1. CHUGACHMIUT Tatitlek Clinic 5S+2 March 8-10, 2010

2. Chugachmiut The Participants Dr. Zetterman Sue, CHP, CHA/P Manager Kyla, CHP-C Susie, CHP-C Jerry, Communications Mgr. Kert-Facilitator

3. Chugachmiut The Before Picture It was messy and unorganized There were too many extra supplies and storage was overflowing; some items were very old The Emergency Room didnt have enough space for Health Aides to work The crawlspace under the clinic was chock full of stuff The clinic was dusty, including supplies

4. Chugachmiut Emergency Room The ER supplies are unorganized and there are so many unneeded extras that everything is stacked on one another, making it hard to quickly find anything. It is difficult to use the counter or sink because of the clutter. Supplies are old and dusty. Only one bin is labeled.

5. Chugachmiut Emergency Room The cabinets in the ER were jammed with supplies and equipment for broken bones. Most of it was unusable; it would be hard to find anything in here.

6. Chugachmiut Emergency Room The emergency bags are encroaching into the floor space making it difficult to move around. Supply bins are poorly labeled and extremely over stuffed; because of the supplies, the counter is unusable. Everything is dusty.

7. Chugachmiut Storage Room The Storage Room is so full it is hard to move around in. Supplies are stacked in no particular order. Few items are labeled. Some things are too old or there are too many.

8. Chugachmiut Exam Room The countertop is cluttered, the cabinet under the sink has mixed supplies in no order and nothing is labeled.

9. Chugachmiut Exam Room The Exam Room storage cabinet is unorganized and poorly labeled.

10. Chugachmiut Pharmacy/Lab The counters are cluttered and every drawer and cabinet are poorly labeled. Drawers and cabinets are stuffed with too much and outdated supplies.

11. Chugachmiut 5S+2 Sort-Take everything out, throw trash away Set in Order-Put thing back where they should be Scrub-Clean everything well Standardize-Label everything to make things easy to find and use Sustain- Ensure that the standard of organization and cleanliness continues Safety- Ensure that changes keep patients and staff safe Security-Ensure that changes keep patient and staff information secure

12. Susie clears out the Storage Room. There were ONLY 10 backboards and baskets stored here! Dr. Z and Kyla start Setting things back in Order in the Emergency Room. Sue is Setting in Order the Storage Room Kyla is Scrubbing the floors in the ER

13. This is the Sort Area. We pulled items out of their rooms to determine if it should go back in. Dr. Z gets down and dirty to Sort out supplies in the Exam Room. Jerry had the difficult task of pulling junk out from the crawlspace. Kyla Sorts through supplies from the crawlspace.

14. This is a portable lighting kit for performing field surgeries. It was found in the crawlspace; age is unknown. Collected old medicine headed for disposal. The oldest item we found: bandages that expired in 1986! Also found in the crawlspace: instructions on how to take and report samples on mutated/infected subsistence foods.

15. All of the collected trash from the 5S+2, about three truckloads worth! (Extra items went back to Seward with Dr. Z and Sue)

16. Chugachmiut The After Picture It is clean and organized There are enough supplies and storage is well labeled The Emergency Room is clear and uncluttered; health aides have room to work The crawlspace is empty Items can be found quickly

17. Chugachmiut Emergency Room All of the extra and old supplies have been thrown out. Supplies from the other counter have been added and all of the bins have been organized and labeled. Some counter space has been cleared for use. Everything has been cleaned. It is easy to find needed items quickly now.

18. Chugachmiut Emergency Room The cabinets in the ER are now organized with all new and usable supplies that are easy to find. The doors are labeled for quick searches.

19. Chugachmiut Emergency Room The emergency bags have been relocated and so have the supplies. The counter is clear and everything has been cleaned. There is more space to walk around now.

20. Chugachmiut Storage Room The layout was optimized and like items were put together. Supplies were labeled and all extra or old items were disposed of. Items can be found easily and quickly.

21. Chugachmiut Exam Room The countertop is free of clutter and the cabinet under the sink is organized with only like items. The doors and drawers are labeled for quick retrieval.

22. Chugachmiut Exam Room The storage cabinet is clear of old supplies and is organized by use. Everything is labeled and easy to find.

23. Chugachmiut Pharmacy/Lab Clutter was minimized on counters. Drawers and cabinets were cleared of all junk and old or extra supplies. Everything was labeled for easy and fast access.

24. Chugachmiut The Tatitlek Clinic 5S Team