Lean healthcare departmental supply ordering and storage
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LEAN HEALTHCARE: Departmental Supply Ordering And Storage. How the Journey Started…. IRHA offered the opportunity for member hospitals to participate in Lean Training in the 2011 -2012 cycle. Woodlawn Hospital sent 5 people to Yellow Belt training, 1 person to Green Belt t raining

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LEAN HEALTHCARE: Departmental Supply Ordering And Storage

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Lean healthcare departmental supply ordering and storage

LEAN HEALTHCARE:Departmental Supply Ordering And Storage


How the journey started

How the Journey Started…

IRHA offered the opportunity for member hospitals to participate in Lean Training in the 2011 -2012 cycle.

Woodlawn Hospital sent

5 people to Yellow Belt training,

1 person to Green Belt training

1 person to Black Belt training


By the numbers

By The Numbers…

  • 20 critical access and rural hospitals from across the state participated in this project in its entirety

  • 3 Focused Project Areas:

    • Emergency Department Throughput (8 hospitals)

    • Transitions of Care (9 hospitals)

    • Readmissions (3 hospitals)

  • 7 different hospitals used as training locations


By the numbers1

By The Numbers…

  • 85 people attended a 1-day Executive Training Workshop

  • 53 people attended at least one of the pre-training webinars

  • 140 people attended the 4-day Yellow Belt Trainings

  • 41 people attended the 2-day Green Belt Trainings

  • 20 people attended the 1-day Black Belt Training


Lean certification project

Lean Certification Project

  • Woodlawn Hospital, Rochester

    ED Patient Throughput

    • Discharge Summary revision, testing, staff education completed. Staff pleased with the easier format and can more thoroughly document in the available text box.

    • ED Assessment forms have been shortened from 6 pages to 2-3 pages each

    • ED Log data entry by ED staff decreased by 100% due to new automated ad hoc reports


Moving forward

Moving Forward...

Woodlawn Hospital has made a conscious effort to continue using Lean methodologies and tools to make a difference in our hospital since the completion of the original ED project.


On board with lean

ON BOARD WITH LEAN

Presentation to Leadership Team

  • Administration support

  • Lean Project Request Form

    • Here to help

    • Departments invite Lean in


5s project pilot ob

5S PROJECT PILOT- OB

Project Request: Supplies

  • Trouble getting supplies returned

    • Yellow sticker system

  • Issues with par levels

  • Supplies in multiple locations, some not near point of use

  • Special request items not included in sticker system that nursing staff has to track and order


First things first

FIRST THINGS FIRST

  • Compile team

    • OB Manager, Materials Management Director, Materials clerk, OB nurses (as available during their shift)

  • Education of project team

    • Lean

    • Changes made with them, not to them

    • Quick Overview of 5 S for Nurses


Data collection

DATA COLLECTION

Voice of the Customer/Stakeholder (VOCS)

  • Interview those closest to the process

    • Nursing staff

    • Comments

      • “Not enough storage space”

      • “We don’t get supplies returned very well”

      • “Delay patient care until the item is located”


Data collection continued

DATA COLLECTION, continued

  • Process Flow Map

    • Time spent on inventory, ordering, restocking supplies

      • OB staff spent 146 min/week

        • Materials spent 47 min/week

  • Time to Find 5 Items

    • OB nurses: 50.1 seconds

    • Non-dept staff: 7 min 11.8 sec

  • Take “Before” pictures


Lean healthcare departmental supply ordering and storage

5S

  • Simple process of organizing supplies/equipment for improved workflow and better use of resources

  • Sort:

    • All unneeded items, equipment, supplies removed from area

  • Set in Order:

    • A place for everything, everything in its place

  • Shine:

    • Keep items and the work area clean

  • Standardize:

    • Apply methods consistently across all areas

  • Sustain:

    • Becomes a part of the culture (this is the difficult part)


Lean healthcare departmental supply ordering and storage

SORT

  • Remove from area unnecessary supplies/equipment

    • Red Tags/Unneeded Items Log

      • Staff completed


Sort continued

SORT, continued

  • Comparison of current stock and par levels with annual usage report to identify over-stocking

    • Established a 3-day par

      • Restock M, W, F (3 days gets through weekend)

    • Consider staff feelings and experience


Set in order

SET IN ORDER

  • A place for everything and everything in its place

    • Nursery items remained in the nursery

    • Medication supplies remained by the Pyxis

    • Supplies were restocked from six locations

      • Decreased to two

      • Supply remains at point of use, but is stocked from central location

    • Looked at how items are distributed from Materials

      • Syringes-- Box v. Each


Standardize

STANDARDIZE

  • Methods applied consistently

    • Color coding established hospital-wide

    • Requisition list cleaned up

      • Eliminate unused products

      • Reassessed special order items

        • If ordered frequently, move to stock


Sustain

SUSTAIN

  • Part of the culture

    • Communication Board

    • Bins used allowed for just enough space for par levels set

      • Adjust pars as necessary

      • Give staff a voice


Shine

SHINE

  • Clean

    • As you move supplies, the dust will fly


The results

The Results

  • Return of supplies in OB totaled $1,545

  • Time spent on supply management (weekly)

    • OB: 146 min decreased to 5 min

    • Materials: 64 min increased to 111 min

    • 40% decrease in total time spent in all dept

    • Shift from Nursing staff to Materials clerk (better use of talent)

  • Time to Find 5 Items

    • OB Nurses from 50.1 sec to 43.7 sec (12.77% )

    • Outside Staff from 7 min 11.8 sec to 74.8 sec (82.68% )


Lean healthcare departmental supply ordering and storage

BEFORE

AFTER


Lean healthcare departmental supply ordering and storage

BEFORE

AFTER


Lean healthcare departmental supply ordering and storage

BEFORE

AFTER


Lean healthcare departmental supply ordering and storage

BEFORE

AFTER


Spread of 5s project

Spread of 5S project

EMERGENCY DEPARTMENT

  • Supplies centralized

  • Secure

  • Restocked by Materials

    • Duplicate orders stopped


Spread of 5s project1

Spread of 5S project

Med/Surg

  • Created a centralized supply room

  • Med Room

  • Previously 8 areas for supplies

  • Decreased to 2 and restocked by Materials, not Nursing

  • Able to return a patient room to patient care from equipment storage


Spread of 5s project2

Spread of 5S project

Med/SurgMed Room

Interruption-Free Zone around Pyxis

All medication supplies and sharps kept here


Spread of 5s project3

Spread of 5S project

ORGANIZATIONAL IDEAS


Lean healthcare departmental supply ordering and storage

Spread of 5S project

Kanban Cards

Standardization of Rooms

  • Device that clearly triggers action

  • Staff knows where everything is and pars stay set


Sustainability of 5s project results

Sustainability of 5S project results

Departmental Follow-up

  • System promotes adherence to par levels

  • Changes in supplies

  • Pars/Update Order sheets

  • Fire Codes 


Sustainability of 5s project results1

Sustainability of 5S project results

Difficulties we’ve encountered along the way…

  • Staffing/Time Constraints

  • Budget Constraints

  • Data Collection

    • Found our way back


Questions

QUESTIONS?


Lean healthcare departmental supply ordering and storage

Dawn Gabrich, MS, ATC, LAT – Rehabilitative Services Coordinator – Lean Black Belt - Woodlawn HospitalCarrie Bowers, MBA – Senior Accountant – Lean Green Belt - Woodlawn Hospital Sheila Kelty, DHA, FACHE – Lean Six Sigma Black Belt - Purdue Healthcare Advisors – [email protected]


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