Process Improvement Plan
September 24, 2003

In examining material management and supply chain systems in the hospital
industry, unexpected inefficiencies to monitor material usage patterns on
hospital units, causes great risk to many processes that are involved in
the healthcare industry on a daily basis. The process necessary to improve
systems involves staff participation in brainstorming and analyzing
criteria for recommending solutions to fine-tune problem areas for
enhancing patient care supply chain management.

Process Improvement Plan
Failure to maintain adequate supply levels in a healthcare process can
cause delays in patient’s care, customer satisfaction, risk to servicing
patients and increased frustration to staff. Processes are implemented in
facilities to help minimize the room for error so that individuals working
in the facility can perform task in a consistent, efficient, and optimal
manner, which could ultimately lead to improvement in both distribution
efficiency and aggregate cost.

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Each nursing unit has to order supplies from the purchasing department
to place on their carts in-order administer and distribute medical supplies
and pharmaceuticals to provide prescribed health care to patients. The
following process is utilized for ordering supplies in a hospital setting:
Supplies in which the nurses are responsible for ordering are on the AS400
on the computer.

The nurse takes a print out of the supply list and they inventory the
stock and then the list is given to the unit secretary for placing in the
computer. The order request sheet prints in the purchasing department and
the purchasing department fills the request and places them on the unit on
the supply cart.

The purchasing department monitors some of the items that are routine,
such as toothbrushes, pitchers, toothpaste and etc. when they make their
daily rounds and perform cart checks. The problem with this ordering
process is that there has been inadequate stocking of supplies on
medication carts by nurses during shift changes. One way to gain solutions
to this problem is through brainstorming. Brainstorming is defined as the
act of defining a problem or idea and coming up with anything related to
the topic–no matter how remote a suggestion may sound. All the ideas or
recorded and evaluated.

Brainstorming can be an effective way to generate lots of ideas and
then determine which idea or ideas best solve the problem. When a facility
is utilizing brainstorming, this should be performed in a relaxed
environment as if individuals feel pressured, they may not stretch their
minds to full capacity.

Steps to brainstorming:
1). Identify the problem.

2). Set time limit for resolutions.

3). Peer participate through verbalizing issues and possible
solutions to the

4). Selected the five major topic for discussion and resolution.

5.) Select five criteria for evaluate and the best process for
problem containment.

6). Rate and rank each idea and recommended solution (0-5)
7). Choose the idea with the highest ranking as a possible solution
to the
problem. A record should be maintained of all the ideas, incase the
first idea does
not work.

Another method that could assist the organization in identifying the
prevalence of a unit being under stocked is by using the “the Pareto
principle, “the 80/20 rule” This concept can save you time and money. In
the world of quality control, the concept is applied to defects. A small
percentage of root causes are responsible for the majority of the defects.

Data on how often problems occur can be tracked using a bar chart. This can
save an organization time and money by helping its staff to focus on what’s
most important and ignoring the distractions.

Some of the main areas of inefficiencies are:
Medical supply ordering processes were not timely, and follow-up action
with the host MTF was not effective. The host MTF did not effectively
support the reserve unit with required logistics support.

Certificates of transfer for medical equipment management office
property were not completed for the last 2 account transfers.

Additionally, the annual equipment inventory was not completed in a timely

Timely resolution of equipment discrepancies identified during annual
inventories was hampered by incomplete or delayed reports of survey.

Documentation indication that medical equipment inventories were completed
within the required 12 -month period was inconsistent.

MEMO inventory was not accomplished during FYs 01 and 00.

Designation of the individual responsible for approving Inventory
Adjustment Vouchers was not completed in accordance with Vol 5. The
previous medical stock record account inventory was not available for
review. A systematic process to review, follow-up and resolve outstanding
backorders for materiel and equipment was not evident.

Health care organizations should utilize resources to the better good
of the organization and its consumers so that processes work and not fail,
by utilizing a number of approaches. Although changing practice patterns is
the most difficult aspect of any effort to restructure systems,
modifications to ensure change and to make the desired practice the path of
least resistance should be the key factor.

This process will be improved to remedy the issue of restocking
nursing units by using the, “exchange cart system”. Each cart is restocked
to all required Par levels, and taken to the floor on an established
schedule. The “used cart” on the floor is exchanged for the corresponding
full one, and the cycle continues. If a nursing unit manager believes that
reserves of a particular item are running low, usually due to the needs of
a particular patient, interim deliveries of a small number of items can
usually be arranged. Also, this means that the individual nurse manager is
able to set all Par levels, even if an approval process is required to
formally alter them.

In conclusion, the basics of inventory theory, such as daily use
rates, variances in use rates, and legitimate estimates of lead-time are
all factor necessary in the medical supply chain in delivering services to
patients. The two vital partners in the hospital supply chain are nursing
and central supply. The need for a system, which addresses efficiency,
maintenance of stock level, must have an efficiency of scale for both
supplier and customer needs.