledge regarding developing excellent solutions to achieve better health care.
My instructor’s ideologies matched with mine despite him echoing issues of forming a proper
working structure in health wards and outlining the importance of implementing the teamwork
initiative. Teamwork initiative yielded positive results in any health care facility that had an
THE GEMBA WALK
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objective of having an exemplary health care services and the environment. My instructor
illustrated and stressed that inclusion and prioritization of medical teamwork systems in any
performing health care center records minimal clinical errors and a reduction in the nurse
turnover.
Before deciding on which quality measures to report concerning the Gemba walk project
to health care facilities, I found it needful to know the kind of data essential to produce an
excellent score in this project. Since data could be collected from a variety of sources such as
medical records, patient surveys, and administrative databases used to manage health care, I
encountered some methods in the quest to ensure quality data measurement and reporting.
Governmental data sources such as claims, encounter, and enrollment and system providers
could be used to generate administrative data on the patients served and charges imposed on
every diagnosis (Karampela, Ouhbi, and Isomursu, 2018). Patients’ medical records are also
another source of data that I identified regarding having access to patient’s medical history and
care.
The use of electronic record systems in the Gemba Walk project would improve
information access and reduce the cost implication incurred while retrieving information
whenever doing reports. Patient surveys would also play an integral part when it comes to
analyzing the quality of health services offered to patients and provide a platform of an
employer, increasing the required expertise in different medical wards. In the use of medical data
records, I encountered challenges such as complexity in analyzing the data, and the cost incurred
in coming up with these data collection methods was very high. (Karampela, Ouhbi, and
Isomursu, 2018) The administrative data collection method had its challenges such as inaccuracy
THE GEMBA WALK
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in the billing of public records and was also vulnerable to the limited access to clinical
information.
The use of these internal and external data collection sources provided quality measures
that enabled consumer choice. Consumer choice requires a high degree of data validity and
dependence. This data will ensure health plans are done in a fairly and the results presented
results in an actual manner (Sutton, 2018). Data collected also helped in developing teambuilding strategies and organizing workshops on service delivery to the clients.
Despite coming up with sophisticated methods on how to improve service delivery to
clients, other challenges such as complaints from nurses and doctors on reduced salary payment
and heavy workload. This is as a result of different teams working more hours in executing their
duties. Patients also have shown their frustrations due to their inability to play a vital role in
decision making in this Gemba Walk project as they cannot participate in health care systems
that are responsive to their families. Also, the challenge of maintaining the confidentiality of
information in health care centers became one of the significant challenges on board.
With these kinds of challenges such as confidentiality, there was a need to come up with
sophisticated security measures about the accessibility of authorized data (Sutton, 2018). The
need for accountability among the staffs arouse since information regarding the unfortunate
diagnosis of patients destabilizes the health care system
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References
Carter, E. B., Temming, L. A., Akin, J., Fowler, S., Macones, G. A., Colditz, G. A., & Tuuli, M.
G. (2016). Group prenatal care compared with traditional prenatal care, 128(3), 551.
Corti, L., Van den Eynden, V., Bishop, L., & Woollard, M. (2019). Managing and sharing
research data: a guide to good practice. SAGE Publications Limited.
Karampela, M., Grundstrom, C., & Isomursu, M. (2018). Personal Health Data: Value and
Accessibility in a Danish Context.

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