Transitioning to A LEAN Pharmacy

08 Jan Transitioning to A LEAN Pharmacy

IT’S NEVER OUT OF YOUR HANDS

It’s not hopeless even with PBMs and an ever shifting healthcare landscape. By focusing on what you control great things can still happen within your 4 walls. If you have followed the state of the economy over the last decade, particularly the roller coaster rides taken by some of the world’s largest corporations, then the concept of lean principles is probably familiar to you. The functions that fall under this umbrella term, however, may not be so familiar. On the surface, the idea is fairly simple: Determine what the core functions of your operation are, then take steps to eliminate, mitigate, or reorganize non-value-added activities. The results of this process, in an ideal state, include reduced waste, improved product and service quality, and greater employee and management satisfaction.

Healthcare seems to take a long time to accept and adopt techniques and practices known for years to revolutionize other businesses. One of those techniques has been given the name “Lean”. Lean process improvement is an industry-wide initiative to achieve operational excellence. The lean process approach facilitates improvement of process efficiency and quality while delivering faster service and cost reductions. Originating with the Toyota Production System (TPS) soon after World War II, the concepts of lean implementation are no longer confined to manufacturing. As lean principles became integral throughout the automotive and information technology industries, it was only a matter of time before they began to be adopted by the heath care industry. To health care practitioners, the idea that lean principles could be successfully ingrained into the industry requires no stretch of the imagination. For many years the governing philosophy in health care has been that patient safety should supersede all issues, including-and often despite-economic constraints and waste production. It has taken some time to realize that conscious application of economic principles and reduction of waste is actually concomitant to increased patient safety. The underlying fact is that most operational processes carry the imprint of the inherently fallible human hand. Therefore, making work functions more efficient and productive for staff will result in better quality, value, and service for the customer, or in this case, the patient. This, clearly, is the ultimate goal of any enterprise.

While the name certainly conjures up the healthcare reality of having to do more with less, lean actually represents an orientation to production of goods and services that emphasizes just a few basic principles:

• Lean transformation is a process in which the efficiency, cost and quality of a process are improved by the application of lean principles, principally the reduction of
• Work adds value to a process only if it generates a transformation of the product (the object of the work) at a cost the customer is willing to pay; and if it is done right the first Any other work creates waste.
• Human beings (e.g., workers) are at the core of all successful work-process The human beings that know most about work processes are those who perform the work.
• Work cannot be assessed, critiqued or improved without observing it in situ (what the Japanese call the gemba).
• Work processes that result in rework, require activities that do not directly contribute value or delay or prevent productive work create Waste (muda) is the enemy of an efficient and productive work environment.
• Quality is a key factor in eliminating Quality cannot be inspected into a process at the end; it must be built into each step of the process.

The transformation process involves looking at the current state, imagining and describing the ideal state (according to lean principles) and then creating and implementIng the plan to transition toward the ideal state. Efficiency gains within a pharmacy are not meaningful if they result in waste in the overall work flow; analysis of a process for lean transformation requires the effect of any change to be measured against the upstream and downstream effects of the transformation. Quality improvement is a continuous process. Lean transformation is not a one-and-done phenomenon but represents an ongoing quest for improving the way work is performed. Such a transition does not           necessarily require dramatic, sweeping change. Observation of the current process, implementation of small, systemic transformations and continuous change to improve those processes that appear to be the most wasteful characterize the lean journey. What’s holding you back from starting your journey?

– Rafi Benamoz, CEO, Benamoz Business Entrepreneur Solutionz, rafi@benamoz.com