• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Application of Lean Methodology to Improve Chemotherapy Delivery in a COPS Centre
 

Application of Lean Methodology to Improve Chemotherapy Delivery in a COPS Centre

on

  • 334 views

Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter. ...

Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.

In response to a significantly increasing volume of oncology treatments directed to our centre, we undertook a Lean initiative aimed at streamlining our process and eliminating waste. Significant improvements included virtual elimination of patient wait time for treatments by admixing chemotherapy the afternoon prior to treatment and a mean order processing time decrease from 60 to 30 minutes per regimen by creating electronic standardized chemotherapy order sets.
Better Care

Shannan Neubauer, Katherine Diduck, Kendra Soyka, Sunrise Health Region

Statistics

Views

Total Views
334
Views on SlideShare
334
Embed Views
0

Actions

Likes
0
Downloads
2
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Application of Lean Methodology to Improve Chemotherapy Delivery in a COPS Centre Application of Lean Methodology to Improve Chemotherapy Delivery in a COPS Centre Presentation Transcript

    • Application of Lean Methodology to ImproveChemotherapy Delivery in a COPS CentreKatherine DiduckThis Session is sponsored by:
    • Application of Lean Methodology toImprove Chemotherapy Delivery in aCOPS CentreKatherine Diduck , Presenting AuthorShannan Neubauer , Submitting Author , Presenting AuthorKendra Soyka , Presenting Author
    • 020406080100120140160180200Jan Feb Mar Apr May June July Aug Sept Oct Nov DecNumberofDosesYorkton COPSWorkload20082009201020112012
    • 020406080100120140160180200Jan Feb Mar Apr May June July Aug Sept Oct Nov DecNumberofDosesYorkton COPSWorkload20082009201020112012
    • 020406080100120140160180200Jan Feb Mar Apr May June July Aug Sept Oct Nov DecNumberofDosesYorkton COPSWorkload20082009201020112012
    • 020406080100120140160180200Jan Feb Mar Apr May June July Aug Sept Oct Nov DecNumberofDosesYorkton COPSWorkload20082009201020112012
    • 020406080100120140160180200Jan Feb Mar Apr May June July Aug Sept Oct Nov DecNumberofDosesYorkton COPSWorkload20082009201020112012
    • Current State (Feb 2012)Value Stream MapDayBEFORETreatmentDayOFTreatmentNursePharmacy tech/clerkPharmacistSCA
    • Brainstorming
    • 7Types of Waste9%18%3%6%21%28%15%MotionDefectsOverproductionInventoryProcessingWaitTransportation
    • Proportion ofValue Add vsNon-Value Add Kaizens62%38%Value AddNon-ValueAdd
    • Areas of Influence on the 7TypesofWaste Identified0 10 20 30 40 50 60 70 80 90 100MotionDefectsOverproductionInventoryProcessingWaitTransportationNursingPharmacySCAYRHC
    • JANFEBMARAPRMAYJUNEJULYAUG2012........Day beforetray prepStandardizetray prep....Admix allchemomorning oftreatment....Admix allchemo daybeforetreatment....“Single drug”electronictemplates foradmix sheetsand labels.... Save electroniccopies forpatient’s admixsheets and labels....“Regimenset”electronictemplates foradmix sheetsand labels....WinPharmgeneratedlabels....TaylorWinPharm togenerate 2labels....Scheduleappt perguidelines....Track recallappt toanticipatetreatments.... Sharedelectroniccalendar viaMicrosoftOutlook....Access toSCAdatabase(ARIA)StandardworkStandard work/Reduce wait/MotionReduce wait /Processing /
    • Prior to LEAN…
    • JANFEBMAR2012....Standard work
    • FEBMARAPR2012....Standard work
    • MARAPRMAY2012....Standard work
    • MAYJUNEJULY2012....Standard work
    • AUGJULY2012....?Standard work
    • JANFEBMARAPRMAYJUNEJULYAUG2012........Day beforetray prepStandardizetray prep....Admix allchemomorning oftreatment....Admix allchemo daybeforetreatment....“Single drug”electronictemplates foradmix sheetsand labels.... Save electroniccopies forpatient’s admixsheets and labels....“Regimenset”electronictemplates foradmix sheetsand labels....WinPharmgeneratedlabels....TaylorWinPharm togenerate 2labels....Scheduleappt perguidelines....Track recallappt toanticipatetreatments.... Sharedelectroniccalendar viaMicrosoftOutlook....Access toSCAdatabase(ARIA)StandardworkStandard work/Reduce wait/MotionReduce wait /Processing /
    • Prior to LEAN…
    • MARFEB2012....Standard work
    • MARAPRMAY2012....Standard work
    • MAYJUNEJULY2012....Motion / WaitMar.13Mar.13
    • AUGJULY2012....Motion / WaitMar.12Mar.12Mar.13
    • JANFEBMARAPRMAYJUNEJULYAUG2012........Day beforetray prepStandardizetray prep....Admix allchemomorning oftreatment....Admix allchemo daybeforetreatment....“Single drug”electronictemplates foradmix sheetsand labels.... Save electroniccopies forpatient’s admixsheets and labels....“Regimenset”electronictemplates foradmix sheetsand labels....WinPharmgeneratedlabels....TaylorWinPharm togenerate 2labels....Scheduleappt perguidelines....Track recallappt toanticipatetreatments.... Sharedelectroniccalendar viaMicrosoftOutlook....Access toSCAdatabase(ARIA)StandardworkStandard work/Reduce wait/MotionReduce wait /Processing /
    • Prior to LEAN…
    • JULY2012....WaitTreatment MinutesFluorouracil - 5FU 15Fluorouracil - 5FU/Leucovorin 15Doxorubicin(Adriamycin)/Bleomycin/Vinblastine/Dacarbazine 15Adriamycin/Cyclophasphamide 15Adriamycin(Doxorubicin) 15Aldesleukin (Interleukin) 30Premetrexed 45Bacillus Calmette-Guerin (Intravesical) 45Velcade 45Cyclophosphamide/Methotrexate/Flourouracil(5FU) 60Carboplatin 60Carboplatin/Cyclophosphamide 60Carboplatin/Gemcitabine 60Cisplatin 90Cisplatin/Irinotecan 90Cisplatin/Vinblastine 90Cisplatin/Vinorelbine 90Cyclophosphamide 150Doxorubicin(Adriamycin) 150Epirubicin 150Flourouracil(5FU)/Epirubicin/Cyclophosphamide 150Flourouracil(5FU)/Leucovorin/Irinotecan 150Gemcitabine 150Irinotecan 150Methotrexate 150Octreotide 180Pamidronate 180Topotecan 240Trastuzumab(Herceptin) 240Vinblastine 360Vinorelbine 360Zoledronic acid 360Goserelin 360
    • JULYJUNE2012....Processing
    • AUGJULY2012....Processing / Rework
    • AUG2012..Implementationdate:Feb. 27, 2013.Processing /Standard work
    • Future Kaizens
    • 1) Kanban inventory system
    • 1) Kanban inventory system
    • 1) Kanban inventory system
    • 1) Kanban inventory system
    • 2) Future State Mapping withARIA
    • 3)Value Stream Mapping internaldrug delivery processes
    • Activity+ =-
    • Kotters 8-Step Change Modelhttp://www.acgme.org/acgmeweb/Portals/0/PDFs/2013AEC-Presentations/ses046.pdf/Communicatethe ChangeVisionCreating theChangeVisionEmpowerTeamMembersBuild on theChangeCreateShort-termWins
    • Kotters 8-Step Change Modelhttp://www.acgme.org/acgmeweb/Portals/0/PDFs/2013AEC-Presentations/ses046.pdf/Communicatethe ChangeVisionCreating theChangeVisionEmpowerTeamMembersBuild on theChangeCreateShort-termWins
    • The Global Production System“LEAN House”
    • LEAN Team