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Applying lean methodology to improve parenteral chemotherapy and monoclonal antibody documentation processes based on Normalisation Process Theory.
- Source :
-
European journal of hospital pharmacy : science and practice [Eur J Hosp Pharm] 2018 Jan; Vol. 25 (1), pp. 32-37. Date of Electronic Publication: 2017 Jan 02. - Publication Year :
- 2018
-
Abstract
- Objective: To determine the impact of lean thinking on the original time required to prepare the necessary documentation in relation to the preparation of parenteral chemotherapy/monoclonal antibodies.<br />Method: Four pharmacists and one pharmacy technician from the oncology hospital (Malta) all participated in eight focus groups linked to the different constructs of Normalisation Process Theory (NPT): coherence, cognitive participation, collective action and reflexive monitoring. The value stream documentation process was mapped by analysing all steps in the process where each activity must add value for the patient; tools of lean thinking were applied. Points causing delay in processing were considered critical; possible changes to minimise time waste were discussed and implemented. Time spent on critical points was measured by timing in minutes each step of the process 1 month before and after the changes had been implemented and calculating the mean±SD. An audit was performed comparing the process with standard operating procedures to determine whether any steps required quality improvement.<br />Results: Three critical points were identified: time required to search for pharmacy patient medication records for chemotherapy/monoclonal antibodies required on the day; time to generate preparation labels; and time to generate worksheets. Overall, a total of 122±8.6 min (p=0.06) were saved per day, a 37% decrease from the original documentation time. Five deficiencies were identified in the documentation process audit; corrective action was proposed.<br />Conclusions: By applying lean thinking, non-value-added steps leading to time waste in the documentation process were eliminated. This concept could be implemented by using NPT as part of a strategic system to reduce waste.<br />Competing Interests: Competing interests: None declared.
Details
- Language :
- English
- ISSN :
- 2047-9964
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of hospital pharmacy : science and practice
- Publication Type :
- Academic Journal
- Accession number :
- 31156982
- Full Text :
- https://doi.org/10.1136/ejhpharm-2016-001046