J Am Pharm Assoc (2003). 2022 May-Jun;62(3):740-749.e3. doi: 10.1016/j.japh.2021.12.007. Epub 2021 Dec 21.
Lean methodology, specifically value stream mapping, can be used to identify and reduce inefficiencies in the medication synchronization process.
The objectives of this study were to (1) evaluate potential medication synchronization process improvements to reduce nonvalue-added actions, (2) assess fidelity to the medication synchronization core components, and (3) identify the best process for medication synchronization for an independent community pharmacy with multiple locations.
This study used an observational, cross-sectional design. A value stream map was created to provide a detailed illustration of each step in the medication synchronization process. Time for each step of the medication synchronization process was observed on site on different days and times as well as the time required to process, package, and verify prescription medications. These steps were conducted before interventions were made to the process and after to compare the difference. The organizational readiness for change tool was administered to employees of the independent pharmacy before interventions to determine their perspective of the medication synchronization process and assess their readiness for change.
Owing to various interventions made to the medication synchronization process, 2 steps in the process were eliminated. This resulted in a decrease in adherence packaging time workflow by 69.4%. Staff (n = 9) rated the medication synchronization process on 4 components: acceptability of the current process (13.8 ± 3.6), intervention appropriateness (13.7 ± 3.7), feasibility of a new medication synchronization process (17.1 ± 2.3), and organizational level of support (21.8 ± 4.1).
Value stream mapping proved to be a valuable tool in identifying inefficiencies in the medication synchronization process and reducing nonvalue-added waste. The result was a decrease in time required for adherence packaging workflow and a more standardized medication synchronization process across multiple independent pharmacy locations. This more standardized process can play a key role in improving the continuity of patient care, increasing medication adherence, and in turn decreasing the number of hospital admissions.
精益方法，特别是价值流图，可用于识别和减少药物同步化过程中的低效环节。
本研究的目的是（1）评估潜在的药物同步化流程改进措施，以减少无附加价值的操作，（2）评估对药物同步化核心要素的遵循程度，以及（3）确定适用于具有多个地点的独立社区药店的最佳药物同步化流程。
本研究采用观察性、横断面设计。创建了一个价值流图，以详细说明药物同步化过程中的每一个步骤。在不同的日期和时间，在现场观察药物同步化流程的每一个步骤的时间，以及处理、包装和验证处方药物所需的时间。在对流程进行干预之前和之后进行这些步骤，以比较差异。在对独立药店的员工进行干预之前，使用组织变革准备度工具来确定他们对药物同步化流程的看法，并评估他们对变革的准备程度。
由于对药物同步化流程进行了各种干预，流程中的 2 个步骤被删除。这导致遵守包装时间工作流程的时间减少了 69.4%。员工（n=9）对药物同步化流程的 4 个组成部分进行了评分：当前流程的可接受性（13.8±3.6）、干预措施的适当性（13.7±3.7）、新的药物同步化流程的可行性（17.1±2.3）和组织层面的支持（21.8±4.1）。
价值流图被证明是识别药物同步化流程中的低效环节和减少无附加价值浪费的有效工具。结果是遵守包装工作流程所需的时间减少了，并且在多个独立药店地点实现了更标准化的药物同步化流程。这个更标准化的流程可以在改善患者护理的连续性、提高药物依从性以及减少住院人数方面发挥关键作用。
