Paul Levy has shared some photos and a video, from Boston’s Beth Israel Deaconness Medical Center, that gives a glimpse into the design of their new pharmacy. He wrote, in part:
We have an old pharmacy on one side of our campus, and it is time to rehabilitate it. We decided to use Lean principles in designing the new space. To do this, we pulled together a team of people, virtually anyone who touches the pharmacy or its products to look at work flows, find waste, and design a future state.
This idea of pulling together a team of those who actually do the work is so simple, yet so revolutionary.
“3P” is a lesser-known Lean method called the “Production Preparation Process.” That’s a lousy name for a hospital — here, it could be called “Pharmacy Preparation Process.“
Far too often, space in a hospital is designed by architects, not the people who will actually have to work there. I’m not saying architects aren’t needed. They have their role, and it’s important one. The best architects have not only general knowledge about their hospital clients and their workflow and they also involve people from the client. The worst architects throw in cookie-cutter layouts that they use everywhere. I’ve seen this happen a lot with hospital laboratories, for example.
If the space isn’t designed with process and workflow in mind, there’s so much waste built in from the get-go, you might really be stuck with it for a while. Layouts often just evolve — why is that pharmacy carousel over there? Because that’s where we had space when we bought it, that’s what you often hear.
When redesigning space or designing new space, you HAVE to involve those who actually work there. They know their needs best and when you teach them Lean methods, they can find layouts that make their workplace more efficient – making their work easier and providing better patient care.
A good pharmacy layout can impact teamwork and productivity. Better teamwork and collaboration (driven by the layout) can lead to better quality – we can do more than just improve flow and reduce walking distances.
We often start 3P with “paper doll” layout design – using a architectural layout and to-scale cutouts of tables and equipment. A next step often involves full-size mockups (as shown in the pictures from BIDMC) that allow people to really test out their designs BEFORE things get too fixed.
Here is the video from his blog post, thanks to BIDMC for sharing this good practice. I’ve seen it practiced in full at a few other hospitals. In my previous consulting work, we definitely had the staff engagement and the paper cutouts. We mocked up benches and workstations with paper and cardboard, but not the full space as you see and can read about here.
What do you think? Would you be able to make use of a process like this in your organization?
Here is a case study about 3P from Joan Wellman, an outstanding and experienced lean healthcare consultant.
About LeanBlog.org: Mark Graban is a consultant, author, and speaker in the “lean healthcare” methodology. Mark is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as the new Executive Guide to Healthcare Kaizen. Mark is also the VP of Innovation and Improvement Services for KaiNexus.