การประยุกต์ใช้แนวคิดลีนในการเพิ่มประสิทธิภาพการจัดการคลังยา

Abstract

Efficacy of Pharmacy Inventory Management will lead to the efficiency patient care which is one of the important mission of the pharmacy department. Objectives: There were three main purposes of this research. Firstly, to study the working processes of the Pharmacy Inventory Management. Secondly, to improve the working performance using the Lean Thinking. Lastly, to evaluate the result of this Pharmacy Inventory Management. Methods:Phase 1 was a qualitative research conducted by brainstorming from workers in pharmacy inventory. Subsequently, the study employed the fishbone chart to identify the problems on drug inventory management, drawn the process flow chart, Identified value in the work, waste and time spent on each sub-activity. Then the ECRS (eliminate, combine, rearrange, simplify) principle was used to eliminate the waste of work. Phase 2 was a quasi-experimental study that collected 30 data points before (March to May 2020) and after (October to December 2020) applying the Lean thinking. Results: Identified problems included personnel problems (new staff lacking experience and lack of understanding of drug inventory management), problems on equipment (drug carts and information technology systems being user-unfriendly), product problems (amount of medication inconsistent with the need), problems on work process (redundancy) and problems on environment (insufficient storage space). When the ECRS principle was applied, it was found that the number of remained sub-activities was 20 (48.72% reduction), of which 11 activities were operation (31.25% reduction), 6 for transportation (14.29% reduction), one for waiting (88.89% decrease), two for inspectation (66.67% decrease) and one for storage (unchanged). For the value of work, it was found that there were 17 value added activities (30.77% increase), one non-value added activity (95.65% decrease), and 2 necessary but non-value added activities (33.33% decrease). The ratio of total process time to total lead time was 95.64% (67.19% increase). Time for value-added activity time was 83.96% (63.79% increase). Waste remained in two activities (reduced by 95.56%). Total lead time was 96.92±5.20 min (reduced by 424.90±16.98 min) Total process time was 92.70±5.20 min i.e., significantly reduced by 55.75±5.77 min (P<0.001). Conclusion:The application of lean thinking can increase the efficiency of pharmacy inventory management by finding the cause of the problem, eliminating waste, increasing value- added activities, eliminating non-value-added activities and reducing working time.The results of this study can be used as a guide for applying lean thinking ,including finding problem causes and improving processes by brainstorming, using tools to support lean thinking and using information technology to replace human labor, which can reduce the workload of staff and reduce waiting time significantly.