The effect of utilizing Lean tools in a hospital radiopharmacy

Objectives: To outline the method and the effects of using a Quality Improvement (QI) approach on stock, space, motion and time wastes in maintaining a hospital radiopharmacy stocks and supplies.

Methods: QI or Lean tools such as process charts, spaghetti diagrams, Gemba walks, 5S, standard work and Kanban were used to improve supply and workflow in a centralized hospital radiopharmacy. A total of four rooms as well as ancillary storage areas internal and external to the department were affected. Each room was provided with modular-type workstations that had immediately useable materials. Storage location reflected relevancy and frequency of use for each item. ID and maintenance cards were placed on cabinet doors and kept in an electronic system available to all staff. In order to ensure the maintenance of this new reorganization, staff from both radiopharmacy and hospital Central Stores departments were trained throughout the process; the training was tailored to each group through ongoing discussion and trial. Results: In general, both staff groups were satisfied with the reorganization of materials as well as the ease to maintain the new flow of supplies. Staff experienced reduced time to access materials needed, increased speed and accuracy in evaluating need for ordering and less waste due to overstocking. There were less frequent delays and barriers to radiopharmaceutical production which were previously a result of inadequate supplies or inability to locate optimal supplies. Students performing their Radiopharmacy training via 2 - week rotations also found that the new system allowed them to find items faster and provided guidance for re-stocking. The chosen QI tools were adjusted to fit the work environment of a small hospital Radiopharmacy (e.g. fast- paced production runs, single-staff shifts, etc).

Conclusions: In the healthcare system, there are always opportunities to optimize and streamline processes and QI ideologies should be an integral part of every healthcare department. It is important to consider the impact that the cumulative effect of small improvements may have long term not only on the efficiency of the process, but also on the safety for both staff and patients. To ensure that patients are prioritized, it is vital that even apparently negligible wastes are minimized in daily operation.