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LEAN HEALTHCARE: Departmental Supply Ordering And Storage

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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  1. LEAN HEALTHCARE:Departmental Supply Ordering And Storage

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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.

  7. ON BOARD WITH LEAN Presentation to Leadership Team • Administration support • Lean Project Request Form • Here to help • Departments invite Lean in

  8. 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

  9. 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

  10. 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”

  11. 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

  12. 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)

  13. SORT • Remove from area unnecessary supplies/equipment • Red Tags/Unneeded Items Log • Staff completed

  14. 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

  15. 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

  16. 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

  17. 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

  18. SHINE • Clean • As you move supplies, the dust will fly

  19. 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% )

  20. BEFORE AFTER

  21. BEFORE AFTER

  22. BEFORE AFTER

  23. BEFORE AFTER

  24. Spread of 5S project EMERGENCY DEPARTMENT • Supplies centralized • Secure • Restocked by Materials • Duplicate orders stopped

  25. 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

  26. Spread of 5S project Med/SurgMed Room Interruption-Free Zone around Pyxis All medication supplies and sharps kept here

  27. Spread of 5S project ORGANIZATIONAL IDEAS

  28. Spread of 5S project Kanban Cards Standardization of Rooms • Device that clearly triggers action • Staff knows where everything is and pars stay set

  29. Sustainability of 5S project results Departmental Follow-up • System promotes adherence to par levels • Changes in supplies • Pars/Update Order sheets • Fire Codes 

  30. Sustainability of 5S project results Difficulties we’ve encountered along the way… • Staffing/Time Constraints • Budget Constraints • Data Collection • Found our way back

  31. QUESTIONS?

  32. 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 – kelty@purdue.edu

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