Background LEAN philosophy in healthcare settings gives emphasis to performance improvement as a means of developing clinical quality and patient safety standards. It takes into account the expenditure of resources and eliminates/reduces waste. Several types of waste have been identified in the medication use process, namely waiting, motion, overproduction, errors, processing and transport.
Purpose To apply LEAN methodology to the medication distribution process in the pharmacy department, in terms of urgent medication requests from the clinical wards in a general hospital in Portugal, in order to improve inefficiencies.
Material and methods The study took place in a hospital pharmacy of an 800 bed hospital in Lisbon. The selected process was the request/distribution of urgent medications to the wards. Nurses complete a paper form and send a healthcare operational (HO) to the pharmacy to be dispensed by the pharmacy technician (PT). The process was divided into several tasks and analysed with a timetable worksheet and spaghetti diagram. The LEAN team measured the times involved in each task, made a value stream map (VSM) and discussed the process. Tasks with no/little value added were identified. New measurements will be done after implementation of the improvement measures.
Results The VSM identified several tasks with no/little value added, such as requests in paper form, multiple transportations, waiting time in the pharmacy of the HO and continuous interruptions of the PT during allocation to other tasks.
These results highlight the need to take appropriate measures, namely online requests and definitions of timetables with specific times for distribution throughout the day by the pharmacy HO. This will eliminate waiting time from the ward HO and reduce the time wasting, motion, processing and errors of the PT.
Conclusion LEAN philosophy can be applied to healthcare systems with gains in performance. It can be highly effective in reducing waste and applying resources to other important tasks.
The pharmacy team recognised the inefficiencies of the current medication distribution process and identified the necessary changes to improve it, releasing healthcare professionals for other specific and value added tasks.
The pharmacy and hospital as a whole are committed to analysing the outcomes and applying LEAN to other activities.
References and/or Acknowledgements LEAN Pharmacy Team.
No conflict of interest.
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