Applying Lean Principles to eliminate Waste in Healthcare: Implementing Point of Use (POU) Scanning in the Operating Room
As outlined in one of my previous blogs, data collection using barcode scanning at the Point of Use (POU) in the OR has proven to be universally problematic. Product labeling is inconsistent, and items including non-sterile products are often not barcoded because of technical limitations on marking them (imagine having to barcode label and then scan a 1 or 2mm diameter screw). As a result, the default data capture process in the OR is manual, time consuming and error prone, utilizing highly skilled (and high cost) nursing time during a period of resource shortage. Representing 60% of a hospital’s product spend, the operating room presents an enormous opportunity for applying Lean Principals to improve financial health of hospitals and surgery centers.
One key principle in Lean thinking is identifying and eliminating Waste.
In Lean processing, “waste” is commonly defined as any action that does not add value to the customer. Essentially, waste is any unnecessary step in a process that does not benefit the end user. This principle hold true for all customers, both internal and external.
The principles of Lean were first introduced in the book The Machine That Changed the World (1991) by James P. Womack, Daniel T. Jones and Daniel Roos.
DOWNTIME: The Eight Types of Wastes in Healthcare[.
In healthcare, the acronym DOWNTIME is frequently used to define eight Lean Wastes:
· Defects - Errors, mistakes, incorrect information or processes requiring re-work or re-processing
· Overproduction - Production that is redundant, more than required or performed before it is needed
· Waiting - Time wasted waiting for the previous step in a process to complete
· Non-Utilized Talent - Underutilizing people's talents, skills, and knowledge
· Transportation - Unnecessary movement of people, products, information or materials
· Inventory - Excess products or materials not being processed
· Motion - Unnecessary actions or movement by people
· Extra Processing - More work or higher quality than is required by the customer
The most often observed data collection process in the OR has the circulating nurse hand writing information as the surgery progresses, and then manually entered the into the EHR once the case has been completed and the patient has left the OR. This current process of manual data collection and data entry as viewed through the lens Lean Waste identifies several opportunities for improvement by utilizing POU scanning technology.
· Defects – any data error occurring during the collection, transcribing or data entry process will require correction (re-work) or will remain uncorrected impacting downstream transactions including billing and collection errors and failed inventory replenishment signals.
· Overproduction – using ScanMan™, all data currently collected, transcribed and manually entered into the EMR is available to be scanned directly into the EMR at the time and point of use without manual intervention.
· Waiting – The time utilized to transcribe and enter this data increases the OR room turnaround time between cases.
· Non-Utilizing Talent – Utilizing the circulating nurse to collect, transcribe and enter data are all tasks that underutilize the skills, talent and training for nursing staff.
The Summate Odyssey System
Summate Odyssey™
Summate has introduced a revolutionary technology for healthcare which enables true POU scanning of ALL products used in the OR. The Odyssey is a roll-in solution that unifies workflows for managing both pre-packaged and “non-sterile” devices and supplies. Our partnership with Symmetric Healthcare Solutions advances package identification accuracy through label imaging rather than relying solely on barcode scanning. This artificial intelligence technology captures product ID and serial data (lot number and expiration date) of pre-packaged devices and supplies in one step. Through Set Mapping* and Summate’s unique microchip-based laser scanning technology**, we have introduced for the first time the ability to scan “non-sterile” device usage directly from inside the surgical field. Set Mapping is deployed at the set/tray level, which eliminates the need for direct part marking of the individual implants. The Odyssey™ system can document everything used during surgery, and do it faster, more accurately, and more efficiently within current OR workflows*.
POU scanning impacts each of the Lean 8 wastes in healthcare for the OR. For hospitals it lowers defects in documentation, eliminates repetitive manual documentation steps, increases nurse time for patient care, increases patient safety by preventing recalled items from being used, and creates accurate real-time data that can be used to streamline inventory and purchasing processes. For device OEMs it provides a real time demand data that is accurate, timely and complete - all of which can be used to better manage field inventory/assets and marketing and sales activity. POU scanning in the OR holds the promise to transform the entire spectrum of how surgical care is administered.
Importantly, the Odyssey™ does not need IT integration in order to deliver real value though comprehensive OR product usage documentation*. It is truly a “roll and go” solution - just roll in and start scanning. It can, however integrate and hand off the complete surgical consumption record to any enterprise software, giving customers control over their own data and flexibility and choice of preferred software and analytics partners
Every day without the Odyssey™ is a day of waste and lost profit for a hospital or ASC.
Summate is open for business through partnerships and licensing. For more information, please contact us at info@summate.net or go to our website contact page.
* Summate patents issued/pending
** p-Chip Corporation, Monmouth Junction, NJ