Machiavelli famously said to the prince: "It is better to be both loved and feared but if you can only be one, be feared". I've been wondering what Machiavelli would...
Ever have one of those moments when someone presents a new idea and you think, “That just makes way too much sense”? This week, I listened to a presentation by one of our health system’s supply chain directors who presented a new way of managing terminal distribution supplies.
If you have worked for more than about a week in a hospital as a physician or a nurse, then you have had the experience of walking into a supply room on a nursing unit and seeing something like this. Bins of supplies stacked on top of each other and overflowing with syringes, gauze pads, and telemetry leads. Its a mess. If you can even find the bin you are looking for, there is a good chance the person before you took the last one of the items that you wanted. And when you have a JCAHO site survey, the surveyors always head straight to the supply room when they walk into a nursing unit and then dig their hand into the most full bin and pull an item from the bottom of the bin… and the date on it will inevitably be expired, resulting in a citation. Supply rooms were like the first day I walked into the hospital as a 3rd year medical student in 1982 and supply rooms are like that now, 35 years later, in 2017.
So, here was the solution from our supply chain genius. Instead of having one large bin for each item, have 2 small bins, one in the front and one in the back. You stock each bin with a projected 5-days worth of that item. Each bin is bar-coded for inventory management. This is known as a “Kanban” inventory control system
When you use up all of the item in the front bin, you pull the empty bin and leave it out for your central supply personnel to pick up. You then pull the back bin forward and start to use items from it. The central supply staff re-stock the empty bin and replace it behind the front bin. Here’s what happens:
- Your central supply personnel know exactly how fast you are going through each item so that your nurses don’t need to ‘guesstimate’. By using the bar code on each bin, you can monitor item use on the computer real-time.
- You can adjust the number of each item at your terminal distribution supply room based on use, thus optimizing your space utilization.
- The supply room becomes less cluttered.
- The square foot requirement in the supply room actually drops.
- You dramatically reduce the risk of having expired items in your supply room.
- You eliminate all of the time that the nurses are “taking inventory” of everything in the supply room and give them back time to do patient care.
- You save money
There are some caveats, however. The nurses have to be trained so that they always remove items from the front bin and know to pull the empty bins out for re-stocking. If your patient population on any given nursing unit changes, then your product use rate can change, so you have to continually monitor how quickly you are going through bins in each supply room.
This is one of those ideas that when you hear it, you ask yourself, “So, why didn’t I think of this before?”.
March 31, 2017