Waste is a serious issue facing the healthcare industry today. The term “waste” can be applied to a number of areas, from wasted resources and finances to wasted time and human potential. Consequently, many hospitals have adopted formal programs to reduce waste and adopt lean thinking in their organizations.
To better identify where and when waste is occurring, here are eight types of waste in healthcare, as described by Mark Graban in his book Lean Hospitals. We have included many examples related to medication management.
- Defects –Time spent doing something incorrectly, inspecting or fixing errors is time that could be spent on more valuable activities. The effort and cost involved in treating hospital-acquired infections is one example. Another is placing medications in the wrong bin in the automated dispensing cabinet (ADC), or the process involved when missing doses occur. If the medication can’t be found in the nursing unit, the nurse must call pharmacy and wait for another dose to be delivered, which takes time away from both pharmacy and nursing, and delays therapy for the patient.
- Transportation – Unnecessarily moving specimens, materials and even patients results in time and energy waste. Poor facility layout contributes to wasteful movement, such as a cath lab being located far from the emergency department. Workflow that causes staff to constantly travel back and forth between the ADC and patient rooms to retrieve medications also creates “transportation” waste.
- Inventory – Improper inventory control or excess ordering of materials such as medications and medical supplies creates spoilage and waste. Too much inventory results in challenges when space is needed for more critical items. It can also lead to expired supplies and medications that must be disposed of, adding to costs.
- Waiting – This type of waste includes the idle, nonproductive time spent waiting for the next event or activity to occur. Examples include patients waiting for an appointment or, as described above, a nurse waiting for pharmacy to replace a missing dose. Delaying a surgical case due to medical supply stockouts is another illustration.
- Overproducing – Doing more than what is needed for the patient is a form of overproduction. A wide variety of activities fall under this category, including conducting excessive or repetitive diagnostic tests or requiring patients to fill out multiple registration forms with personal information as they move through the health system.
- Processing – Similar to overproducing, this form of waste involves performing steps for which the patient receives no direct value . Examples in medication use processes include nurses having to conduct narcotic counts whenever a controlled substance is removed from the ADC, or manual tracking of expiration dates. These tasks all take time away from direct patient care .
- Motion – Nonproductive staff movement such as unnecessary walking, searching, filing, bending and stretching. Nurses walking out of their way due to poor hospital layout and manual reporting systems are two examples.
- Human Potential – Administrative or manual tasks pose an obstacle to fully realizing the talents and contributions of people. Human potential waste also may occur when staff is not engaged, listened to , or supported in their careers. As a result, employees may get burned out and stop giving valuable input for improvement.
Learn More About Lean
Adopting lean thinking has been shown to produce a number of benefits in health care settings, including reducing waste. To learn more about lean concepts and how pharmacy automation complements lean thinking, download our white paper, Lean Thinking in the Pharmacy.