Use of Lean Production to Reduce Waste When Compounding Sterile Pharmaceutical Products

Davis, Jennifer

doi:10.1310/hpj4411-974

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…This finding is of great importance for economic efficiency and healthcare sustainability. The studies [ 36 , 39 , 64 , 75 , 80 , 105 ] showed reductions in costs that range from 24% to an extraordinary 179%. For example, one study [ 64 ] reported a decrease of 179%, which is an exceptional improvement in cost efficiency.…”

Section: Reviewmentioning

confidence: 99%

Enhancing Hospital Pharmacy Operations Through Lean and Six Sigma Strategies: A Systematic Review

Sallam

2024

Cureus

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Hospital pharmacies are integral to the healthcare system, and evaluating the factors influencing their efficiency and service standards is imperative. This analysis offers global insights to assist in developing strategies for future enhancements. The objective is to identify the optimal Lean Six Sigma methodologies to improve workflow and quality of hospital pharmacy services. A strategic search, aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, encompassed an extensive range of academic databases, including Scopus, PubMed/Medline, Web of Science, and other sources for relevant studies published from 2009 to 2023. The focus was on management tactics and those examining outcomes, prioritizing publications reflecting pharmacy operations management's state. The quality of the selected articles was assessed, and the results were combined and analyzed. The search yielded 1,447 studies, of which 73 met the inclusion criteria. The systematic review found a low to moderate overall risk of bias. The number of publications rose during the coronavirus disease (COVID-19) outbreak. Among studies, research output in the United States of America represented 26% of the total. Other countries such as Indonesia, Spain, Canada, China, Saudi Arabia, the United Arab Emirates, and the United Kingdom also made significant contributions. Each country accounted for 12%, 8%, 7%, 5%, 5%, 5%, and 5%, respectively. The pharmacy journals led with 26 publications, and healthcare/medical with 14. The quality category came next with 12 articles, while seven journals represented engineering. Studies used empirical and observational methods, focusing on practice quality enhancement. The process control plan had 26 instances, and the define, measure, analyze, improve, and control (DMAIC) was identified 13 times. The sort, set in order, shine, standardize, and sustain (5S) ranked third, totaling seven occurrences. Failure mode and effects analysis (FMEA) and root cause analysis were moderately utilized, with six and four instances, respectively. Poka-Yoke (mistake-proofing measures) and value stream mapping were each counted three times. Quality improvement and workflow optimization dominated managerial strategies in 22 (30.14%) studies each, followed by technology integration in 15 (20.55%). Cost, patient care, and staffing each featured in three (4.11%) studies, while two (2.74%) focused on inventory management. One (1.37%) study each highlighted continuing education, collaboration, and policy changes. Analysis of the 73 studies on Lean and Six Sigma in hospital pharmacy operations showed significant impacts, with 26% of studies reporting decreased medication turnaround time, 15% showing process efficiency improvements, and 11% each for enhanced inventory management and bottleneck/failure mode reduction. Additionally, 9% of studies observed decreased medication errors, 8% noted increased satisfaction and cost savings, 6% identified enhancements in clini...

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Section: Reviewmentioning

confidence: 99%

Enhancing Hospital Pharmacy Operations Through Lean and Six Sigma Strategies: A Systematic Review

Sallam

2024

Cureus

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“…Several studies of drug wastage have revealed the economic dimension of the effect of waste on the health system. [5][6][7] The aim of this study was to assess wastage of drugs used IV and IM in the pediatric emergency department of a tertiary hospital in Turkey and to determine the financial burden imposed by such wastage.…”

Section: Introductionmentioning

confidence: 99%

The status of drug wastage in the pediatric emergency department of a tertiary hospital

et al. 2020

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Background : The aim of this study was to evaluate surplus drugs left over from medications used via the intravenous and intramuscular routes in a pediatric emergency unit of a tertiary hospital in Turkey and to determine the financial burden imposed by drug wastage. Materials and Methods : The study was planned prospectively on patients presenting to the pediatric emergency department of a tertiary university hospital between January 1 and April 30, 2017, on weekdays and between 08:00 and 16:00, for any reason, and receiving intravenous and/or intramuscular drug administration resulting in drug wastage after treatment. Results : The number of patients enrolled in the clinical trial was 1620 (35.9%). Twenty-one different medications were administered via the intravenous or intramuscular (IM) routes during the study. The proportion of total medication wastage at the end of trial was estimated to be 0.425. The drug with the highest proportion of mean wastage to drug form was paracetamol (1000mg vial) at 0.79. The total cost of the drugs used for the patients in the study was US$580.98, and the overall burden of drug wastage was US$288.09. The three medications involving the highest wastage costs were methylprednisolone, ondansetron, and dexamethasone. The total wastage cost/total drug cost ratio was 0.495. Conclusion : If commercial drugs with intravenous and IM formulations are used by the pediatric age group, then dosage formulations appropriate for pediatric age group use also need to be produced. The development by manufacturers of ampoules and similar products suitable for multiple use will also reduce drug wastage. Reducing levels of drug wastage will inevitably reduce the drug expenditure.

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“…Wastage rates in hospitals have been reported as between 16.6% and 28.7% dependent on the types of pharmaceuticals examined, type of hospital, and patient population served. [2][3][4][5][6] Much of this waste stems from batch preparation and scheduled delivery of non-urgent, patient-specific medication. Patient-specific medications make up a high proportion of doses produced by pediatric hospital pharmacies (estimated at 85% for the pharmacy studied) because of weight-based customization.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6][7] Discontinuations result from clinical decisions to stop medication or alter dosage, frequency, administration route, or administration time. In addition, discontinuations occur from patient discharges that were uncertain at the time of medication order placement.…”

Section: Introductionmentioning

confidence: 99%

“…8 This has triggered several hospital pharmacies (pediatric and adult) to initiate efforts to decrease waste, with reductions spanning from 31% to 85%, totaling $60,000 to $426,244 in annual cost savings. [2][3][4][5][6] Many of these interventions focused solely on intravenous medications, not accounting for other types. They were also multifaceted, improving several aspects of hospital-based pharmacy services.…”

Section: Introductionmentioning

confidence: 99%

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Medication Waste Reduction in Pediatric Pharmacy Batch Processes

Toerper

Veltri

Hamrock

et al. 2014

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES:To inform pediatric cart-fill batch scheduling for reductions in pharmaceutical waste using a case study and simulation analysis. METHODS: A pre and post intervention and simulation analysis was conducted during 3 months at a 205-bed children's center. An algorithm was developed to detect wasted medication based on time-stamped computerized provider order entry information. The algorithm was used to quantify pharmaceutical waste and associated costs for both preintervention (1 batch per day) and postintervention (3 batches per day) schedules. Further, simulation was used to systematically test 108 batch schedules outlining general characteristics that have an impact on the likelihood for waste. RESULTS: Switching from a 1-batch-per-day to a 3-batch-per-day schedule resulted in a 31.3% decrease in pharmaceutical waste (28.7% to 19.7%) and annual cost savings of $183,380. Simulation results demonstrate how increasing batch frequency facilitates a more just-in-time process that reduces waste. The most substantial gains are realized by shifting from a schedule of 1 batch per day to at least 2 batches per day. The simulation exhibits how waste reduction is also achievable by avoiding batch preparation during daily time periods where medication administration or medication discontinuations are frequent. Last, the simulation was used to show how reducing batch preparation time per batch provides some, albeit minimal, opportunity to decrease waste. CONCLUSIONS: The case study and simulation analysis demonstrate characteristics of batch scheduling that may support pediatric pharmacy managers in redesign toward minimizing pharmaceutical waste.

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Use of Lean Production to Reduce Waste When Compounding Sterile Pharmaceutical Products

Cited by 5 publications

References 4 publications

Enhancing Hospital Pharmacy Operations Through Lean and Six Sigma Strategies: A Systematic Review

Enhancing Hospital Pharmacy Operations Through Lean and Six Sigma Strategies: A Systematic Review

The status of drug wastage in the pediatric emergency department of a tertiary hospital

Medication Waste Reduction in Pediatric Pharmacy Batch Processes

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