Pharmacy Process Improvement Series: Improving Pharmacy Process With DMAIC. PlusDelta Technologies, LLC

Transcription

1 Pharmacy Process Improvement Series: Improving Pharmacy Process With DMAIC PlusDelta Technologies, LLC

2 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 %!!

3 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!

4 Variability & Defects Process 3 Process 2 Process 1

5 DMAIC DEFINE CONTROL MEASURE IMPROVE ANALYZE

6 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

7 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

8 The Problem Medica,on order received Pharmacist verifies order Label prints in pharmacy Technician fills order Order delivered 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 Poten,al root causes Due,mes inaccurate or inconsistently entered Lack of visibility into process, staff unaware of priori,es Invalid delivery loca,ons

9 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)

10 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

11 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

12 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

13 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

14 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

15 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

16 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

17 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

18 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

19 Thank You Thank you for joining us for this Pharmacy Process Improvement Webinar. Please view our other webinars on pharmacy process improvement, available at