Friday, July 15, 2022

Reducing Waste in Pharmacy Operations through the Lean Management System (LMS)

When it was time for our Pharmacy department to choose what system to improve next, the decision was unanimous – optimization of the refill process for Omnicell medication dispensing cabinets. 

Staff recognized that some of the settings implemented when Omnicells were deployed in 2019 no longer made sense. Too often, medication would get depleted from pockets (stockouts) before the Pharmacy was able to refill them, leading to potential delays in patient care. Technicians found themselves restocking the same pockets multiple times a week. Imagine going to the gas station every day just to add another gallon to your tank! Finally, low-use medications were stagnating in Omnicells and expiring, generating waste, and using limited Omnicell space.

To address these issues with a systematic approach, the Pharmacy department formed an LMS team and broke down the optimization objective into three goals aligned with GBMC’s four aims. Specifically, these were: 1) Decrease stockouts by 10% (Better Care), 2) Remove low-use items that are not needed for emergencies (Least Waste), and 3) Improve technician work life by reducing rework (More Joy).

The Pharmacy’s LMS team utilized Omnicell analytics and developed their own formulas to optimize stock levels and refill thresholds of high-use items, while reducing or eliminating low-use items. These strategies were applied to a pilot Omnicell on Unit 36. The team then studied the effects of the interventions and used the model for improvement to learn and improve on the initial approaches.

Results: Stockouts decreased by 15.6%. Fifteen low-use items, totaling over $300, were removed from the Omnicell. Average daily restocks decreased by 28%.

The Pharmacy’s LMS team has begun applying this new design to the Omnicell on Unit 45, with the ultimate goal of applying these changes throughout the hospital.

This work is preparing the Pharmacy department to serve the two new units that will come on board with the Promise Project. The team is moving as close as possible toward a cart-less model of medication management. Today, technicians bring medications (in a cart) to inpatient units every day for medications that are not stored in the Omnicells. This LMS initiative helps the Pharmacy team study the current process, and then redesign to create the most efficient system possible. 

What a great example of redesign work to move us closer to our vision! Please join me in thanking our Pharmacy colleagues and LMS teams for this fabulous work!

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