Lean Thinking in Practice
LEAN TOOLS HELP INCREASE CAPACITY, DESPITE RESOURCE CONSTRAINTS
Healthcare
Case Study
Series
Organization Profile
Northern Health Authority (NHA)
has over 7,000 employees and
serves over 300,000 people, with
multiple regional offices and
commercial outlets throughout
Canada.
Project Goals
To identify the scope for efficiency
gains in pharmacy practices and
develop an executable plan to
realise these gains.
Project Timeframe
12 months
Key Deliverables
A framework specifying the
pharmacy processes to be
eliminated, reassigned or
streamlined and the human and
technological resources necessary
to implement these changes.
Leading Edge Group applied its Lean expertise to overcome
resource constraints and increase hospital pharmacy capacity
As part of a program to increase capacity and achieve greater efficiency in its
pharmacy practices, the NHA engaged Leading Edge Group (LEG) to develop a
sustainable framework and executable plan to improve its dispensary processes
through the deployment of Lean thinking and tools.
The NHA was facing human resource challenges. Recruitment of staff across all
disciplines presented a constant challenge and, at the time (December 2011),
over 40% of available positions were vacant. The hospital pharmacies faced
significant resource constraints; many of the smaller hospitals relied on
pharmacy technicians to oversee the operational running of the dispensary,
while pharmacists provided support remotely through the use of videoconferencing technology.
To address these resource constraints, improve efficiency and increase capacity,
LEG worked with NHA on a project charter and scope that aimed to:
 Streamline and standardise pharmacy processes.
 Eliminate duplicated processes and non-value added steps.
 Allow the technician to have greater responsibility, removing the need
for a pharmacist in certain activities.
 Move the pharmacist to the front end of the process.
 Provide a roadmap for progressively improving dispensary processes.
Within the allocated 12 month timeline, LEG delivered an executable
framework that enabled staff to identify and implement process changes,
eliminate waste and deliver measurable savings in processing time and tasks.
“Using Lean, as supported by the Leading Edge Group, we have been able to engage the front line staff in
identifying and implementing process changes that have resulted in measurable improvements. Staff feedback on
the approach has been extremely positive. Senior Executive members have been impressed with the level of
improvement and the degree of engagement by the staff.”
Director of Strategic Initiatives, Northern Health Authority
Lean Thinking in Practice
How was the project implemented?
CURRENT STATE
ASSESSMENT
AND METRICS
KAIZEN
EVENTS
STANDARD
PROCESS
TEMPLATE
The first step involved mapping and
measuring the current state. A Leading
Edge Group consultant assessed the
largest eight pharmacies of the NHA and
mapped the differences in their
processes, including, order receipt, order
entry, dispensing, shipping & receiving,
and inventory management.
The regions of the Health Authority were
then divided into four separate project
teams, based on geographical
considerations. The consultant
conducted a three-day Kaizen event in
each region, which included two
pharmacies per region i.e. all eight
pharmacies were represented.
Following this, metrics were developed
to accurately measure the current
situation. These included key
performance indicators, such as number
of errors made in the dispensing
process, number of medications
returned to the dispensary unused, and
average turn- around time from order
received to order dispensed. Each site
also recorded the number missing or
delayed doses.
The Kaizen events revealed that the
pharmacists were spending the majority
of their time (82% - 88%) checking that
dispensary staff had appropriately
prescribed and dispensed medications.
Having the pharmacist at the end of this
process meant that errors were being
caught at the end of a long process, thus
resulting in high levels of re-work, nonvalue add and waste.
MEASURE AND
REPORT
BENEFITS
This insight allowed LEG to develop a
template for centralising and standardising
processes which focused on eliminating the
duplication of tasks and re-work in the
process. It re-distributed tasks across the
pharmacist and technician roles,
empowering the technician and providing
the pharmacist the necessary increased
capacity to do more clinically appropriate
work.
In addition to intangible benefits, a number
of tangible benefits were measured and
reported including:
• 52% reduction in the number of nonvalue-added items
• 39% reduction in total time spent
processing non value-added items
• 43% reduction in the total number of
memos to pharmacy
• 28% reduction in total time spent
processing memos
•
Lean Terms and Tools
Phrase
Project Charter
Current State Map
Kaizen
Non-Value-Add Activity
LEI GROUP AUSTRALIA
Suite V75/38 Ricketty St.,
Mascot, NSW 2020
Tel: +61 (2) 8004 9470
Mob: + 61 (0)401 608733
Description
A project charter is a statement of the scope, objectives and participants in a project and is a critical document
to ensure that everyone involved in the project is aware of its purpose and objectives.
A graphic illustration of an organization’s current process, enabling one to see where value is added and lost.
Essential to Value Stream Mapping, a primary Lean technique describing the flow of material and information
through a system.
A Japanese term meaning good (“zen”) change (“kai”). A Kaizen event is the tool used to initiate dramatic
change in a short period. It is a facilitated workshop that focuses exclusively on the improvement effort and
the intention is to implement rapid improvement in a targeted work area and/or process
Any activity that does not add value to a product or service from the customer’s perspective.
LEADING EDGE GROUP –
IRELAND
Charter House, 34 Harbour Row,
Cobh, Co. Cork
Tel: +353 21 4855863
LEADING EDGE GROUP –
CANADA
Suite 805, 60 St. Clair Ave East,
Toronto, ON, M4T 1N5
Tel: +1 416 637 5074
FURTHER INFORMATION (AUSTRALIA)
www.leigroup.com.au
[email protected]
LEADING EDGE GROUP – UK
Oxford Centre for Innovation,
New Road, Oxford, OX1 BY1
Tel: +44 (0) 1865 261438