1. Optimization of EVS Supplies Stocking Procedure Final Presentation
IOE 481 | W17 | Team 7
Kathy Chen, Eve Gendron, Harneet Singh, Joey Varsanik
April 14, 2017

2. Overview Current Process Key Issues Goals & Objectives Project Scope
Project Approach
Findings & Conclusions
Recommendations
Expected Impact
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

3. Current Stocking Process

4. Key Issues Multiple Trips to Stockroom Inconsistent Usage
Inadequate Stock Levels
Inconvenient Locations
Unknown Inventory Levels
Cleanliness of entire hospital – 3 million sq feet
Broken up to house keepers and stock keepers
The closets are stocked every other day.
Closets contain cleaning supplies which include mostly paper products like paper towels and toilet paper, but also sharp containers, purel, and soap.
Closet in each of the 4 units on the floor, A,B,C,D
Problem: stockouts: creating inefficiencies in the hospital and in the cleaning process

5. Improve Efficiency of Stocking Process
Goals & Objectives
Decrease trips to supply room 2
Decrease instances of inadequate supplies 1
Improve Efficiency of Stocking Process 3
Propose methods for future study
Goal: Create a more efficient stocking process
Objectives
Decrease the number of trips stock keepers take to the supply room
Decrease the number of instances in which closets do not have sufficient supplies
Increase the efficiency of the stocking process
Propose methods for study high rates of supply usage

6. Project Scope Included Excluded 21 University Tower Supply Closets
Replenishing & Stocking Closets
Supply Stocking Process
Placing Supply Orders
Schedule to maintain PAR levels
Creating PAR levels
Plans for Future Studies
Evaluating Other Products & Closets
Priorities floors 4.8

7. Project Approach
Literature Review
Data Collection
Data Analysis

8. Literature Review Exchange Cart & PAR Level Supply Distribution[2]
Just-in-time method
Redesigning the replenishment process with RFID[3]
E-Kanban RFID two-bin replenishment system
A Guide to Improvement Projects: OR Inventory Optimization[4]
Steps to study supply stockage and usage process
Exchange Cart- cart as a central location for all supplies, when empty supply cart is replaced
Steps
Parties involved/needed, deadline
Current State Map
Solution developed through research, requirements, process map, inventory analysis, technical review, & trail

9. Data Collection: Process Times
Closet #
Time to Stock Closet
Time walking to Next Closet
Time to Restock Cart
Time to Stock Floor
Time spent in Elevator
Start Floor
End Floor

10. Data Collection: Elevator Times
Date/Time
Building
Elevator #
Floors Traveled (a to b)
Travel Time (from floor a to b)
# of times kicked out of elevator
Stock keeper

11. Key Findings Time Studies Current State Interviews & Observations
Cleanliness of entire hospital – 3 million sq feet
Broken up to house keepers and stock keepers
The closets are stocked every other day.
Closets contain cleaning supplies which include mostly paper products like paper towels and toilet paper, but also sharp containers, purel, and soap.
Closet in each of the 4 units on the floor, A,B,C,D
Problem: stockouts: creating inefficiencies in the hospital and in the cleaning process

12. Time Studies: Findings
Elevator Times
Time to go down to Supply Room
Time to go up from Stock Room
Mean Time
26.51 mins
17.98 mins
St. Dev.
11.23 mins
11.06 mins
Max
37.74 mins
29.04 mins
Peak Total Trip Time: ~67 mins
Trips to supply groom can be up to 40 minutes round trip
Creates large bottleneck in the efficiency

13. Time Studies: Findings
Current Stocking Period
7am to 4 pm

14. Time Studies: Findings
Elevator Times
Morning
(7am – 12pm)
Afternoon (12pm-5pm)
Evening
(5pm-10pm)
Night
(10pm-5am)
Mean Time
7 mins
4.5 mins
2 mins
1 min
St. Dev.
6 mins
3 mins
0.5 mins
Peak Total Trip Time: ~13 mins
Peak Total Trip Time: ~1.5 mins
Trips to supply groom can be up to 40 minutes round trip
Creates large bottleneck in the efficiency

15. Time Studies: Findings
PEAK ELEVATOR TIMES

16. Time Studies: Findings
Process Times
Stock Closet
Stock Floor
Number of trips to stock room (per shift)
Mean
8.33 mins
42.75 mins
4 trips
St. Dev.
0.15 mins
8.73 mins
1.63
Max
17 mins
52 mins
7 trips

17. Time Studies: Conclusions
Time to Stock Room
Up to 40 mins one way
Elevator peak times
8am-9am & 11am-1pm
Trips to Stock Room
Room to decrease frequency
Process Times
Large St. Dev. due to lack of standardization

18. Current State: Findings
Fix picture

19. Current State: Findings
EVS Management
Peak internal traffic
Stock Keepers
Heaviest stocking shift
Heaviest housekeeping shifts
Housekeepers
We can also take a look at the schedules for the stock keepers and the housekeepers. The stock keepers’ shifts, in green, have their heaviest stocking between 8 AM and 3 PM, as there are 3 stock keepers here that do the majority of the stocking. The house keepers have their heaviest shifts from 11 AM to 7 PM, as seen by the multiple discharge teams and general housek keeping shifts. This visual shows how house keeping shifts overlap with about half of the stock keeping shifts, which could potentially be contributing to the stock leaving closets faster than anticipated.
STATE FINDINGS AND CONCLUSIONS

20. Current State: Conclusions
Shift Overlap
Difficult to track supplies leaving closets
Peak Hospital Hours
Stock keepers main shift
Decision Making
Stock keepers make several decisions
Stockouts
EVS relies on Housekeepers

21. Interviews & Observations: Findings
EVS is not well aware of where supplies goes and how they are used
Stock keepers load up their carts differently
Stock keepers use different logic to determine when to return to the supply room
Model 1: as soon as a certain supply has run out
Model 2: once all closets have been visited
Stock keepers do not know how much of each stock item to stock on their carts
N = 15 hours observations, 10 hours interviews

22. Interviews & Observations: Conclusions
Track Supplies
System to record usage
Inventory
System to know what is needed
Stocking Process
Need standardization

23. Recommendations 1 Standardize Training 2 Switch to Night Schedule 3
Create Runner Position 4
Implement Communication System

24. Recommendation 1: Standardize Training
EVS can create a standardized and more efficient stocking process by:
Virtual Map of Hospital
Visual Management System
Standardize Process- trips to stock room, stocking cart
Document Best Practices
Train with someone who stocks same floors
Record what goes into each closet
Video training Modules
Impact: Reduces variability in stocking process

25. Recommendation 1: Standardize Training
Pros
Cons
Standardizes work based on best practices
Reduces variability of stock times
Minimizes trips to stock room
Increased job satisfaction
Requires strict enforcement
Funding for online modules and maps
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

26. Recommendation 1: Standardize Training
Implementation Plan 1
Hold Focus Groups 2
Create Standardized Workflow 3
Create Online Modules & Maps 4
Retrain Stock Keepers 5
Enforce Standardization
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

27. Recommendation 2: Switch Night Schedule
May want to zoom in on parts
Impact: Save ~50 minutes per shift
Improved tracking of supply usage

28. Recommendation 2: Switch to Night Schedule
Pros
Cons
Closets full at start of housekeeping shifts
Better tracking of supply usage
Decrease time of closet stocking process
Need to adhere to quite hour regulations
Retraining/rehiring
Management has less direct oversight
Does not directly affect stockouts on off days
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

29. Recommendation 2: Switch to Night Schedule
Implementation Plan 1
Pilot Study 2
Retrain Employees 3
Rehire Employees (if necessary)
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

30. Recommendation 3: Create Runner Position
Refill stock keepers carts
Use walkie talkies to communicate
Impact: Eliminate elevator time to stock room
ASK for radio type

31. Recommendation 3: Create Runner Position
Pros
Cons
Runner Absorbs Elevator Time
Stock keepers do not need to make trips to supply room
Runner has to wait for elevator
Stock Keeper may have to wait on Runner
Have to hired another employee
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

32. Recommendation 3: Create Runner Position
Implementation Plan 1
Purchase Radios 2
Hire Runner 3
Train Runner & Stock Keepers
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

33. Recommendation 4: Implement Communication System
PAR Level stock inventory record sheet
Housekeepers record stock they use
Stock keepers gather inventory record sheets
Impact: Stock keepers optimize space on their carts = less trips to stock room
ASK for radio type

34. Recommendation 4: Implement Communication System
Fix picture

35. Recommendation 4: Implement Communication System Cont.
PAR Level stock inventory record sheet
Develop advanced online record system
Administer electronic tablets
Stock keepers record stock taken from closets
House keepers review the used items
Impact: Stock keepers optimize space on carts = less trips to stock room
Microsoft NuVision TM800W610L Signature Edition Tablet [5]

36. Recommendation 4: Implement Communication System
Pros
Cons
Stock Keepers able to fully stock more closets before reloading their cart.
Minimizes trips to stock room
Housekeepers could take advantage of the system.
Increase work for stock keeper to record inventory.
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

37. Recommendation 4: Implement Communication System
Implementation Plan 1
Determine PAR levels 2
Create appropriate record sheet 3
Purchase/Set Up Tablets
Introduction & Background-
Key Issues-
Goals & Objectives-
Project Scope-
Project Approach-
Expected Impact-
Findings & Conclusions-
Recommendations-

38. Recommendations Night Schedule High Training Communication Impact
Runner
Low
Low
High
Effort

39. Expected Impact Increase Efficiency Decrease Supply Shortages
Decrease Trips to Stock Room
Improve Working Environment
Improve Patient Experience
Develop Future Study Methods
Increase efficiency of cleaning process
Decrease in the number of calls from housekeepers for more supplies
Decrease the number of trips stock keepers take to the supply room(s)
Improve the working environment for housekeepers
Improve patient experience
Create ways to study PAR levels and supply usage in the future

40. THANK YOU

41. Michael Alexander & EVS Team
SPECIAL THANKS TO:
Client:
Michael Alexander & EVS Team
Coordinator:
Jonathan Lee
Instructors:
Dr. Van Oyen
Jai Sura

42. References
[1]
[2] Chapter 3: OR Inventory Management. (2011). In Optimizing Your Perioperative Supply Chain: A Guide to Improvement Projects. Ontario: Ontario Hospital Association.
[3] Bendavid, Y., Boeck, H., & Philippe, R. (2010, November). Redesigning the replenishment process of medical supplies in hospitals with RFID. Retrieved from tals_with_RFID
[4] Perrin, R. A. (1994). Exchange cart and par level supply distribution systems: Form follows function. Hospital Materiel Management Quarterly, 15(3), 63. Retrieved from
[5] Tablet/productID
[6]

43. Data Analysis: SIPOC Hospital Stocking Process
Finished: EVS determines amount for next order
Start: Supplies are ordered
Suppliers
Inputs
Process
Outputs
Customers
Stock Keeper
EVS
House Keepers
Stocked Closet
Supply Order
Outage Complaint
Money
Stocked Closet
Outage Complaint
EVS
House Keepers
Supply order is placed
Supplies delivered to loading dock
Supplies transferred to supply room
Carts are brought upstairs to closets
Supplies are organized
Carts are stocked
Closets are stocked
If need more supplies go back to stock room
EVS determines amount to order
House keepers use supplies
Head to next floor
Too busy?
If outage, go and restock