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Applying lean principles to continuous renal replacement therapy processes.

C Brett Benfield1, Philip Brummond2, Andrew Lucarotti2

  • 1C. Brett Benfield, Pharm.D., is Postgraduate Year 1 Ambulatory Administrative Resident, Fairview Pharmacy Services, Minneapolis, MN; at the time of writing he was Student Pharmacist, University of Michigan College of Pharmacy (UMCP), Ann Arbor. Philip Brummond, Pharm.D., M.S., is Director of Pharmacy, Froedtert Hospital, Milwaukee, WI; at the time of writing he was Pharmacy Assistant Director, University of Michigan Health System (UMHS), Ann Arbor. Andrew Lucarotti, Pharm.D., is Pharmacist-Generalist UMHS, and Adjunct Clinical Instructor, UMCP. Maria Villarreal, CPhT, is Certified Pharmacy Technician; Adam Goodwin, CPhT, is Certified Pharmacy Technician; Rob Wonnacott, RN, is Critical Care Nurse; Cheryl Talley, RN, is Critical Care Nurse; and Michael Heung, M.D., M.S., is Medical Director, Inpatient Dialysis Programs, Department of Medicine, Division of Nephrology, UMHS. cbenfie1@fairview.org.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|January 18, 2015
PubMed
Summary
This summary is machine-generated.

Applying lean principles to continuous renal replacement therapy (CRRT) reduced medication waste and improved workflow efficiency. This initiative saved over $70,000 annually by decreasing discarded CRRT solution bags.

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Area of Science:

  • Nephrology
  • Healthcare Management
  • Process Improvement

Background:

  • Continuous renal replacement therapy (CRRT) processes can be prone to medication waste.
  • A significant amount of CRRT solution was being discarded in an academic medical center.
  • Optimizing CRRT workflows is crucial for efficiency and cost savings.

Purpose of the Study:

  • To describe the application of lean principles to CRRT processes.
  • To examine the workflow for CRRT preparation and implement an intervention.
  • To reduce medication waste and improve staff satisfaction in CRRT.

Main Methods:

  • Lean principles were applied to analyze the CRRT preparation workflow.
  • An educational program was developed to enhance communication between nursing and pharmacy.
  • The CRRT solution reordering workflow was shifted from nurses to pharmacy technicians.

Main Results:

  • A manual audit revealed 133 discarded 5-L bags of CRRT solution over six weeks.
  • The mean number of CRRT solution bags dispensed per day of CRRT decreased substantially post-intervention.
  • Projected annual cost savings exceeded $70,000 due to reduced solution waste.

Conclusions:

  • Lean principles effectively identified and reduced medication waste in the CRRT workflow.
  • Shifting workload to pharmacy technicians improved CRRT workflow efficiency.
  • Staff satisfaction increased following the implementation of lean principles and workflow changes.