Presentation
PS14 - The impact of streamlining of logistic processes in Polish hospitals on improving patient safety in the area of pharmacotherapy
DescriptionDespite many years of activities taken up for the sake of medical services quality, numerous problems and limitations can be observed within intrahospital logistics processes significantly influencing the quality of patient care, patient safety, and process efficiency. In many countries around the world, research has been carried out regarding patient care in hospitals. In countries such as USA, UK or New Zealand [HDMA 2006, p. 3; The National Academies Press 2006, p. 105; Department of Health 2007, p. 5; Jones 2009, p. 1; Metzger et al. 2010 p. 4; GS1 2010, p. 15] the research in the field of management of medicinal products flow in the context of patient care showed that patient safety – inside and outside a hospital – is very often endangered. Additionally, it has been proved that pharmacotherapy is the most error-burdened therapy [Marczewska 2010]. The consequences of such a situation can be observed both with respect to decreasing patient safety as well as on the financial ground.
Reasons for the lack of effectiveness and efficiency in the field of management of logistics in hospitals include difficulties and challenges in the area of providing quick and automated access to real-time reliable data in order to reduce response time to patient needs and guarantee a high level of safety that constitute the research problem:
- difficulties with patient service and medicinal products flow, resulting from ineffective and inefficient identification and data exchange methods,
- inappropriate organization of work and inadequate management methods, resulting from a large number of manual and duplicated activities, which influences labor time and patient response time,
- lack of adjusting of current activities to coming legal changes, influencing intrahospital logistics,
- insufficient readiness of hospitals to implement solutions regarding the eHealth area.
On the basis of conducted observations, it is justified to formulate the following research problem, consisting in the lack of a reference model using global GS1 identification and communication standards that guarantee an adequate patient safety level as well as effectiveness and efficiency of medicinal products flow, in the context of both current and future legal regulations.
The above-defined research problem includes a set of detailed problems, reflecting the real needs of a hospital. These needs can be expressed in the following theses:
- there is a need to adopt a solution eliminates disadvantages of existing methods and tools devoted to process organization, such as manual and duplicating activities, low level of automation of processes, lack of the GS1 standards, lack of mechanisms enabling product traceability required by law,
- there is a need to rebuild logistics processes in hospitals for the sake of patient safety and efficiency of patient service,
- there is a need to integrate activities related to law compliance and streamlining of logistics process processes,
- there is a need to formulate assumptions of a reference model compliant with the EU strategy, promoting standards interoperability for the sake of eHealth solutions.
On the basis of the literature overview, long-term engagement in the hospital industry as well as active participation in the creation and development of healthcare standards, the following research hypotheses have been formulated:
(H1) Real-time management of the medicinal products flow with the use of ADC techniques and mobile solutions leads to streamlining of this process with respect to assessing engagement and reduction of patient needs response time.
(H2) Adequate application of the international GS1 standards
in the field of management of the process regarding medicinal products flow results in increased patient safety.
In order to solve the presented research problem, particular fact-finding methods have been used, understood as a set of theoretically justified conceptual and instrumental measures, including the whole research approach which is expected to lead to the solution of a research problem [Kamiński 2006, p. 274].
Research aimed at simulating the effects of reference model implementation was conducted in three hospitals in the Wielkopolska Province, each of them representing a different type of entity: district hospital, government hospital, and prison hospital. Patient care process and identification of bottlenecks in non-medical processes regarding medicinal product distribution. A top-down approach used in the research allowed us to focus on the whole patient process from a bird’s eye view in order to identify possible optimization potential on the ground of logistics in each hospital.
The following processes were analyzed:
a) placement of an order with a supplier, understood as a sequence of activities from the moment when information about the demand for particular medicinal products appears in the IT system until the moment the supplier confirms the readiness to realize the demand,
b) receipt of delivery, understood as a sequence of activities from the moment medicinal products are physically delivered until the moment medicinal product information data is updated in the pharmacy IT system,
c) ward order picking, understood as a sequence of activities from the moment when information about the demand for particular medicinal products on a ward appears in the IT system until the moment these products are dispensed to the ward and medicinal products level is updated in the IT system,
d) patient order picking and medicinal product dispensation, understood as a sequence of activities from the moment patient order appears in the IT system until the moment a confirmation of medicinal product dispensation is registered in this system.
Research logic and sequence of activities have been included in the following steps:
a) development of reference model assumptions,
b) process analysis of current processes in hospitals,
c) verification of possibilities of implementing the reference model and consequences of recommended changes within chosen measures, possible to estimate by means of the iGrafx software.
Process analysis and mapping have been conducted by means of the BPMN standard. It is a standard developed by the Object Management Group, and its main objective is to provide a method of business process description, understood for both people monitoring processes in various entities and for programmers responsible for technical implementation [Drejewicz 2012, p. 9].
As a result of the simulation of streamlining logistics processes, the possibility of reducing service time, labor time, and asset engagement have been confirmed. Additionally, possibilities of quality change thanks to better visibility of the internal medicinal products supply chain and better patient service through access to data regarding inventory level, type, and location have been proved. Therefore, hypothesis (H1), saying that real-time management of the medicinal products flow with the use of ADC techniques and mobile solutions leads to streamlining of this process with respect to assessing engagement and reduction of patient needs response time, can be considered to be true.
Analysis of trends in the field of development of various solutions based on the GS1 standards, both existing and future ones, shows that including these standards will contribute to better patient safety and nurses' work comfort through the introduction of a mechanism enabling verification of patient order picking as well as more efficient medicinal products traceability and identification of location of medicinal products. In summary, on the basis of the conducted analysis hypothesis (H2), claiming that adequate application of the international GS1 standards in the field of management of the process regarding medicinal products flow results in increased patient safety, can be considered to be true.
Reasons for the lack of effectiveness and efficiency in the field of management of logistics in hospitals include difficulties and challenges in the area of providing quick and automated access to real-time reliable data in order to reduce response time to patient needs and guarantee a high level of safety that constitute the research problem:
- difficulties with patient service and medicinal products flow, resulting from ineffective and inefficient identification and data exchange methods,
- inappropriate organization of work and inadequate management methods, resulting from a large number of manual and duplicated activities, which influences labor time and patient response time,
- lack of adjusting of current activities to coming legal changes, influencing intrahospital logistics,
- insufficient readiness of hospitals to implement solutions regarding the eHealth area.
On the basis of conducted observations, it is justified to formulate the following research problem, consisting in the lack of a reference model using global GS1 identification and communication standards that guarantee an adequate patient safety level as well as effectiveness and efficiency of medicinal products flow, in the context of both current and future legal regulations.
The above-defined research problem includes a set of detailed problems, reflecting the real needs of a hospital. These needs can be expressed in the following theses:
- there is a need to adopt a solution eliminates disadvantages of existing methods and tools devoted to process organization, such as manual and duplicating activities, low level of automation of processes, lack of the GS1 standards, lack of mechanisms enabling product traceability required by law,
- there is a need to rebuild logistics processes in hospitals for the sake of patient safety and efficiency of patient service,
- there is a need to integrate activities related to law compliance and streamlining of logistics process processes,
- there is a need to formulate assumptions of a reference model compliant with the EU strategy, promoting standards interoperability for the sake of eHealth solutions.
On the basis of the literature overview, long-term engagement in the hospital industry as well as active participation in the creation and development of healthcare standards, the following research hypotheses have been formulated:
(H1) Real-time management of the medicinal products flow with the use of ADC techniques and mobile solutions leads to streamlining of this process with respect to assessing engagement and reduction of patient needs response time.
(H2) Adequate application of the international GS1 standards
in the field of management of the process regarding medicinal products flow results in increased patient safety.
In order to solve the presented research problem, particular fact-finding methods have been used, understood as a set of theoretically justified conceptual and instrumental measures, including the whole research approach which is expected to lead to the solution of a research problem [Kamiński 2006, p. 274].
Research aimed at simulating the effects of reference model implementation was conducted in three hospitals in the Wielkopolska Province, each of them representing a different type of entity: district hospital, government hospital, and prison hospital. Patient care process and identification of bottlenecks in non-medical processes regarding medicinal product distribution. A top-down approach used in the research allowed us to focus on the whole patient process from a bird’s eye view in order to identify possible optimization potential on the ground of logistics in each hospital.
The following processes were analyzed:
a) placement of an order with a supplier, understood as a sequence of activities from the moment when information about the demand for particular medicinal products appears in the IT system until the moment the supplier confirms the readiness to realize the demand,
b) receipt of delivery, understood as a sequence of activities from the moment medicinal products are physically delivered until the moment medicinal product information data is updated in the pharmacy IT system,
c) ward order picking, understood as a sequence of activities from the moment when information about the demand for particular medicinal products on a ward appears in the IT system until the moment these products are dispensed to the ward and medicinal products level is updated in the IT system,
d) patient order picking and medicinal product dispensation, understood as a sequence of activities from the moment patient order appears in the IT system until the moment a confirmation of medicinal product dispensation is registered in this system.
Research logic and sequence of activities have been included in the following steps:
a) development of reference model assumptions,
b) process analysis of current processes in hospitals,
c) verification of possibilities of implementing the reference model and consequences of recommended changes within chosen measures, possible to estimate by means of the iGrafx software.
Process analysis and mapping have been conducted by means of the BPMN standard. It is a standard developed by the Object Management Group, and its main objective is to provide a method of business process description, understood for both people monitoring processes in various entities and for programmers responsible for technical implementation [Drejewicz 2012, p. 9].
As a result of the simulation of streamlining logistics processes, the possibility of reducing service time, labor time, and asset engagement have been confirmed. Additionally, possibilities of quality change thanks to better visibility of the internal medicinal products supply chain and better patient service through access to data regarding inventory level, type, and location have been proved. Therefore, hypothesis (H1), saying that real-time management of the medicinal products flow with the use of ADC techniques and mobile solutions leads to streamlining of this process with respect to assessing engagement and reduction of patient needs response time, can be considered to be true.
Analysis of trends in the field of development of various solutions based on the GS1 standards, both existing and future ones, shows that including these standards will contribute to better patient safety and nurses' work comfort through the introduction of a mechanism enabling verification of patient order picking as well as more efficient medicinal products traceability and identification of location of medicinal products. In summary, on the basis of the conducted analysis hypothesis (H2), claiming that adequate application of the international GS1 standards in the field of management of the process regarding medicinal products flow results in increased patient safety, can be considered to be true.
Event Type
Poster Presentation
TimeMonday, March 254:45pm - 6:15pm CDT
LocationSalon C
Digital Health
Simulation and Education
Hospital Environments
Medical and Drug Delivery Devices
Patient Safety Research and Initiatives