SVMC Makes Pharmacy Workflow Leaner

When the SVMC Pharmacy Department was fed up with their crowded and noisy work environment they opted to try Lean Quality Improvement methods to see if they could make a difference. They put together a team led by Vice President Dianne Probola and made up of seven pharmacy department staff members. Together they set out to re-design the pharmacy lay-out, improve work flow, remove clutter, and improve the ability of the staff to focus on their work. As part of this effort, they also sought to design a more effective drug inventory management system.

The team first audited their environment, recording a below-average score of 1.5 (out of a possible 6.0). They opted to use the Lean 6Sigma methodology to address the areas of poor performance on the initial audit and completed the following:

• To unclutter their main work space, they moved old pharmacy records off-campus, removed obsolete equipment and extra supplies, and moved file cabinets to back room.
• To make the work space more efficient, they relocated and reorganized supplies using plastic bins and colored filing systems, relocated three work stations, installed a few more staff lockers and changed type of mail boxes, and reorganized the space used for the mini-kitchen.

In addition, they analyzed the distance traveled by the pharmacy technicians when filling medication carts and Pyxis refills. Then by redesigning the workspace and relocating  supplies and medications, they reduced this distance by 72%.

By cleaning out the unnecessary equipment, supplies and records, they opened up more overall space for actual work. They figured out how to separate the work areas of the pharmacists and the technicians so that the pharmacists could be moved to a quieter location. For the type of work they do, it is vitally important to patient safety that they perform their work with as few distractions as possible.

At the end of this phase of the project, the team repeated the 6S audit. In the month following the project the score had improved to 4.2. And now a full year later, the score is a whopping 5.75! This indicates that the improvements made a difference to the staff – and have been maintained.

Lastly, the team evaluated the drug inventory system. They noted at the project start that the pharmacy stocks 2835 different drugs for a total inventory cost of $501,762. They reviewed a 3-month sample of special order drugs and found that the hospital had to spend $7,035 on those orders. They elected to implement a Kanban Inventory Management System, which uses signaling cards to re-order based on usage. In the four months following installing the Kanban system, they did not spend any money on special deliveries of medications.