Lean in clinics and hospitals Part-II

Let is see how Lean can be used to improve the processes.

 

The operational excellence methods used to discover the best inventory control system and distribution model within a hospital or healthcare network range from simple and inexpensive to complex and costly.

                

                              Decisions in favor of any one approach require that the issue is tackled across the board by supply-chain and clinical leadership. Four elemental concepts and methods used in continuous improvement are: 5S, par-level balancing, consolidating storage locations, and automation and technology.

 

5S:

5S is a basic method of reducing waste and one of the fundamental principles of a lean environment and an effective material management system.

 

The five S’s stand for:

 

1. Sort : The basic housekeeping step of sorting a work area or storeroom to remove all unnecessary items unrelated to the function of that area. For example, a medical supply room should have all the materials required to replenish the area(s) assigned to it. It does not need to stock printer cartridges or old IV pumps. These are considered “waste” for that specific area.

 

2. Set : Once all waste has been removed, the remaining items must be organized. “Setting” involves grouping supplies by type or amount of usage, and labeling or assigning a specific location for them. This step is considered complete only when the area has become self-explanatory—i.e., anyone should be able to enter the work area and understand what goes where.

 

3. Shine : Now that unnecessary items and materials have been removed, and everything has an identified and assigned location, it’s time to clean the area to establish the baseline expectation. This describes the basic layout that this area should maintain so that when something is out of place or an unrelated item comes into the area, it can be easily identified and removed.

 

4. Standardize : This step involves educating staff about the new work area and replicating this throughout a unit, department, or system.

 

5. Sustain : To maintain the benefits and efficiency created from an effectively designed work area, audits must be performed to ensure and enforce compliance with the baseline expectations.

 

A concept related to lean and just-in-time (JIT) production, where a signal triggers a pull system action.

 

Typically, paper or stock cards are used as the signal when an item is needed. As a bin becomes empty, this card becomes visible and is taken by a material handler and used as the order for that specific location and item. Unfortunately, there is significant manual resource needs to ensure cards are correct, updated, and are replaced if lost.

 

All these solutions can interface with ERP systems to provide inventory data and visibility throughout a hospital. Apart from the wealth of knowledge available from data visibility, the main benefit is eliminating the need for material management and clinical staff to track and manage inventory; this is now performed autonomously in real time.