Process Improvement PlanSeptember 24, 2003 AbstractIn examining material management and supply chain systems in the hospitalindustry, unexpected inefficiencies to monitor material usage patterns onhospital units, causes great risk to many processes that are involved inthe healthcare industry on a daily basis. The process necessary to improvesystems involves staff participation in brainstorming and analyzingcriteria for recommending solutions to fine-tune problem areas forenhancing patient care supply chain management.
Process Improvement PlanFailure to maintain adequate supply levels in a healthcare process cancause delays in patient’s care, customer satisfaction, risk to servicingpatients and increased frustration to staff. Processes are implemented infacilities to help minimize the room for error so that individuals workingin the facility can perform task in a consistent, efficient, and optimalmanner, which could ultimately lead to improvement in both distributionefficiency and aggregate cost. Each nursing unit has to order supplies from the purchasing departmentto place on their carts in-order administer and distribute medical suppliesand pharmaceuticals to provide prescribed health care to patients. Thefollowing process is utilized for ordering supplies in a hospital setting:Supplies in which the nurses are responsible for ordering are on the AS400on the computer.
The nurse takes a print out of the supply list and they inventory thestock and then the list is given to the unit secretary for placing in thecomputer. The order request sheet prints in the purchasing department andthe purchasing department fills the request and places them on the unit onthe supply cart. The purchasing department monitors some of the items that are routine,such as toothbrushes, pitchers, toothpaste and etc. when they make theirdaily rounds and perform cart checks. The problem with this orderingprocess is that there has been inadequate stocking of supplies onmedication carts by nurses during shift changes.
One way to gain solutionsto this problem is through brainstorming. Brainstorming is defined as theact of defining a problem or idea and coming up with anything related tothe topic–no matter how remote a suggestion may sound. All the ideas orrecorded and evaluated. Brainstorming can be an effective way to generate lots of ideas andthen determine which idea or ideas best solve the problem. When a facilityis utilizing brainstorming, this should be performed in a relaxedenvironment as if individuals feel pressured, they may not stretch theirminds to full capacity.
Steps to brainstorming:1). Identify the problem. 2). Set time limit for resolutions. 3).
Peer participate through verbalizing issues and possiblesolutions to theproblem. 4). Selected the five major topic for discussion and resolution. 5. ) Select five criteria for evaluate and the best process forproblem containment. 6).
Rate and rank each idea and recommended solution (0-5)7). Choose the idea with the highest ranking as a possible solutionto theproblem. A record should be maintained of all the ideas, incase thefirst idea doesnot work. Another method that could assist the organization in identifying theprevalence of a unit being under stocked is by using the “the Paretoprinciple, “the 80/20 rule” This concept can save you time and money. Inthe world of quality control, the concept is applied to defects. A smallpercentage of root causes are responsible for the majority of the defects.
Data on how often problems occur can be tracked using a bar chart. This cansave an organization time and money by helping its staff to focus on what’smost important and ignoring the distractions. Some of the main areas of inefficiencies are:Medical supply ordering processes were not timely, and follow-up actionwith the host MTF was not effective. The host MTF did not effectivelysupport the reserve unit with required logistics support. Certificates of transfer for medical equipment management officeproperty were not completed for the last 2 account transfers.
Additionally, the annual equipment inventory was not completed in a timelymanner. Timely resolution of equipment discrepancies identified during annualinventories was hampered by incomplete or delayed reports of survey. Documentation indication that medical equipment inventories were completedwithin the required 12 -month period was inconsistent. MEMO inventory was not accomplished during FYs 01 and 00. Designation of the individual responsible for approving InventoryAdjustment Vouchers was not completed in accordance with Vol 5.
Theprevious medical stock record account inventory was not available forreview. A systematic process to review, follow-up and resolve outstandingbackorders for materiel and equipment was not evident. Health care organizations should utilize resources to the better goodof the organization and its consumers so that processes work and not fail,by utilizing a number of approaches. Although changing practice patterns isthe most difficult aspect of any effort to restructure systems,modifications to ensure change and to make the desired practice the path ofleast resistance should be the key factor. This process will be improved to remedy the issue of restockingnursing units by using the, “exchange cart system”. Each cart is restockedto all required Par levels, and taken to the floor on an establishedschedule.
The “used cart” on the floor is exchanged for the correspondingfull one, and the cycle continues. If a nursing unit manager believes thatreserves of a particular item are running low, usually due to the needs ofa particular patient, interim deliveries of a small number of items canusually be arranged. Also, this means that the individual nurse manager isable to set all Par levels, even if an approval process is required toformally alter them. In conclusion, the basics of inventory theory, such as daily userates, variances in use rates, and legitimate estimates of lead-time areall factor necessary in the medical supply chain in delivering services topatients. The two vital partners in the hospital supply chain are nursingand central supply.
The need for a system, which addresses efficiency,maintenance of stock level, must have an efficiency of scale for bothsupplier and customer needs.