1. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. PlusDelta Technologies, LLC Pharmacy Process Improvement Webinar: Common Sources of Waste in Healthcare Organizations

2. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Waste and Value Added Waste – defined as any activity that does not add value to the service or product provided – Adds to the cost of operations – Impairs ability to meet core performance metrics – Decreases customer satisfaction Successful adaption of continuous improvement principles can reduce waste and non-value added activities Successful adaption of continuous improvement principles can reduce waste and non-value added activities

3. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Sources of Waste Overproduction Producing too much or producing too soon Transportation Any nonessential transport Inventory Maintaining more inventory than minimum to get the job done Waiting Waiting for the next step in the process without added value Processing Over-processing, unnecessary steps Rework Correcting any errors or doing completion steps not done before Motion Any motion that does not add value Intellect Failure to fully utilize the time and talents of people

4. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Waiting Waiting – Any idle time in the process that would be considered non-value time. – Examples Nursing waiting for medications Pharmacist waiting for medications to be prepared before checking product Patients waiting for discharge paperwork to be completed. Waiting may constitute up to of the cycle time of a process Waiting may constitute up to of the cycle time of a process 90%

5. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Overproduction Overproduction – Preparing products ahead of time or preparing more than is required Examples: – Requesting additional labs before receiving initial laboratory results – Infrequent large batches, farther in advance of use (utilizing more time and with increased risk of wasted doses)

6. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Rework Rework – Correcting mistakes/errors, remaking products – Examples Medications not transferred with patient Re-preparing any medication (IV, oral, etc) Reordering labs

7. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Motion Motion – Any movement of people that does not add value – Examples: Staff searching for medications or supplies Staff looking for information Movement between locations to fulfill orders (example: ADC fills)

8. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Over-Processing Over-Processing- Excessive processing or doing more than is minimally required – Examples: Excessive paperwork to meet regulatory compliance Duplicate documentation Multiple forms completed with same information

9. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Inventory Inventory- Maintaining inventory that is more than the minimum – Examples: Overstocked medications on units or in pharmacy Maintaining full automated dispensing cabinets Expired medications Check internal and regulatory policies requiring minimum required inventory Check internal and regulatory policies requiring minimum required inventory

10. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Intellect Intellect - Failing to use the talent and knowledge of the organization – Examples: Pharmacists performing technician related tasks Performing process improvement without consulting front line staff members in the process

11. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. 8 Sources of Waste Transportation Transportation – Transporting patients or materials around an organization that does not add value to the product or service – Examples: Moving patients between rooms with no added value Travel to storage room to retrieve medications repeatedly (Medications not located near point of work)

12. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Reducing Waste in Pharmacies Waste can be reduced through incorporating continuous improvement principles and Lean methods – Standardize work and simplify workflow See Future Webinar on 5S – Utilize visual management For quick and easy prioritization of work – Prevent errors or process failures – Identify and resolve root causes of problems – Avoid work-arounds

13. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Reducing Waste in Pharmacies Ensure point-of-care access to information Reconsider role of batching medications, considering just-in-time preparation – To minimize likelihood of rework or wasted doses Simplify processes when possible Synchronize steps within workflow – Implement downstream triggers to signal need for next step

14. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Reducing Waste – Root Causes To achieve improved results: Do not address the symptom Continue to investigate all sources of waste by asking Why? – See Webinar on the 5 Whys Determine Problem Identify Root Cause Change the Conditions

15. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Operational Pearls Examine physical workflow to identify opportunities to limit motion and transportation related waste Limit manual documentation when possible Process map various pharmacy process and identify sources of waste Identify technology that can reduce rework, motion, over-processing, or other sources of waste

16. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Three Immediate Steps 1.Collect Data regarding frequency of phone calls from Nursing for missing medications – Waiting, Rework, Motion, Intellect, Transportation 2.Examine Batch processing times – Waiting, Overproduction, Rework, Motion, Inventory, Transportation 3.Examine one hour of pharmacy workflow and document sources of waste – Waiting, motion, rework, inventory, transportation

17. The information contained in this presentation, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC. Thank You Thank you for joining us for this Pharmacy Process Improvement Webinar. Please view our other webinars on pharmacy operational process improvement, available at www.plusdeltatech.com