Waste in Philly Pharmacies


Phila. health agency in disarray | Philadelphia Inquirer | 09/26/2007

I saw this in the news as I was leaving Philly earlier this week. Would you run your manufacturing warehouse like this? Dell keeps better track of computer parts than these pharmacies track medications, sadly.

“The Philadelphia Health Department does not keep track of prescription-drug deliveries, fails to remove expired medication from the shelves of its pharmacies, and can't account for more than 2,000 pieces of equipment, the city controller said yesterday.”

Just a basic lack of processes and controls:

“…the department does no accounting of its $7.6 million in prescription-drug orders each year. It has no way of knowing whether drugs are delivered as ordered, whether the correct price was charged, or whether supplies have been depleted by theft.”

Reading on:

The audit also found six expired bottles of prescription medicine in one health center. Domzalski called that a “dangerous” practice that would end.

Butkovitz noted that city pharmacists, who fill three times the number of prescriptions of their commercial peers, were often too busy to properly keep track of their stocks. Domzalski said that before July, when salaries were raised, city pharmacists were paid about half what their private-sector counterparts earn.

I'm tired of the “too busy” excuse. It's not a good excuse, particularly in healthcare. If tasks are important, we MUST make time to do those tasks. We have to eliminate waste to free up time and we need a Standardized Work system to make sure key tasks get done. No more excuses.

And we can't just blame the pharmacists. Lean isn't about making people work harder. If they're already 3x more productive than commercial peers, they're probably already working hard. But, I bet there's still waste in their process that can be reduced, freeing up time to more carefully keep track of expired meds.

Next week, I'm attending a pharmacy supply chain expo, will be interesting to hear more about current issues in that area. I've seen quite a few hospital pharmacies and there are some fairly systemic process design issues — pharmacies tend to be like other pharmacies (although not all of them have waste to the same extent as those mentioned in the article here).

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


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