Improving Pharmacy Services at Peterborough and Stamford Hospitals NHS Foundation Trust
The Situation
Established in April 1993 Peterborough Hospitals Trust comprised two hospitals, Peterborough District Hospital and Edith Cavell Hospital and in April 2002, Stamford and Rutland Hospital joined the Trust. On 1st April 2004 the Trust was awarded Foundation status to become one of the first ten NHS Foundation Trusts in England. Today, the Trust delivers patient care through six service units employing more than 3000 staff and providing acute medical, surgical and day surgery services for the people of Peterborough and the surrounding district.
In the Autumn of 2008, in partnership with Trust, WCI undertook, an innovative service delivery project to radically improve pharmacy services. The pharmacy department, spanning two sites, dispense over half a million prescriptions a year to both inpatients and outpatients, and also services a number of local Service Level Agreements (SLA’s.)
Eager to be in the vanguard of delivering the highest quality pharmacy service to patients, the Trust had recently invested in a Rowa “robot” to speed up dispensing, and had previously introduced a system of Patients Own Drugs (PODs) on the wards to improve medicines management.
However, neither of these initiatives had fully met expectations or anticipated improvements:
- inpatient and outpatients were waiting unacceptable long times for dispensed items,
- ward boxes were taking up to 48 hours to reach destinations and returns were high.
The Solution
WCI Healthcare, working closely with management and members of staff, undertook a review of dispensary operations using “Lean” principles and tools.
Using data from the Trusts Ascribe pharmacy IT system, annual, monthly and daily demand patterns were analysed. Key processes were mapped and non value added steps identified for the areas of procurement, stock management, storage and replenishment. Even though most of the 200+ suppliers could deliver within 24 hours, the average stock levels overall, were unnecessarily high. Also, there was less than five days stock cover for many individual lines, and based on the statistics for annual usage, meant ample stock was available. This excess stock not only increased pressure on storage but contributed to the problem of stock exceeding expiry dates and thus being wasted.
The application of Lean tools, analysis of inpatient and outpatient dispensing processes and analysis of workflow and spaghetti maps, proved powerful evidence that there were issues with storage, workflow, layout and the general dispensary environment. Non value adding activity included unnecessary transportation, excess movement of people, stock, equipment and waiting time.
"WCI helped us to pin point the main areas of concern within our department, which without their expertise and time we would not have been able to achieve."
Deborah Parsonage, Pharmacy Operations Manager
For the full case study contact:
info@wcihealthcare.com