Faculty Disclosures. Pharmacy Inventory Practices Let s get LEAN. Fast Facts. Learning Objectives

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Faculty Disclosures Pharmacy Inventory Practices Let s get LEAN Bonnie Helms has no relevant financial relationships to disclose Bonnie Helms CPhT October 26, 2017 Greenville, South Carolina Nestled up against the foothills of the Blue Ridge Mountains in the heart of South Carolina's Upcountry, you'll find Greenville situated just about halfway between Charlotte, North Carolina and Atlanta, Georgia. Greenville's friendly, thriving downtown pulses with things to do year round. Bon Secours St. Francis Health System Part of a not for profit Catholic healthcare system that includes 19 hospitals plus other care facilities primarily on the East Coast BSSF Greenville 2 Acute Care facilities plus other types of care facilities DT Location 245 bed / Eastside Location 93 beds / Outpatient Infusion Center. Fast Facts I currently oversee a $32 million dollar annual medication budget at St. Francis Cancer Center. Implemented just in time procurement practice Last year we achieved 40.2 inventory turns Learning Objectives Learning Objectives Pharmacy Technician Describe at least two tools that can be used for cost effective and efficient purchasing. Outline two strategies used to ensure efficient inventory practices. 1

What is Lean Thinking Lean Identify Lean Methodology is a business application to systematically streamline processes by eliminating inefficiencies (waste) within the current state of the processes. Two primary concepts that guide all practice of Lean methodology Continuous Improvement Respect for the frontline workers Review How changes working for the team? Opportunities in the process of workflow. Lean Execute Implement Changes. Plan How can the current process be improved? Inventory Tools Automation Optimization 5S Just in TIME Ordering Communication Automation Optimization High Cost Drugs Set Pars Review Medications Appropriate for Patient Care Area Collaborate with Nursing Pharmacy Automation Processes Loading Unloading Relocating 5S Organize the Workplace 5S Lean Project Goal Statement: Utilize the 5S Methodology to Organize Stock Decrease Value of Pharmaceutical Inventory Carry Actions: Eliminate Duplicate Stock Areas Remove All Items NO LONGER USED Shelf Labels PAR, High Cost, Ancillary Ensure Stock is Grouped Appropriately Ophthalmic, Otic, Topical, etc.. Arranged Stock Alphabetical by GENERIC. 2

Just in Time Ordering What is Just in time? Inventory strategy used to increase efficiency and decrease waste by receiving goods only as they are needed in the production process, thereby reducing inventory cost. Benefits Low month to month holding cost Low impact of daily cost of money( money is not tied up in inventory ) Minimize/Eliminate the problem of obsolete and outdated inventory Communication Open the lines of communication Don t fall victim to the telephone game Barrier Must forecast demand accurately Communication Tools Visual Management Board can effectively communicate across multiple individuals and multiple shifts. What are Three Inventory tools that can lead to cost effective and efficient inventory practices? Three Inventory Tools Automation Optimization 5S Just in time ordering Purchasing Tools Focused Review High Cost Drug Management SKU Analysis Continuous Performance Improvement 3

Focused Review Purchasing Process Limit Number of those Placing Wholesaler Order Direct Orders Purchase for Ancillary Departments Timely Return of Medications NOT USED Par Levels Monthly OUTDATE Checks Delay Prep of High Dollar IV Medications Checking in on Mid Month Spend High Cost Drug Management Identification of Agents Costing >$500 Staff Education Shelf Label Ongoing Automation Review. SKU Analysis SKU=Stock Keeping Units Review of medications with Multiple Strengths Use of each strength Cost 23 Combination medications reviewed Conversion to component drugs if cost effective Validation of 56 Meds Previously moved to Non formulary Status Continuous Improvement The Market New Generic Conversion Continuous Analysis of Formulary Prioritizing Medication Usage Order Sets Keep Order Sets Current Use Technology/Analytics Wholesaler Reports Automation Reports What are Three Purchasing Tools that can lead to effective and efficient inventory practices? Purchasing Tools Focused Review High Cost Drug Management SKU Analysis 4

Assertively Develop and manage alternative therapy options In advance, determine specific substitutes which can fill the gap during a MUST HAVE drug shortage Setup product in procurement data base complete with sources Conduct additional training and document protocol changes in advance Formalize a Drug Shortage Management Protocol (DSMP) to maneuver through periods of particular drug shortages. Use a variety of resources, stay informed Closely manage with wholesaler and direct purchase opportunities. Build collaboration with clinical and procurement staff in your organization How do you handle a shortage? 5