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Transcript of Pharmacy Process Improvement Series: Improving … final with recording1.pdf · •...
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Pharmacy Process Improvement Series:
Improving Pharmacy Process With DMAIC
PlusDelta Technologies, LLC
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Six Sigma
• Six Sigma – Data driven methodology for improving a process
• Improve the quality of process outputs – Iden,fy and eliminate defects or errors within a process – In most environments, DMAIC is undertaken to reduce costs, improve profit or improve customer sa,sfac,on
• The term “six sigma” refers to a process that produces less than 3.4 defects per million opportuni,es
The Goal is 99.9937%!!
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
DMAIC
• One type of Six Sigma methodology – Used to ensure quality within an exis,ng process – A data driven improvement cycle
• An easily managed systema,c process to deliver measurable results and accelerate change
Reduce Varia+on and Defects!
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
Variability & Defects
Process 1
Process 2
Process 3
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
DMAIC
DEFINE
MEASURE
ANALYZE IMPROVE
CONTROL
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
DEFINE
• Define the business case • Iden,fy the problem or key issue
• Write a problem statement • What does the “customer” want you to address? • What is cri,cal to quality (CTQ)? • Define scope, objec,ve and goals of the project • Develop the ini,al high-‐level process map
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
DEFINE -‐ Example
• Hospital ABC’s Inpa,ent pharmacy has iden,fied that their ability to deliver medica,ons on-‐,me or deliver STAT medica,ons within 30 minutes is inconsistent • Nursing sa,sfac,on is falling as a result • Pa,ents not receiving medica,ons in ,mely manner in some cases
• Problem: • Failure to deliver medica,ons on ,me results in increased nursing workload, increased costs due to missing medica,ons, and wasted produc,vity.
• In order to reduce missing medica,ons and improve produc,vity, medica,ons need to be consistently delivered on-‐,me
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
The Problem
Iden,fied failure modes (FMEA) – Incomplete or inaccurate orders
on admission, requiring pharmacist interven,on to correct
– Due ,mes inaccurate or inconsistently entered as part of order
– No tracking of delivery process – Mul,ple and invalid delivery
loca,ons
Medica,on order
received
Pharmacist verifies order
Label prints in pharmacy
Technician fills order
Order delivered
Poten,al root causes – Due ,mes inaccurate or
inconsistently entered – Lack of visibility into process,
staff unaware of priori,es – Invalid delivery loca,ons
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
MEASURE
• What are the core metrics for the problem? • Define each metric, as well as baseline for each metric
• Map out the current state of the process • Avoid mapping out the process as it should be or as it is assumed to be
• Include individuals with a good working knowledge of the process and how it works
• Addi,onal useful tools: SIPOC (see our webinar on SIPOC)
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
ANALYZE
• Analyze all relevant data and process maps • Summarize inves,ga,ons • Summarize root cause analysis • Validate root cause if appropriate • Determine what can be explained vs what is s,ll not fully understood
• Numerous tools may be useful: 5 Whys, run charts, cause and effect diagram
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
MEASURE AND ANALYZE
• Data was collected randomly across 3 months which were representa,ve of typical volume, staffing
• While the majority of medica,ons are delivered prior to the due ,me, 42% of medica,ons were not delivered on ,me
• Further analysis demonstrated that medica,ons prepared in the IV room represented ~60% of the medica,ons that were delivered aoer the due ,me
• The range for late deliveries was between 1 min and 75 minutes past due ,me
• Staff were completely unaware of where medica,ons were in the process and thus were unable to move medica,ons to the next step in the process
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
IMPROVE
• Brainstorm poten,al solu,ons • Evaluate cost, complexity, benefit, risk • Priori,ze solu,ons (long term vs interim solu,ons)
• Communicate an implementa,on plan • Implement solu,on • Assess solu,on effec,veness
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
IMPROVE
• A good solu,on… • Is well understood and supported by the organiza,on • Addresses the issues of problem containment and focuses on preven,on and elimina,on of non-‐value-‐added ac,vi,es
• Maximizes the effec,veness of the solu,on while minimizing complexity and cost
• Is durable, thus remains effec,ve for an extended period of ,me
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
IMPROVE
• Standardize process with technology support • Con,nuous monitoring of process • Just-‐in-‐,me medica,on prepara,on and delivery
• Accurate due ,mes entered into pharmacy informa,on system
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
CONTROL
• Iden,fy opportuni,es for standardiza,on • Determine stability of the solu,on • Determine controls • Realize the benefits of the solu,on • Debrief/reflect on the improvement process
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
CONTROL
• Standardiza,on ooen provides the greatest benefit to the organiza,on
• Numerous types of controls • Measurement based (scorecard) • Documenta,on (process flow, writen procedures) • Design (error-‐proofing) • Periodic Checks (scheduled maintenance) • Incen,ves
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
CONTROL
• Implemented technology solu,on that incorporated: • Real-‐,me scorecard/dashboard • Ensures visibility into the process and drives standardized process
• Incorporated educa,on of staff on delivery process
D M A I C
The informa,on contained in this presenta,on, the source code and underlying program are protected by copyright owned by PlusDelta Technologies, LLC.
SUMMARY
• DMAIC is an effec,ve method to improve exis,ng processes within an organiza,on – Systema,c approach – A data driven improvement cycle
• More detailed informa,on regarding the use of Six Sigma and LEAN in pharmacy opera,ons will be provided in future webinars
The informa,on contained in this presenta,on, 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 process improvement, available at
www.plusdeltatech.com