d1 dennis jang - movement of charts to pharmany for iv chemotherapy treatment - a lean experience

Movement of Charts Movement of Charts to Pharmacy for IV to Pharmacy for IV

Chemotherapy Chemotherapy Treatment -Treatment -

A Lean ExperienceA Lean ExperienceDennis Jang, BSc (Pharm)Dennis Jang, BSc (Pharm)

BCCA – VC BCCA – VC

DISCLOSURE I have no real or potential conflicts to

disclose.

Background Average 70 patients scheduled for Chemo

treatment = 70 charts Pharmacy to clinically checked and release all

charts to ACCU the night before chemotherapy treatment.

Chemotherapy can be delayed or cancelled due to charts not reaching Pharmacy on time = lost treatment slot, lost nursing time.

Wait list for chemotherapy slots, so lost slot = bad.

Daily Management why are charts not checked on time? charts not in pharmacy early enough to

meet deadlines rush, stress, work left over for next

morning possible increase in errors AIM – get more charts to pharmacy before

1 :00 pm

Charts5

9

43

13

Background

Heath Information Systems (HIS)

Is responsible for the tracking and delivery of the charts

Walk the “GEMBA”

Breakdown silos and multidisciplinary brain storming

Team: Pharmacist ,

HIM clerk,

Chemotherapy treatment nurse,

Unit clerk and clerical supervisor,

Lean Facilitator

Chemotherapy Booking Clerk will page HIM clerk for any patients booked for next day chemo after 4:30 pm.

Negotiating with IT to schedule a complete download on a routine basis.

Results

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Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year

title

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Sustainability:Number of charts not received before deadline

Results

Level workload - 25-30% vs 45-55% of charts received before 1:00 pm.

Minimal left over charts to check in AM Nurses have charts in AM to do their clinical

checks Potential to increase capacity in Pharmacy?

Lessons and Next Steps Always walk the “Gemba” Breakdown “Silos” Need higher level support for external

changes Next – apply Lean techniques to

Chemotherapy set up and Preparation

Dennis Jang, BSc (Pharm) Drug Distribution Coordinator, PharmacyBCCA-VC