d1 dennis jang - movement of charts to pharmany for iv chemotherapy treatment - a lean experience
TRANSCRIPT
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
0
5
10
15
20
25
30
Baseline RPIW Final Week 1 Week 2 Week 3 30 Days 60 Days 90 Days 6 Months 9 Months 1 Year
title
0
5
10
15
20
25
30
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
