Pharmacy Process Improvement Webinar:
Common Sources of Waste in
Healthcare Organizations
PlusDelta Technologies, LLC
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Waste and Value Added
• Waste – defined as any activity that does not
add value to the service or product provided
– Adds to the cost of operations
– Impairs ability to meet core performance metrics
– Decreases ‘customer’ satisfaction
Successful adaption of
continuous improvement principles
can reduce waste and non-value added activities
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Sources of Waste
Overproduction
Intellect
Failure to fully utilize
the time and talents
of people
Producing too much
or producing too soon
Transportation
Any nonessential
transport
Inventory
Motion
Maintaining more
inventory than minimum
to get the job done
Any motion that
does not add value
Rework
Waiting
Correcting any errors or
doing completion steps
not done before
Waiting for the next step in
the process without added
value
Processing
Over-processing,
unnecessary steps
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Waiting
• Waiting – Any idle time in the process that
would be considered non-value time.
– Examples
• Nursing waiting for medications
• Pharmacist waiting for medications to be prepared
before checking product
• Patients waiting for discharge paperwork to be
completed.
Waiting may constitute up to
of the cycle time of a process
90%
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Overproduction
• Overproduction – Preparing products ahead
of time or preparing more than is required
• Examples:
– Requesting additional labs before receiving initial
laboratory results
– Infrequent large batches, farther in advance of use
(utilizing more time and with increased risk of
wasted doses)
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Rework
• Rework – Correcting mistakes/errors,
remaking products
– Examples
• Medications not transferred with patient
• Re-preparing any medication (IV, oral, etc)
• Reordering labs
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Motion
• Motion – Any movement of people that does
not add value
– Examples:
• Staff searching for medications or supplies
• Staff looking for information
• Movement between locations to fulfill orders
(example: ADC fills)
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Over-Processing
• Over-Processing- Excessive processing or
doing more than is minimally required
– Examples:
• Excessive paperwork to meet regulatory
compliance
• Duplicate documentation
• Multiple forms completed with same
information
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Inventory
• Inventory- Maintaining inventory that is more
than the minimum
– Examples:
• Overstocked medications on units or in pharmacy
• Maintaining full automated dispensing cabinets
• Expired medications
Check internal and regulatory policies
requiring minimum required inventory
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Intellect
• Intellect - Failing to use the talent and
knowledge of the organization
– Examples:
• Pharmacists performing technician related tasks
• Performing process improvement without
consulting front line staff members in the process
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
8 Sources of Waste
Transportation
• Transportation – Transporting patients or
materials around an organization that does not
add value to the product or service
– Examples:
• Moving patients between rooms with no added
value
• Travel to storage room to retrieve medications
repeatedly (Medications not located near point of
work)
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Reducing Waste in Pharmacies
• Waste can be reduced through incorporating
continuous improvement principles and Lean
methods
– Standardize work and simplify workflow
• See Future Webinar on ‘5S’
– Utilize visual management
• For quick and easy prioritization of work
– Prevent errors or process failures
– Identify and resolve root causes of problems
– Avoid work-arounds
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Reducing Waste in Pharmacies
• Ensure point-of-care access to information
• Reconsider role of batching medications,
considering just-in-time preparation
– To minimize likelihood of rework or wasted doses
• Simplify processes when possible
• Synchronize steps within workflow
– Implement downstream triggers to signal need for
next step
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Reducing Waste – Root Causes
To achieve improved results:
Determine
Problem
Identify Root
Cause
Change the
Conditions
• Do not address the symptom
• Continue to investigate all sources of waste by
asking “Why?”
– See Webinar on the 5 Why’s
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Operational Pearls
• Examine physical workflow to identify opportunities
to limit motion and transportation related waste
• Limit manual documentation when possible
• Process map various pharmacy process and identify
sources of waste
• Identify technology that can reduce rework, motion,
over-processing, or other sources of waste
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Three Immediate Steps
1. Collect Data regarding frequency of phone calls from
Nursing for missing medications
–
Waiting, Rework, Motion, Intellect, Transportation
2. Examine Batch processing times
–
Waiting, Overproduction, Rework, Motion, Inventory,
Transportation
3. Examine one hour of pharmacy workflow and
document sources of waste
–
Waiting, motion, rework, inventory, transportation
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Thank You
Thank you for joining us for this Pharmacy
Process Improvement Webinar.
Please view our other webinars on pharmacy
operational process improvement, available at
www.plusdeltatech.com
The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.