For Mercy Gowe who works as a linen checker at Mtawatawa District Hospital in Mashonaland East, managing linen and laundry at the health facility a few years ago was a challenge as there was not much of a coordinated system to handle the hospital’s laundry.
By Michael Gwarisa in Mashonaland East
Her job is to ensure that linen is flowing to patient areas. This includes receiving linen from vendors, distributing, and restocking clean linen via linen carts, picking up soiled/dirty linen carts, and emptying dirty linen containers. The linen includes towels, gowns, blankets, cushions, curtains, personnel uniforms, chef aprons, etc.
Before, it was like working a double shift,” says Mercy as she hangs some laundry on the washing line.
“Laundry would be mixed up and it was cumbersome separating the laundry before and after washing.”
According to the American Centre for Diseases Control (CDC), contaminated textiles and fabrics in healthcare facilities can be a source of substantial numbers of pathogenic microorganisms that can cause infections. Global healthcare standards mandate health facilities prioritize laundry services as they serve a great purpose about avoiding any setback caused by an infection passed through the hospital clothing or linens.
In Zimbabwe, 238 Health Facilities including Provincial Hospitals (8), Central Hospitals (6), PHEs (10), and DHEs (30) have had their staff oriented or initiated around an advanced system of management, known as Kaizen 5S or the Continuous Quality Improvement (CQI) model for their departments to improve health outcomes. The Kaizen 5s model was introduced in Zimbabwe’s health institutions in 2017.
The CQI or Kaizen 5s model is being implemented by Cordaid Zimbabwe through support from the Ministry of Health and Child Care (MoHCC) and the Japan International Cooperation Agency (JAICA.) The MoHCC roles included capacity building, resource mobilization, support & supervision, coaching, organising experience sharing meetings, ensuring integration of QI programs, providing leadership and governance, ensuring implementation of quality activities and they are also implementers as Health Facilities.
On the other hand, Cordaid’s roles under the CQI involve being a fund holder, technical and implementation assistance, and assisting support and supervision. The Kaizen or CQI is being implemented under the Health Sector Development Support Additional Financing V which is is financed by the World Bank.
At Mtawatawa Hospital, the Laundry department was the first to benefit under the Kaizen 5s or the Continuous Quality Improvement program. Now Mercy can breathe a sigh of relief following the introduction of the Kaizen model at her facility as her department was among the first departments to benefit from this renewed system of doing business.
Sister Winnie Muriga Gumbo, the Matron at Mtawatawa Hospital said the changes being effected under the Kaizen 5s have greatly improved the quality of care at the facility.
“In terms of quality improvement, we have labeled our areas where we have marked the areas by the services that are offered there. At the laundry department, we implemented the 5s and that was the first department and we moved on to the Outpatient Department (OPD) department before we moved to the Kitchen department where work is still in progress,” said Matron Gumbo.
Under the 5s model at Mtatawa Hospital, the system ensures linen from different departments do not mix and the areas under which the linen is sorted are clearly labeled for ease of identification and processing.
Kaizen is a Japanese term that means change for the better or Continuous Improvement. The 5S methodology developed in Japan enables businesses to achieve these objectives through the implementation of five key steps. The 5S entails that you Sort, Set-up, Shine, Standardize, and sustain your operations.
The Kaizen 5S elaborates the 5s in the following manner: Sort – sort out and separate that which is needed and not needed in the area.-Straighten – arrange items that are needed so that they are ready and easy to use. Identify locations for all items so that anyone can find them and return them once the task is completed.-Shine – clean the workplace and equipment regularly, to maintain standards and identify defects- Standardise – revisit the first three of the 5Ss frequently and confirm the condition using standard procedures and Sustain – keep to the rules to maintain the standard and continue to improve every day.
In rural health facilities the Kaizen 5s model has improved quality of care service, improved teamwork, Improved client satisfaction, addressed needs of the clients through conducting root-cause analysis, Improved time management hence clients spent less time at facility as well as Community involvement through Health Centre Committees (HCCs) who are in quality Improvements (QI) committees.
Most Districts in Mashonaland East have adopted the Kaizen 5s Model. Dr. Gladman Mbonani, the District Medical Officer for Mtawatawa District Hospital said they are now implementing the model in all departments in the hospital.
“We are using the Kaizen model and we have adopted a quality control team at the hospital which is headed by the Matron. I would say we are implementing the Kaizen Model in all our wards now and in all departments. The best-performing department right now is the laundry department and the Kitchen is also having some improvements,” said Dr Mbonani.
In terms of implementation, the Kaizen or CQI model is managed by giving ownership to the health facilities to lead the program. The program is also managed by capacitating the PHEs and DHEs to supervise the subordinates respectively and training local coaches who then coach the implementing facilities. CQI is also done by first doing the 5s concept then Kaizen and Managed by establishing QI teams who oversee the implementation at the facility. CQI rides on the quality support and supervision done on a quarterly basis.
Meanwhile, Dr. Paul Matsvimbo, the Provincial Medical Officer for Mashonaland East Province said the shift of focus on quality improvement has greatly reduced maternal deaths in the province.
“One of the support being enjoyed by four districts in this province includes the concept of strengthening community health through Community Results Based Financing (RBF). The system can be resilient if communities are participating or are partaking in terms of health matters because this is in line with the Primary Health Care approach the Ministry of adopted in 1980 as a model of service delivery.
