An application of lean healthcare tools to improve management capability in a teaching hospital clinical pharmacy service

Abstract

Background: The pharmacist's profession has gone from a dispensary-based function for the provision of clinical services. So that, we must consider the importance of management inserted in the clinical routine in order to ensure success of the professional actions of pharmacist in the care process. To identify opportunities for the best use of the clinical pharmaceutical resource in hospitals requires understand how such resources are effectively consumed by patients. Objectives and Methods: This study applied Lean principles and tools aiming to understand how clinical pharmacists’ resources are effectively consumed by the patients in an academic hospital, using tools such as value stream mapping, the time of the professional involved in those activities, the value-added based activity and activity designation matrix. The data was mainly obtained through interviews with the professionals, time-motion observational studies, chronoanalysis and meeting with head of the sector. Results: The clinical pharmacy services have its value stream map designed considering the relationship of the activities and added-value based. Exploring the map, it is demonstrated that the activity “clinical round” is the most time consuming (27%) is not necessarily considered as value-added for both parts. In addition, there is a long time dedicated to activities that are not identified as valued activities by the pharmacists, and also activities of high value to patient being performed and monitored by trainees. Conclusion: Lean healthcare may become a truly positive force once it encourages reflection of the activities performed by the pharmacist professional in a hospital which works in a patient oriented-based care.