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Declutter Your Simulation Center - Doing More with Less

Monday, February 10, 2020  
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By SimGHOSTS Board member Dr Scott Crawford

 Healthcare simulation spaces are one of the most unique work environments anyone will ever encounter and can very easily become some of the most cluttered. A mixture of manikins, task trainers, hospital equipment, medical supplies, medications, arts and crafts tools, chemicals, audio and video cables, makeup, wigs, computers, and specialized technology devices are just a few of the items in your average simulation space. 

 The reasons for this clutter are multifactorial. With limited budgets, old equipment is kept around beyond its ideal life due to financial constraints, or the consideration of “what if…” an item is needed in the future. Administrators and directors have many other items to keep track of, so having an extra piece of equipment or two around may not be a top priority. Perhaps it should be. The pop culture cleaning phenomenon Marie Kondo, who introduced the world to the KonMari concept of decluttering and organizing, has led many to follow her teaching and clean up their lives. The importance of this concept may be more important for function than some programs realize, and extends beyond just determining whether something will “spark joy.”

Research on the subject shows that individuals function more slowly in cluttered environments.  The environment where people work also plays an important role in their overall job satisfaction.   As increasing attention is focused on employee retention and burnout, this may be an important area of consideration. Although environment is more than just the size and organization of a storage room (coworker interactions, parking, feeling valued, good leadership, etc.), tidying a workspace is one aspect of their environment in which individual employees can enact change and feel empowered. Decluttering your simulation center may just lead to a more positive and enjoyable work-life experience.

Where does all the stuff come from?

For some programs, having too much stuff comes from large initial funding to establish a program and then cessation or stagnation of revenue. In these instances, centers keep old and antiquated equipment out of necessity, but more often equipment purchased without a directed plan for curricular integration, or equipment that was used for a specific course is kept even though the curriculum no longer calls for it. Another cause is that equipment is upgraded to newer and better products, but the old, and still functional equipment is never discarded.

For many simulation programs, supplies and materials that are donated allow training to continue with otherwise limited budgets; and as beggars can’t be choosers, this equipment is often kept, even if it doesn’t have an immediate need. In many instances these varied materials are put away in closets, drawers, and other nooks and crannies where their full scope is hidden. 

How can we fix it?

Because of this phenomenon, one recommendation for tackling the problem of clutter is to understand how much stuff you have. To accomplish this, bring all of the same type of item into a single place.  After items are consolidated, the true scope of the problem can be seen and decisions to remove extra equipment are much easier.

Hoarding can be a true pathological process. It is defined as “the acquisition of, and failure to discard, possessions which appear to be useless or of limited value,”  but this is not likely the case for most simulation centers. Because the process by which equipment is purchased, acquired, and stored is rarely under the control of a single individual, the solution to workplace clutter in a shared environment may be approached through motivational theory. People are more likely to do a task if it they see purpose in it. In other words, people need a reason to do something (goal), to feel that the activity has purpose (salient), and understand the importance to them (relevant). Most likely people know that cleaning up is important but they may, just like exercise, view it as taking too much effort and time to be worthwhile. 

To create this change, staff must develop the motivation to do it. You can help to achieve this through culture and modeling. Creating the culture of purpose and community will increase the interest and motivation to seek improvement and enact change. Go ahead and offer to take the lead, it may just be that no one has thought to go through the process yet. Hinting at how to approach the problem may be more successful than giving specific direction for how to do it.

Finding a new home for an object may make some people feel that it is acceptable to let go of it. Often this is through sale, donation, or recycling, but with elaborate rules and regulations for many large state institutions, this may not be realistic. The disposal mechanism for many programs is through a bulk surplus disposal that will auction off equipment to try to recover some money before either giving away or throwing away an item. I have even seen some programs attempt to do this though online list-serves. Someone may even develop an online service – “SimBay” – in the future to buy and sell used simulation equipment, but currently no such process exists.
Usable but non-useful equipment is always the hardest to part with. Take a photo of these items and send them to the primary stakeholders at the institution with a brief description of their function (PowerPoint is a great way to do this). If no one claims them in a week or suggests a use, it is time to make like Elsa and “Let it go…”

Inventory Considerations (KonMari applied to simulation)

After a full list (or pile) of equipment is assembled, by category, go through and identify when each item was last used, and if there are other considerations such as warranty expenses or associated parts/supplies, and identify the realistic continued value it has with the organization.
Does it still teach an important or relevant skill?
Does it still support part of the curriculum?
Does something else have the same function?
Does it still work? Is it worth fixing? 

If you are finding a lot of new-in-box and already obsolete items, it is time to review the purchasing and approval process for buying new items. If you have lots of equipment that is heavily used and worn out, this information can be used to help justify and quantify the value of new purchases.

Grouping items by category can help decrease clutter and assist with inventory management. As an example, if all IV tubing and supplies are kept in a single location, it will be easier to find these supplies and rapidly identify excesses or deficiencies in stock level.

One method to assist with grouping supplies that was presented at IMSH 2020 is to color code equipment that is similar or always used together with colored tags, specifically duct tape. Duct tape is cheap, removable, and some items could be tagged with more than one color to indicate a dual use.

Try to clean everything. Schedule a few days when there are no other activities and really dig deep to get it all done at once. Just like all of the half-started DIY-innovation projects that take up space, a half-started cleanup project can actually increase the clutter and decrease the sense of accomplishment. In addition to making things easier to find and having open work surfaces, employees and staff should feel a sense of pride and accomplishment from having a well-organized and show-ready simulation center.
  Mateo, R., Hernández, J. R., Jaca, C., & Blazsek, S. (2013). Effects of tidy/messy work environment on human accuracy. Management Decision.
  Raziq, A., & Maulabakhsh, R. (2015). Impact of working environment on job satisfaction. Procedia Economics and Finance, 23, 717-725.
  Frost, R. O., & Gross, R. C. (1993). The hoarding of possessions. Behaviour research and therapy, 31(4), 367-381.