FIFO sum, look out Pharmacy Lean we come

1. FIFO sum, look out Pharmacy Lean we come Jane Maloy Chief Technician Northampton General Hospital

2. Workshop/ Presentation • What is Lean • Game 1– be careful you don’t get wet!! • Lean Principles • WORMPIT • Game 2 • 5S • Lean at NGH

3. “A place for everything and everything in it’s place

4. WHAT IS LEAN • Lean is simply a philosophy designed to help organisations systematically identify and eliminate activities and processes that are preventing them from being effective. • ‘Structured common sense’

5. History of Lean • Lean started over 200 years ago • Toyota Production System (TPS) - Toyota’s Chief Production Engineer, Taiichi Ohno. • Reviewed what the company was doing and found that much of it was not adding value to the customer.

6. Using a mechanical example

7. ‘Built ins’

8. Game 1/ Simulation • Customer asks for three full cups of water • Cups 1 – 3 added every 15 seconds. • Time how long it takes • Was the order fulfilled? Any spillage? • How long did it take? • Where are the bottle necks? • How can you improve the process?

9. The 5 Lean Principles • Value – understand what your customer ‘values’ • Value stream - understand how you currently deliver value to your customer • Flow – eliminate bottle necks and constraints so that the value can ‘flow’ • Pull – keep the process flowing by triggering activity only on demand • Perfection – drive for continuous improvement

10. The Hierarchy of Improvement • Eliminate the Non Value Adding activity by getting rid of it completely. • If you can’t eliminate it Reduce the size or impact of the Non Value Adding activity. • If you can’t reduce it, can you Combine it with another activity.

11. WORMPIT/ WASTE • Waiting – waiting for things to start or arrive • Over-Processing (or overproduction) – this is doing more activity than is required or making more items than can be sold. • Rework – also known as correction, this is about repeating activities because of a problem. • Motion (& transport) – motion is the movement of humans and transport the movement of things • Processing waste –this is about doing things that do not need to be done. • Inventory – stacking information, materials or patients. • Talent –misusing the skills of individuals or teams.

12. Key Lean Tools & Concepts • 5S is a tool designed to create a ‘Visual Workplace’. • A place where things are organised logically. • 5S originally came from 5 Japanese words that began with a sound similar to S in English.

13. Game 2 /Simulation • 5S Game • Follow the instructions given. • You must not look at the sheets until instructed and must finish when time is up.

14. 5S • Sort – remove unwanted items from the area to reduce clutter. • Set – set what remains in order and give each item a marked ‘home location’ • Shine – keep the area clean and return items to their ‘home location’ at the end of shifts etc.

15. Standardise – define the responsibilities of Teams and Managers in maintaining standards. • Sustain – audit and improve the area • +1 Safety !!!!!!!!!!

16. Lean at NGH • Staff attended simulation • Worked with Service Improvement Team • Identified area that needed improving. • Dispensing turnaround times from receipt of prescription to completing of checking. • Gathered and recorded data before making any changes. • Quick fixes

17. Current process mapping • Identified key dispensary staff to work with SI team. • Planning and Ideal process mapping • FIFO • Rapid Improvement Event (RIE) • Continue data recording – one week every six months and one day every month.

19. This area was 5S’d on 17th December 2008 Please keep it clean and tidy so that everyone can enjoy it. After Before

20. Ideal Process Mapping

21. Layout of Ideal Process

25. Dispensary Before

29. Achievements • Two Pharmacy staff completed the Improvement Practitioners Programme • Two Pharmacy staff took part in the Lean Associates programme. • Further Lean improvement in Stores and ASU.

30. What now?? • Lean simulation sessions still being held in the Trust and staff encouraged to attend. • Lean in Stores • ‘Milk run’ • Enlarging ASU chemo support room – lean principles being applied to ensure efficient flow of work. • Installation of Pharmacy Tracker – ensure it adds value to the customer. • Ongoing Action Plan……………..

31. Acknowledgements • NGH Service Improvement Team • Chris Albone Service Improvement Manager (for keeping us all focused). • All Pharmacy staff.