| Course | EDN 818 Innovation and Technology in Health Care |
|---|---|
| Module | Module 6 |
| Paper type | Lean improvement paper |
| Length | About 1,132 words, 7 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Education |
| Updated | September 2026 |
Free sample paper for EDN 818 Module 6
Fourteen Minutes a Shift: A Lean Redesign of a Medical Unit's Medication Room
Student Name
Doctor of Education Program, Aspen University
EDN 818: Innovation and Technology in Health Care
Instructor Name
Month Day, Year
Fourteen Minutes a Shift: A Lean Redesign of a Medical Unit's Medication Room
Nurses on Kingsmere Regional Hospital's 30-bed medical unit complained that the medication room was a place where time disappeared: supplies were never where they should be, the automated dispensing cabinet queue backed up at the two scheduled morning and evening medication times, and a missing flush or tubing set could cost a nurse several minutes of searching or a trip to another unit. Observation confirmed the complaint. Nurses spent an average of 14 minutes a shift searching for items. This paper describes how the unit used Lean methods to redesign the room, what changed in the first 90 days and what the evidence on Lean suggests about sustaining the gains.
Lean in Brief
Lean began in Toyota's factories as a way of managing production. Applied to health care, it judges every step by whether it adds value for the patient and works to strip out the steps that do not. Toussaint and Berry (2013) described Lean in health care as more than a set of tools: it is a culture of continuous improvement in which frontline staff are trained and expected to find and fix problems, leaders support them, and respect for people is as central as the elimination of waste.
The Forms of Waste
Lean practitioners classify waste into types: defects, overproduction, waiting, unused talent, transportation, inventory, motion and extra processing. In nursing work, motion and searching are among the most common. Every minute a nurse spends looking for an item, walking to another unit or waiting at a cabinet is a minute not spent with patients, and the frustration it causes adds to the strain of the job.
Seeing the Process
Lean begins by observing work where it happens. Over two weeks, a team of two staff nurses, a pharmacy technician, a materials handler and the unit's clinical nurse specialist observed 24 medication-room visits across shifts, mapped nurses' paths and timed each activity. They recorded searching time, trips outside the room, interruptions and stockouts. Nurses were partners in the observation, not its subjects; each observation ended with the question, what got in your way?
What the Team Found
The table lists the main wastes observed and the countermeasures chosen.
| Waste | What the team observed | Countermeasure |
|---|---|---|
| Motion and searching | About 14 minutes a shift per nurse spent looking for supplies | 5S: sort, set in order, shine, standardize, sustain |
| Inventory | Expired and duplicate supplies in four locations | Remove duplicates; one location per item with labels |
| Waiting | Cabinet queues of four or five nurses at scheduled medication times | Stagger scheduled times; second cabinet drawer access for common items |
| Transportation | Trips to other units for stocked-out items, about 9 a week | Two-bin replenishment with pharmacy and materials |
| Defects | Wrong tubing picked from mixed bins | Separate, labeled bins with photographs |
| Unused talent | Nurses' fixes never adopted | Weekly huddle to review and test staff ideas |
5S in the Medication Room
The team applied 5S over two weekends. In the sort step, they removed 212 items that were expired, duplicated or never used. In set in order, they arranged remaining supplies by frequency of use, with the most common items at waist height nearest the cabinet, and labeled every location with a photograph and a par level. Shine meant a cleaning and restocking schedule. Standardize produced a one-page map of the room posted on the door and matched on the unit's intranet. Sustain assigned a weekly five-minute audit to the charge nurse, with results posted.
Standard Work and Replenishment
Two further changes addressed recurring problems. The team worked with pharmacy to stagger scheduled medication times for patients whose timing was not clinically fixed, which shortened cabinet queues. And materials management introduced two-bin replenishment for the 40 most-used supplies: when the front bin empties, the nurse pulls the card, the full back bin moves forward, and materials refills the empty bin on the next round. Nurses no longer have to notice and report low stock.
Results After 90 Days
Repeat observation at 90 days showed average searching time down from about 14 minutes to 5 minutes a shift per nurse. With about 11 nurse shifts a day on the unit, the 9 minutes saved amount to roughly 600 nursing hours a year. Trips to other units for stocked-out supplies fell from about 9 a week to 2. The share of nurses who described the medication room as a source of frustration on the unit's pulse survey fell from 71% to 28%. The team has not yet measured effects on medication errors or patient outcomes, which would require a longer period and more careful design.
Respect for People
Lean has sometimes been used as a cost-cutting program that removes staff, which destroys trust quickly. Kingsmere's chief nursing officer stated at the outset that no positions would be reduced because of the project and that time saved would return to patient care. The team measured this directly by asking nurses what they did with the time; the most common answers were earlier pain reassessments and more complete discharge teaching. Keeping that promise is what allows the next Lean project to begin with staff support.
What the Evidence Says About Lean
The evidence on Lean in health care is encouraging but incomplete. A comprehensive review by D'Andreamatteo et al. (2015) analyzed 243 articles and found that Lean was best understood as a way to increase productivity, that emergency and surgical departments were the pioneers, and that sustainability, measurement frameworks and critical appraisal remained neglected; the authors concluded that the research did not yet allow a final judgment on Lean's impact. DelliFraine et al. (2010), reviewing a decade of published projects using these methods, found that few reported outcomes tested statistically. Kingsmere's results should be read in that light: promising, locally measured and in need of follow-up.
Sustaining the Gains
Lean projects often slip back when attention moves elsewhere. The unit will sustain its gains through the weekly charge nurse audit, monthly searching-time spot checks, a standing item on the unit's improvement huddle and a rule that any change to the room's layout goes through the same team. The team will also spread the approach to the unit's clean supply room, using staff from the first project as coaches.
Conclusion
A medication room that cost each nurse about 14 minutes a shift became one that costs about 5, through observation, 5S, standard work and two-bin replenishment, carried out by the people who use the room. The result returns roughly 600 nursing hours a year to patients. The broader evidence on Lean is mixed, which makes measurement and honest reporting part of the method. Respect for people, keeping the promise that saved time returns to care, is what will allow this small project to become a lasting way of working.
References
D'Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, 119(9), 1197-1209. https://doi.org/10.1016/j.healthpol.2015.02.002
DelliFraine, J. L., Langabeer, J. R., II, & Nembhard, I. M. (2010). Assessing the evidence of Six Sigma and Lean in the health care industry. Quality Management in Health Care, 19(3), 211-225. https://doi.org/10.1097/QMH.0b013e3181eb140e
Toussaint, J. S., & Berry, L. L. (2013). The promise of Lean in health care. Mayo Clinic Proceedings, 88(1), 74-82. https://doi.org/10.1016/j.mayocp.2012.07.025
EDN 818 Module 6 instructions, in plain terms
Lean Enterprise Theory appears in Aspen's EDN 818 description as a way leaders enact cost-saving measures, and since the sixth module's text is held in the classroom, this example applies Lean to one clinical process. A Lean assignment generally wants a process chosen, its waste identified, Lean tools applied and results reported or projected. Begin with direct observation of the work, not a meeting about it. Classify what you see using the standard forms of waste. Match each countermeasure to a specific waste. Report results with a baseline and a follow-up measure. Because Lean is also a culture, explain how staff were involved and how the gains will be sustained. Address what happens to time saved, since that question decides whether staff trust the next project.
How this EDN 818 Module 6 example is built
The paper opens with nurses' complaints about the medication room and the measured 14 minutes a shift. It explains Lean as a toolset and a culture, lists the forms of waste and describes a two-week observation of 24 medication-room visits by a team of nurses, a pharmacy technician, a materials handler and a clinical nurse specialist. A three-column table pairs six wastes with countermeasures. Sections describe 5S in detail, including removal of 212 items, then staggered medication times and two-bin replenishment for 40 supplies. The results section reports searching time, trips for missing items and a staff survey, and notes what was not measured. Respect for people, a review of the evidence on Lean and a plan to sustain and spread the gains close the paper.
Where the marks sit in the EDN 818 Module 6 rubric
Lean papers are graded on correct use of Lean concepts, evidence from observation, clear links between waste and countermeasure, measured results and attention to sustainability. This example ties each countermeasure to a named waste in the table and reports results against a baseline. Its three APA sources are a Mayo Clinic Proceedings article on the promise of Lean in health care, a Health Policy review of 243 Lean studies and a Quality Management in Health Care review of Six Sigma and Lean evidence. Acknowledging that the broader evidence is incomplete, and that medication errors were not yet measured, shows the critical stance doctoral instructors expect. The commitment that saved time returns to patient care connects the project to Lean's principle of respect for people.
EDN 818 Module 6 help from the desk
Lean papers often list tools, value stream maps, 5S, kanban, without showing that anyone watched the work. Observe first and record what you see with times. Another common error is claiming savings without a baseline or follow-up measure. Measure something simple before and after. Classify waste using the standard categories so the analysis is systematic. Involve the people who do the work in choosing countermeasures, and say how you did. Address sustainability, since most Lean gains fade without routines to hold them. Be careful with claims about cost; time saved is not money saved unless it is used differently. If you have not done a time observation before, a tutor can help you design a simple data collection sheet.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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EDN 818 Module 6 questions, answered
What does EDN 818 Module 6 usually ask for?
Aspen's EDN 818 says leaders need to enact cost-saving measures such as Lean Enterprise Theory, so a paper applying Lean to remove waste from a process is a typical sixth assignment. Follow your classroom prompt.
What is 5S in Lean health care?
A method for organizing a workspace in five steps, sort, set in order, shine, standardize and sustain, so that needed items are easy to find and unneeded ones are removed.
What does respect for people mean in Lean?
Treating frontline staff as the experts on their work, involving them in improvement and not using efficiency gains to cut jobs, so they trust and sustain the changes.
Where can I find a free EDN 818 Module 6 sample paper?
The complete example is above, a Lean redesign of a medication room with a table of wastes and countermeasures and results measured after 90 days.
What are the forms of waste in Lean health care?
Defects, overproduction, waiting, unused talent, transportation, inventory, motion and extra processing, often remembered as eight wastes.