FIFO sum, look out Pharmacy Lean we come

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FIFO sum, look out Pharmacy Lean we come

• Jane Maloy
• Chief Technician
• Northampton General Hospital

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Workshop/ Presentation

• What is Lean
• Game 1 be careful you dont get wet!!
• Lean Principles
• WORMPIT
• Game 2
• 5S
• Lean at NGH

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A place for everything and everything in its
place
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WHAT IS LEAN

• Lean is simply a philosophy designed to help
  organisations systematically identify and
  eliminate activities and processes that are
  preventing them from being effective.
• Structured common sense

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History of Lean

• Lean started over 200 years ago
• Toyota Production System (TPS) - Toyotas Chief
  Production Engineer, Taiichi Ohno.
• Reviewed what the company was doing and found
  that much of it was not adding value to the
  customer.

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Using a mechanical example
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Built ins
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Game 1/ Simulation

• Customer asks for three full cups of water
• Cups 1 3 added every 15 seconds.
• Time how long it takes
• Was the order fulfilled? Any spillage?
• How long did it take?
• Where are the bottle necks?
• How can you improve the process?

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The 5 Lean Principles

• Value understand what your customer values
• Value stream - understand how you currently
  deliver value to your customer
• Flow eliminate bottle necks and constraints so
  that the value can flow
• Pull keep the process flowing by triggering
  activity only on demand
• Perfection drive for continuous improvement

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The Hierarchy of Improvement

• Eliminate the Non Value Adding activity by
  getting rid of it completely.
• If you cant eliminate it Reduce the size or
  impact of the Non Value Adding activity.
• If you cant reduce it, can you Combine it with
  another activity.

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WORMPIT/ WASTE

• Waiting waiting for things to start or arrive
• Over-Processing (or overproduction) this is
  doing more activity than is required or making
  more items than can be sold.
• Rework also known as correction, this is about
  repeating activities because of a problem.
• Motion ( transport) motion is the movement of
  humans and transport the movement of things
• Processing waste this is about doing things that
  do not need to be done.
• Inventory stacking information, materials or
  patients.
• Talent misusing the skills of individuals or
  teams.

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Key Lean Tools Concepts

• 5S is a tool designed to create a Visual
  Workplace.
• A place where things are organised logically.
• 5S originally came from 5 Japanese words that
  began with a sound similar to S in English.

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Game 2 /Simulation

• 5S Game
• Follow the instructions given.
• You must not look at the sheets until instructed
  and must finish when time is up.

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5S

• Sort remove unwanted items from the area to
  reduce clutter.
• Set set what remains in order and give each
  item a marked home location
• Shine keep the area clean and return items to
  their home location at the end of shifts etc.

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• Standardise define the responsibilities of
  Teams and Managers in maintaining standards.
• Sustain audit and improve the area
• 1 Safety !!!!!!!!!!

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Lean at NGH

• Staff attended simulation
• Worked with Service Improvement Team
• Identified area that needed improving.
• Dispensing turnaround times from receipt of
  prescription to completing of checking.
• Gathered and recorded data before making any
  changes.
• Quick fixes

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• Current process mapping
• Identified key dispensary staff to work with SI
  team.
• Planning and Ideal process mapping
• FIFO
• Rapid Improvement Event (RIE)
• Continue data recording one week every six
  months and one day every month.

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This area was 5Sd on 17th December 2008 Please
keep it clean and tidy so that everyone can enjoy
it.
After
Before
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Ideal Process Mapping
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Layout of Ideal Process
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Dispensary Before
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Achievements

• Two Pharmacy staff completed the Improvement
  Practitioners Programme
• Two Pharmacy staff took part in the Lean
  Associates programme.
• Further Lean improvement in Stores and ASU.

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What now??

• Lean simulation sessions still being held in the
  Trust and staff encouraged to attend.
• Lean in Stores
• Milk run
• Enlarging ASU chemo support room lean
  principles being applied to ensure efficient flow
  of work.
• Installation of Pharmacy Tracker ensure it adds
  value to the customer.
• Ongoing Action Plan..

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Acknowledgements

• NGH Service Improvement Team
• Chris Albone Service Improvement Manager (for
  keeping us all focused).
• All Pharmacy staff.