A Pharmacy’s Long Turnaround Time?


Star-Telegram.com: | 05/06/2008 | LETTERS

OK, so we're piling on JPS Hospital at this point.. but this letter to the editor caught my eye today:

One glaring omission in your series was failure to critique the pharmacy. It's one of the worst parts of the JPS system.

One example: The pharmacy won't let us order refills until five days before our medications run out. But it often takes seven days or more to get the refills. Some patients need a continuous supply of life-or-death medications. The pharmacy seems to operate independently, with an air of indifference, as if it's not part of a patient-care facility.

I hope your series will prompt those officials in charge to act aggressively to fix the hospital's problems so you'll have plenty of material for your series on JPS's positive aspects.

Yikes. That's one anecdotal story, but still. A pharmacy's “value added” time (filling a prescription and having a pharmacist review) should really be measured in minutes, if not seconds. It shouldn't take one day, let alone seven, to get a prescription filled.

A standard Lean measure is the percentage of “Value Added” time to the total “cycle time” or “turnaround time.” As with many non-Lean processes (whether in manufacturing or healthcare), the percentage of VA time is very low according to that story about JPS. The non-value added time is waste — waiting due to not having enough capacity to get the work done or waiting due to batching and other systemic delays.

I certainly do hope there are JPS success stories in the future. Lean methods could certainly be used to improve processes, reducing turnaround time in the pharmacy.If there isn't enough capacity (people or equipment) to get each day's work done, Lean would focus on reducing wasted time so people can be more effective. Lean isn't about cutting corners or doing work too fast — that might introduce more errors, something you don't want to do in a pharmacy, yet alone any process.

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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.


  1. I don’t know if this is relevant to this particular blog, but I thought it important that I warn people against using online pharmacies, especially those that are not registered, nor certified. A fraudulent online pharmacy site, Canadian Health&Care Mall is literally stealing people’s money. They claim to be certified by the state of Minnesota (they are not) and the two “doctors” mentioned on their site do not exist and they never deliver products ordered. Please, do not give these theives your money.


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