Tsana Associates Health Service Consultancy: NHS News & Comment

Tuesday, October 2, 2007

NHS is 17th in Europe-wide poll of patients - Telegraph.co.uk.

BBC News
NHS is 17th in Europe-wide poll of patients
Telegraph.co.uk, United Kingdom - 4 hours ago
The survey will be hugely embarrassing to Gordon Brown, who has made the NHS and education his top two priorities. The Euro Health Consumer Index, ...
Tories 'party of NHS' - Lansley BBC News
Tories aim to be 'party of the NHS' Channel 4 News
UK falls further down European health league Guardian Unlimited
This is London
all 9 news articles
[nhs - Google News]
8:13:02 AM
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Waste in Philly Pharmacies. Phila. health agency in disarray | Philadelphia Inquirer | 09/26/2007

I saw this in the news as I was leaving Philly earlier this week. Would you run your manufacturing warehouse like this? Dell keeps better track of computer parts than these pharmacies track medications, sadly.

"The Philadelphia Health Department does not keep track of prescription-drug deliveries, fails to remove expired medication from the shelves of its pharmacies, and can't account for more than 2,000 pieces of equipment, the city controller said yesterday."

Just a basic lack of processes and controls:

"...the department does no accounting of its $7.6 million in prescription-drug orders each year. It has no way of knowing whether drugs are delivered as ordered, whether the correct price was charged, or whether supplies have been depleted by theft."

Reading on:

The audit also found six expired bottles of prescription medicine in one health center. Domzalski called that a "dangerous" practice that would end.
Butkovitz noted that city pharmacists, who fill three times the number of prescriptions of their commercial peers, were often too busy to properly keep track of their stocks. Domzalski said that before July, when salaries were raised, city pharmacists were paid about half what their private-sector counterparts earn.

I'm tired of the "too busy" excuse. It's not a good excuse, particularly in healthcare. If tasks are important, we MUST make time to do those tasks. We have to eliminate waste to free up time and we need a Standardized Work system to make sure key tasks get done. No more excuses.

And we can't just blame the pharmacists. Lean isn't about making people work harder. If they're already 3x more productive than commercial peers, they're probably already working hard. But, I bet there's still waste in their process that can be reduced, freeing up time to more carefully keep track of expired meds.

Next week, I'm attending a pharmacy supply chain expo, will be interesting to hear more about current issues in that area. I've seen quite a few hospital pharmacies and there are some fairly systemic process design issues -- pharmacies tend to be like other pharmacies (although not all of them have waste to the same extent as those mentioned in the article here).

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[Lean Blog]
8:03:54 AM
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Hospitals Learning from Hospitals. Oshkosh Northwestern - Systems turn to ThedaCare

There's a great sense of community and sharing in the hospital space -- something the manufacturing world can learn from, I think. Sure, it's possible to spend your whole career working in a single hospital and never seeing other ways of doing things, but hospitals have a few built-in mechanisms to help with sharing and spreading of ideas:

A history of peer inspections (through certification organizations)
Labor mobility (people jumping from institution to institution)

Can hospitals do more to share best practices and good ideas? Of course. There's such an opportunity for the manufacturing world to do the same thing, especially in non-competing cases. Does your town have an organization of local manufacturers who help each other out? Or, are you hung up on the idea that only people inside your sub-industry and market can help you? You'd be surprised how much a shoe manufacturer might be able to help a company that makes tubing. Having fresh eyes and new perspectives can help. Maybe you can try an exchange with a neighbor in your industrial park? Walk each others' processes and see what questions come up. I've written before about a local Lean group I was a part of when I lived in Phoenix.

Maybe another inherent advantage hospitals have is that hospitals are basically like other hospitals (except for specialty hospitals... but they're still hospitals). Does that encourage better sharing and collaboration? A hospital in Florida might be more willing to help a hospital in Washington, since they're not competitors, so that dynamic is different than in manufacturing.

Back to the article I linked to... it's about hospitals visiting ThedaCare, in Wisconsin, a hospital that gets a lot of attention for their impressive Lean efforts.

ThedaCare is no stranger to finding ways to reduce patients' time in a hospital while ensuring they receive optimum care.

For the past four years, the Appleton-based health system, has applied lean methods, similar to models followed by many manufacturers who are streamlining production to reduce costs.

Those principles also have worked for ThedaCare. Today through Friday, representatives from Appleton Medical Center and Theda Clark Medical Center in Neenah, will meet with about 150 health care leaders from nine different systems across the country.

Read the rest of the article...

Have you tried to increase collaboration in the manufacturing world? What have you tried? What would you like to try? Click "comments" to let us know. What can we do to help facilitate this? We've been able to use the blog a few times to put people in touch (with me playing middle man). Can we do more of this?

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[Lean Blog]
8:02:42 AM
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