Tilson Vera, Dobson Gregory, Haas Curtis E, Tilson David
Associate Professor of Operations, Simon School of Business, University of Rochester , Rochester, New York.
Associate Professor of Operations Management, Simon School of Business, University of Rochester , Rochester, New York.
Hosp Pharm. 2014 Jul;49(7):616-27. doi: 10.1310/hpj4907-616.
In recent years, many US hospitals embarked on "lean" projects to reduce waste. One advantage of the lean operational improvement methodology is that it relies on process observation by those engaged in the work and requires relatively little data. However, the thoughtful analysis of the data captured by operational systems allows the modeling of many potential process options. Such models permit the evaluation of likely waste reductions and financial savings before actual process changes are made. Thus the most promising options can be identified prospectively, change efforts targeted accordingly, and realistic targets set. This article provides one example of such a datadriven process redesign project focusing on waste reduction in an in-hospital pharmacy. A mathematical model of the medication prepared and delivered by the pharmacy is used to estimate the savings from several potential redesign options (rescheduling the start of production, scheduling multiple batches, or reordering production within a batch) as well as the impact of information system enhancements. The key finding is that mathematical modeling can indeed be a useful tool. In one hospital setting, it estimated that waste could be realistically reduced by around 50% by using several process changes and that the greatest benefit would be gained by rescheduling the start of production (for a single batch) away from the period when most order cancellations are made.
近年来，许多美国医院开展了“精益”项目以减少浪费。精益运营改进方法的一个优点是它依赖于从事这项工作的人员对流程的观察，并且所需数据相对较少。然而，对运营系统捕获的数据进行深入分析，可以对许多潜在的流程选项进行建模。这些模型能够在实际流程变更之前评估可能的浪费减少情况和财务节省情况。因此，可以前瞻性地识别出最有前景的选项，相应地确定变革努力方向，并设定切实可行的目标。本文提供了这样一个以数据为驱动的流程重新设计项目的示例，该项目聚焦于减少医院药房的浪费。利用药房准备和交付药品的数学模型来估计几种潜在重新设计选项（重新安排生产开始时间、安排多个批次生产或在一批内重新排序生产）的节省情况以及信息系统增强的影响。关键发现是数学建模确实可以成为一个有用的工具。在一家医院的案例中，据估计通过采用几种流程变更，浪费可以切实减少约50%，并且通过将（单个批次的）生产开始时间从大多数订单取消的时间段重新安排，将获得最大收益。
