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Reducing Stock-Outs in MD Anderson Cancer Center’s Outpatient Clinics. Speaker: Kaycee Wilson, Quality Engineer. David Bivens , Caitlin Byler, Rachel Douglas, & Kaycee Wilson. Supply Availability Project Teams. Current Inventory Management Process. Clinic Close. 1.

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reducing stock outs in md anderson cancer center s outpatient clinics

Reducing Stock-Outs in MD Anderson Cancer Center’s Outpatient Clinics

Speaker: Kaycee Wilson, Quality Engineer

David Bivens, Caitlin Byler, Rachel Douglas, & Kaycee Wilson

current inventory management process
Current Inventory Management Process

Clinic Close


Note: Items Received were Ordered Night Before

Clinic Open



Note: Those orders arrive the next evening



new supply process objectives
New Supply Process Objectives
  • Quantitative Objectives
    • Minimize: Stock-outs ( Patients Denied Care )

Subject to:

      • Available Space
      • Available Labor
      • Inventory Cost
  • Qualitative Objectives
    • Ease of Use
    • Ease of Implementation
    • Ease of Sustainment
process observation and analysis
Process Observation and Analysis
  • Four inventory process areas were identified for improvement efforts
    • Level Setting
    • Reorder Signal
    • Reorder Quantity
    • Business Roles
baseline analysis
Baseline Analysis
  • Level Setting
pilot solution level setting
Pilot Solution Level Setting
  • There are two numbers important for level setting
    • Reorder Point
      • Based on a one day delay between order and actual delivery
      • Calculated with historical ordering data by material reps
      • Calculated based on items pulled from the warehouse
      • Derived using statistical analysis yielding stock-out risk
    • PAR Level
      • Based on current workload

1. PAR Level

2. Reorder Point

baseline analysis1
Baseline Analysis
  • Reorder Signaling
baseline analysis2
Baseline Analysis
  • Order Quantities

The materials rep will have to put the number remaining in the bin in the handheld.

pilot solution order quantities
Pilot Solution Order Quantities
  • Always order the same amount

Always order about ½ bin size

baseline analysis3
Baseline Analysis
  • Business Roles
    • Materials Management
      • Responsible for responding to clinic requests for par changes
      • Responsible for order and delivery of supplies
    • Clinics
      • Responsible for setting the inventory level of each item
pilot resupply process and business roles



Daily Clinic Usage

Pull the card when the supply level is at or below the tapeline

Place the card in the low stock bin

Pilot Resupply Process and Business Roles



Low Stock

Pull the card when you use the item

Nightly Replenishment





Deliver supplies & make sure that the waterline holds the “reorder point” quantity

Put all cards in the ordered bin back on delivered item bins

Scan the barcode on the back of the card and enter the handheld # in handheld. If you have to pull the quantity from the warehouse, pull the warehouse # amount

Pull out all of the cards in the “low stock” bin

! Note


Place scanned cards in the “ordered” bin

Back of Card

par setup process and business roles
PAR Setup Process and Business Roles

Clinical Team


Approve/Disapprove suggested removal of items

Materials Management Team



Request approval for removal of low usage items from Par (Red Tagging)



Reorganize closet with nursing feedback

Reset levels

Put in waterlines

and adjust preset levels

Card Slot





Reset Par in handhelds

Create Stock Cards

**Blue boxes represent steps requiring tool created by OPI

tapeline setting fixed ordering methodology2
Tapeline Setting & Fixed Ordering Methodology
  • Undershoot **
  • Fixed Order Quantity

**See References Slide

summary of assumptions
Summary of Assumptions
  • Objective – stock-out minimization
    • Carry a minimum of two days on hand
  • Constraints – labor, space, and budget
    • Increase the days on hand to meet labor standards
  • Distribution of daily demand - normal
    • Set reorder points according to a normal distribution
  • Daily supply usage
    • Estimate daily demand using work days between ordering instances
future work
Future Work
  • Pedi – Child & Adolescent Center
  • Cardiopulmonary Center
  • Breast Center
  • Leukemia Center
  • Clinical & Translational Research Center