waste and value added

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PlusDelta Technologies, LLC

Pharmacy Process Improvement Webinar:Common Sources of Waste in

Healthcare Organizations


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


Sources of Waste

OverproductionProducing too much or

producing too soonTransportation

Any nonessential transport

InventoryMaintaining more

inventory than minimum to get the job done

WaitingWaiting for the next step in the process without added

valueProcessing

Over-processing, unnecessary steps

ReworkCorrecting any errors or doing completion steps

not done before

MotionAny motion that

does not add value

Intellect Failure to fully utilize the time and talents

of people


8 Sources of WasteWaiting

• 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%


8 Sources of WasteOverproduction

• 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)


8 Sources of WasteRework

• Rework – Correcting mistakes/errors, remaking products– Examples• Medications not transferred with patient • Re-preparing any medication (IV, oral, etc)• Reordering labs


8 Sources of WasteMotion

• 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)


8 Sources of WasteOver-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


8 Sources of WasteInventory

• 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


8 Sources of WasteIntellect

• 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


8 Sources of WasteTransportation

• 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)


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


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


Reducing Waste – Root Causes

To achieve improved results:

• Do not address the symptom • Continue to investigate all sources of waste by

asking “Why?”– See Webinar on the 5 Why’s

Determine Problem

Identify Root Cause

Change the Conditions


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


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


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

waste and value added

Documents

common sources of waste

numerous sources of

value time

sources of wastewaitingwaiting

hospital pharmacy

inpatient pharmacy

pharmacy environment

value addedwaste