May 21st, 2020 at 10:30AM AEST
By Gerard Stevens AM B.Pharm, FPS, AACPA, FASCP*
One of my guiding principles has its roots in the assembly lines and corporate meeting rooms of post-war Japan. ‘Kaizen’ describes the process of continuous quality improvement. It is the belief that everything can be improved through ongoing trial and error. A ripple from the smallest positive change can create a flow that achieves the most productive and cost-efficient processes across an organisation.
I was first introduced to Kaizen by a manufacturer who described how a machine operator becomes 'as one' with the machine. The operator can pick the slightest change to the rhythm or sound. Allowing them to intervene early, which can be crucial to prevent a bad batch or a machine failure.
So what does a post-war Japanese industrial concept have to do with pharmacy? Eliminating issues within any process improves productivity and output. This means fewer recalls and a corresponding reduction in costs. Quality therefore costs less. It makes sense to me.
The concept of Kaizen offers similar applications in pharmacy. We get into a zone of concentration – being totally in the moment – where we can almost intuitively identify when something is out of the ordinary, irrespective of however slight an irregularity might be. It is both an art and a mindset.
Kaizen inspired the fundamental thinking I put into the MedsPro® Medication Packing Solution. MedsPro arose from my desire to ensure we achieve the same accuracy in manually hand-packing medication as we get from the completely automated MedsPro® Packing Robot.
Successfully applying the Kaizen concept creates an environment of movement and rhythmic momentum.
The first step in applying this concept to the development of the MedsPro solution was to make sure everything is in reach – no more than one-and-a-half steps. The one-and-a-half steps actually came from a staff member who played netball. For the technician preparing a Webster-pak® or Unit Dose 7® pack, having everything they need within one-and-a-half steps, helps to foster a rhythmic momentum. With this rhythm comes productivity and quality output.
We have zero tolerance for error in pharmacy. We have a responsibility to ensure the protection of the community and those most vulnerable. The systematic – almost automatic – process of MedsPro helps cut packing errors to zero.
The MedsPro solution creates a productive packing rhythm with numbered and colour-coded shelving positions to store the medication. These features ensure the most frequently used medications are always closest to the packing technician to improve their flow of movement. The MedsPro process is a unique workflow solution, acknowledged and strengthen by our current patents.
Before MedsPro I remember watching staff packing out of the ‘integrity bags’. They were sitting and working diligently, no doubt, but I never really had a sense of how efficient or productive they were.
Now I can 'feel' the efficiency just by standing in their workspace. I can measure their productivity through the reporting and audit trails. I don't have to guess. I can tell which staff are more productive than others. That matters when staff put in the effort to optimise their performance above and beyond others. Why should they not be acknowledged and rewarded?
Achieving and feeling the rhythm makes the work more interesting and actually reduces stress. It’s the same as the meditative concept of being in the moment. Letting muscle memory guide our packing process has a soothing effect, as well as being most efficient. Our staff feel this way and no I have no doubt yours will too. The greater the rhythm, the fewer the interruptions, the closer you get to achieving the Kaizen principle.
The closer we get to achieving 'pure' Kaizen, the greater the accuracy in outcomes, and the greater reduction in mistake-related costs.
In my pharmacy we packed 574,000 individual doses of medication over a five-week period without even one ‘correction’ required. In this context, ‘correction’ is a soft term where the pharmacist checking packs identifies an anomaly before it is delivered to customers. It’s about never allowing a mistake to get out. Never the wrong medication. Never the wrong dose. The sense of achievement is palpable!
If you operate with MedsPro now, or plan to in the future, my best advice is to set it up as we recommend. It is an optimised system; a practiced process to follow. Doing so will achieve immediate benefits in productivity enhancement, incredible accuracy and flexibility.
This is one more innovation that continues to have a direct benefit to medication management safety. It is also a win-win situation: reducing the chance of error means reducing patient risk; and greater efficiency helps to keep costs down. It’s the perfect example of why quality costs less.
* Gerard Stevens is founder and Managing Director of Webstercare, Australia’s leading provider of state-of-the-art medication management systems.