Meriam Signo

Meriam Signo

ValleyCare Health System, USA

Title: Reduce nursing waste time: Basic lean concepts


Meriam Signo is an accomplished nurse executive and American Nurse Credentialing Center Nurse Executive Board Certifi ed and held positions of chief nursing offi cer/vice president in her career. She has been a California Registered Nurse for over 23 years and holds a BSN/PHN and MSN in Nursing Administration. She also serves as adjunct nursing faculty to various Bay Area universities such as San Francisco State University and University of Phoenix Bay San Francisco. She is an expert in LEAN methodology concepts and applications in nursing and has currently transformed one of her departments to CMS 5 STAR ratings in less than one year.


Application of LEAN in nursing is oft en seen as an impossible process to implement and sustain. Nursing is drawn to getting tasks done without realizing work duplication and the decrease in effi ciencies are occurring every time they perform nursing care. Are they driven by habits, duplication of policies and procedures, guidelines or how about old practices which are oft en hard to break? Th e nursing waste time is overlooked in healthcare. With increasing expectations of patient satisfaction and clinical care outcomes from accreditation and regulatory agencies to managing expenditures, how can nurses reduce their waste time and be more productive and remained satisfi ed with their work? Basic LEAN concepts help nurses reduce unnecessary workloads. Reducing waste time, increasing effi ciencies and providing the tools without reducing staffi ng resources are important so nurses will have more time with their patients and less time with unnecessary duplication of processes. How does one apply LEAN in nursing? It is about learning the basics of 5 S (sort, simply, sweep, standardized, self-discipline), performing gembas (go out and see) and continually focusing on its processes. Th ese are simple steps and practices which are applicable even not in the work place setting. It takes time and commitment and the habits need to be developed and be part of daily workload. Investing on nurses to learn and practice LEAN concepts are worthwhile, the return of investment results to better patient care clinical outcomes, provides high quality care, increases patient experience satisfaction rates, decreases fi nancial waste and increases nursing satisfaction. It has been proven eff ective in reducing waste in healthcare from direct and indirect patient care activities, initiatives, projects and improved processes at work with successful outcomes. It is time we all look at what we can do to reduce waste in nursing and be more effi cient so we can provide more care to our patients.

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