Pharmaceuticals can be expensive, and certain drugs can be critical to a patient’s health and must always be kept on hand in large hospital facilities. This dynamic coupled with the variability for patient demand can lead to health systems having to destroy expired inventory. As part of a lean yellow belt, a pharmacy teamed learned lean techniques and methodologies to tackle this issue.
As with most lean projects, scope is incredibly important, and it was especially true in this case as there are thousands of medications, which all have an expiration date. The team initially narrowed their scope down to high interest of; high cost, critical importance, and high volume/use frequency.
Choosing the high-cost route, the team indentified one expensive narcotic for scope. This drug was stocked both on the inpatient units, and was delivered from a larger stock in the pharmacy. It also had a rapid expiration. They next collected data from the automated inventory systems to verify this particular pharmaceutical was a good scope solution.
Once there was waste reduction verified by metrics, and data was found readily available, the team then dived into how the process worked. To do this, the team developed the following process map and found the focus point for their project.
Through several PDSA cycles involving both setting par levels and adding logic re-order triggers, the team developed a new order process aimed at reducing the total monthly destruct ions. Once implemented, the team reduced their average monthly destructions by 64% (from 24.8 to just 9), achieving valuable savings. This also led to a plan to analyze other drugs with the same lean approach.
