6. Once the action plan is implemented,
the changes should be evaluated for
effectiveness. This can be done as a
formal pilot program or by using
informal reporting. It is valuable at
this stage to engage an industry specific ergonomics specialist to provide
a long term compliance program
which may include someone on the
team being responsible for adherence
to the program.
Ergonomics can affect an entire organization by enhancing the most important
component of its business—the ability
of workers to do their work. Ergonomics
strives to fit the job to the worker rather
than expecting the worker to fit into a
static work environment. By reducing
injuries, experienced workers can be retained and can perform at their best level.
This impacts the quality of patient care,
productivity, and profits.
Initiating a continuous improvement
program requires that the key personnel are willing to make changes. Often,
workers and/or managers are resistant
to change for a variety of reasons. Workers will be resistant if they have not been
consulted about the process or the need
for change. They fear that any changes
might negatively affect their established
work patterns or may even threaten their
jobs. In busy departments, the workers
may not view the benefits of change as
outweighing the effort. In some instances,
fatigue is a factor and the effort needed
to implement change and to assess the
effects seems too exhausting. Clearly
communicating the need for continuous
improvement programs and the components of those programs will create
awareness among the workers. Establishing a culture of bottom up management
empowers employees and allows them
to develop the skills to actively participate in the change process. This type of
environment gives the workers “
permission” to change and demonstrates respect
for their role in the organization. 15-17
Traditional top down management can be
viewed by the employees as unapproachable and unconcerned with their issues
and concerns. The employees continue
to work in a difficult environment which
can lead to work injury and poor morale.
In healthcare, this can transfer to poor
patient care, long wait times, and a disinterested workforce.
As continuous improvement methods used in manufacturing are applied
to healthcare, medical facilities are finding ways to eliminate waste, increase
productivity, and enhance the patient
experience. Productivity and quality in
the ultrasound department not only depends on standardized exam protocols
but also on maintaining an experienced,
healthy workforce. An ergonomic work
environment and employee education in
safe work postures can be an integral part
of any continuous improvement process.
A productive work unit has a number of
interconnected components that work
best together when workers are at the
center of problem solving discussions
and management plays a facilitative,
rather than a dictatorial role.
1Cusumano MA. The Limits of “Lean.” Sloan
Management Review. Summer 1994:
2Orenstein B. “Lean Management: Wisconsin’s
Theda Care Improves its Radiation Oncology Care Process.” Radiology Today. June
3Dictionary.com, LLC. Kaizen. Available at:
kaizen. Accessed December 13, 2012.
4Jones D, Mitchell A. “Lean Thinking for the
NHS.” The NHS Confederation. 2006.
Available at: http://www.leanuk.org/
nhs_leaflet.pdf. Accessed December 13,
5Abdulmalek FA, Rajgopal J. Analyzing the
benefit of lean manufacturing and value
stream mapping via simulation: A process
sectior case study. Inter J of Production
Economics . 2007;107:223-236.
6Six Sigma—What is Six Sigma? Available at:
Accessed December 13, 2012.
7Linderman K, Schroeder RG, Zaheer S, Choo
AS, Carlson CL. Six Sigma: a goal-theoretic
perspective. J of Operations Management.
2003; 21( 2):193-203.
8Schroeder RG, Linderman K, Liedtke C, Choo
AS. Six Sigma: definition and underlying
theory. J of Operations Management.
9Kwak YH, Anbari F T. Benefits, obstacles, and
future of six sigma approach. Technovation.
10Rapid Impact Assessment of The Productive
Ward: Releasing time to care TM. NHS Institute for Innovation and Improvement.
January 2011. Available at: http://www.
December 13, 2012.
11Lillrnak P. The transfer of management innovations from Japan. Organization Studies.
12Gaikwad VV, Gaikwad AV. Quality Circle as
an Effectige Management Tool: A Case
Study of Indira College of Engineering and
Management Library. ICAL-2009.
13Pike I, Russo A, Berkowitz J, Baker J, Lesso-way V. The prevalence of musculoskeletal
disorders among diagnostic medical
sonographers. J Diagn Med Sonography.
14Evans K, Roll S, Baker J. Work-related musculoskeletal disorders ( WRMDS) among registered diagnostic medical sonographers &
vascular technologists: a representative
sample. J Diagn Med Sonography. 2009;
15Resistance to Change; Center for Urban
Transportation Studies, University of
16Schuler AJ. Overcoming resistance to change:
Top ten reasons for change resistance.
Schuler Solutions, Inc. 2003.
17Grazier PB. Overcoming resistance to
employee involvement. Teambuilding, Inc.
Carolyn T. Coffin, MPH, RDMS, RV T, RDCS, BOEC is
chair and associate professor in the department of
diagnostic ultrasound at Seattle University in Seattle,
WA and ergonomics consultant with Sound
Ergonomics, LLC in Woodinville, WA. She has over
25 years of experience as a radiographer and
sonographer and has been an ultrasound educator
for 20 years. Her area of scholarship is occupational
injury and ergonomics in imaging professionals.
Carolyn can be contacted at firstname.lastname@example.org.