Chaos minus Lean Nudge = Order

I stopped nibbling on my gingerbread snack. At the Swiss Lean Healthcare Award 2019 another expert entered the stage of the nominees and presented a smart project. Amazingly simple, well thought-out, effective.

Barbara Ligresti, expert for infection prevention, from the surgery care (130 employees) department of the University Hospital Basel beamed the first foil on the canvas and showed order with colors. Crime scene (as in many hospitals): the surgical equipment room.

University Hospital Basel_Lean with Colors_Nudge_Maurice Codourey

Picture: the surgical equipment room in Basel.
1: After each use, the devices are somewhere else in the room. The passageways are blocked, the large units are at the front and small at the back. And the clusters (sorted by departments such as traumatology and emergencies) are scattered throughout the room instead of bundled in one place.
2: Sorted by cluster by colour coding and by degree of readiness within the colour area – rare devices are at the back.

Its lean, its a Nudge, its extremely effective
During the careful analysis and questioning phase, for example, the team uses the Gemba-Walk method (by Taiichi Ohno – observe the actual work and build relationships with the employees – link:

Furthermore, the lean project team defines four readiness levels for all devices, including different color coding, for sorting by cluster in the device room. Like Orthopaedics, Trauma in green, PHC Primary Health Care in blue or visceral, da Vinci surgical system, urology, gynecology in yellow. And red – for the area of heart & vessel. This order can compete with any clinical area.

Overview: the core piece is the colour cluster with floor markings
Cluster Coloring USB

«Back to the start»
The initially simple idea became a project according to the Lean A3 problem-solving method/way of thinking (link –
Lean Color project operation room USB

And the questions for this project? And the questions that led to this unique, dedicated and effective work? In this blog post only at the end, after all these colourful, fascinating and impressive changes.

– How can safety and hygiene be maintained effectively and efficiently?

– How do we sensitize the teams and «activate» their knowledge in order to make improvements usable in a structured way for the entire OR (surgery) team?

– Do we have in the operating room/theatre the material we need and only really that?

Do we know where we have the material or is the order redefined after every operation?

And the Nudge?
The Nobel Prize-winning theory (link – of Thaler and Sunstein (2008) can be translated as: a minimally invasive invitation to make a better decision, to engage in a behavioural change for an increased common good.

In my opinion, ten years of working with Nudge in healthcare: Finally a Nudge, which also brings a noticeable process streamlining – a real Lean Nudge. A hybrid form that not only has almost infinite potential in the healthcare market, since it brings future-oriented added value in direct connection with improved billing capability of the ever tighter tariffs.

In short: The bee house colour system reloaded. In the hospital. Chaos-reducing. Mindful, with evaluation and measuring points. #WomeninLean or #WomeninLeanNudgeHealthcare would probably be the order of the day for the usual and well deserved hashtag #WomeninHealth.

My compliments and appreciation goes to this really good hospital lean team.

Maurice Codourey

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s