Tools for Hospital Pharmacy Process Improvement

Tools for Hospital Pharmacy Process Improvement

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Abstract

With increasing operation costs, patient safety awareness, and a shortage of trained personnel, it is becoming increasingly important for hospital pharmacy management to make good operational decisions. In the case of hospital inpatient pharmacies, making decisions about staffing and work flow is difficult due to the complexity of the systems used and the variation in the orders to be filled. Pharmacy turnaround time is a crucial metric for patient safety and caregivers’ satisfaction. Pharmacy management is under constant demand to reduce turnaround time. In order to help The Methodist Hospital Pharmacy Management make decisions about work flow, a team was created to analyze the impact of an alternate work process. The team examined the impact of the process and work flow changes on the amount of time medication orders take to be processed. The goal is to help the pharmacy management team find the best process and workflow to get medications to the patients as quickly as possible. Systems Thinking and Kaizen are used as tools to achieve that goal by using pharmacy staff effectively and make the process more efficient.

The pharmacy division’s initial goals for 2006-07 were to increase patient safety by improving turnaround time (TAT) by 25% for the preparation, dispensing, and delivery process for first dose medication orders. Improved TAT means that the patient receives medication when he or she needs it without delay, thus ensuring optimal, timely, and safe administration of the medication. The goals changed after the data were analyzed by lean team using the value-stream map. Systems Thinking (thinking transformation) and Kaizen (continuous improvement) were the principle means which demonstrated marked improvement.

Six pharmacists and four technicians were selected as a “Lean Team”. A systems thinking & Kaizen workshop, using a group model-building approach, was held for three days. A facilitator introduced the qualitative system dynamics approach, which would be used for finding a way to make sense of the complex relationships and work flow.