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- 1. Confidential Demand Flow Clinical Area DF Stage Demand Flow is: A two bin supplies delivery system that uses visual triggers to deliver the right supplies, to the right place, at the right cost Demand Flow’s objective: To remove the end-user from the supplies management business, while optimizing supply availability, eliminating supplies lead time, and reducing cost
- 2. Confidential Demand Flow Kanbans sized exactly to LUM requirement End-user removed from supplies management Elimination of excess and obsolete supplies Order placement is error-proofed Cost per order line significantly decreased Product standards set and maintained
- 7. Confidential
- 8. Confidential Objectives • Save Critical Resources: Time and Money! • Remove silos and develop a unified data driven supply chain operation • Introduce and sustain standard work and lean processes that drives continuous improvement
- 9. Confidential Pre-Demand Flow Excess supplies overran clinical work areas Unreliable methods to ensure FIFO posed a risk to patients Inventory levels were “eyeballed”, reorder quantity was “best guess” Unreliable system was driving millions in waste Clutter led to chaos and cost Too much clinical time was spent searching for supplies; delaying patient care
- 14. Confidential The Journey Compartmentalized Supply Chain Operations Inventory Management Push Distribution Redundancies & Rework Basic Tools & Infrastructure Fill-rate = 82% (inpatient only) Unified Supply Chain Focus on Total Cost of Ownership Variance Control Visibility to all Spend Data Driven Operation Kanban Distribution Disciplined Processes o Standard Work Continuous Improvement 28K clinical hours saved 30% less storage space 97% overall fill-rate 37K less stat/rush orders $900K saved in medical supply expense (ops ex) CS warehouse reduced $300K o 8K to 4K sqft 33% supply chain staff efficiency o 12 to 8FTE, who now also service surgical services Operations July 2011 Current Operation Realized Goals (annual numbers)
- 15. Confidential 1. Average SKU’s available = 164 2. Average time to service = 25 mins 3. Weekly time required to service floors 1-11 = 252 hours 1. Average SKU’s available = 278 2. Average time to service = 5 mins 3. Weekly time to service 1-11 under LUM = 60 hours a. 4.0FTE efficiency improvement b. Redeployed to service OR, Lab, etc DF General Inpatient Pre-DF General Inpatient The Journey
- 16. Confidential Annual Savings ~$1,000,000 saved on medical supply expense!! ~28,000 clinical hours saved!!
- 18. Confidential Program Impact 0 100 200 300 400 500 600 700 800 900 1000 0 500 1000 1500 2000 2500 3000 3500 4000 HoursWaiting DirectIssues Direct Issues Waiting Time (HRS) Direct Issues/Call Downs
- 19. Confidential Lean Impact (Efficiency) Room Size: 7ft x 12ft (84sqft) Supply Value: $8,943 SKU Variety: 41 Room Size: 4ft x 7ft (28sqft) Supply Value: $1,810 SKU Variety: 57 Outpatient Lab Then Outpatient Lab Now
- 20. Confidential Lean Impact (Rapid 5S)
Notes de l'éditeur
- You been to Seattle, so I know you know the mechanics. They are same here. Two bin system, that when triggered hits our dashboard so we can consantly monitor and manage the performance of the program…so that it runs perfect, all the time. Clinical departments start to trust us again…and we use that trust to get them completely out of the supply chain business. You care for the patient….we’ll move the supplies.
- Our Demand Flow program is that visual management process. Everything you need to do your work is here, not just the volume stuff. It’s organized…it’s never under stocked, it’s never overstocked. It’s error proof and highly efficient.
- The second big driver in the program is our Dashboard. From here we can see every kanban in every area. Is it moving too fast, too slow…it allows us to pin point the variance so we can immediately remedy.
- The second big driver in the program is our Dashboard. From here we can see every kanban in every area. Is it moving too fast, too slow…it allows us to pin point the variance so we can immediately remedy.
- The second big driver in the program is our Dashboard. From here we can see every kanban in every area. Is it moving too fast, too slow…it allows us to pin point the variance so we can immediately remedy.
- The second big driver in the program is our Dashboard. From here we can see every kanban in every area. Is it moving too fast, too slow…it allows us to pin point the variance so we can immediately remedy.
- All of this rests on Standard Work. To control the variance, we have to have standard work….and we are all accountable for it. Our staff is trained and must demonstrate their performance to our standards before they can be certified in their positions. Long gone are they days that only “Joe” can deliver to the 3rd Floor, because only Joe knew what the department needed to do their work. With Demand Flow, a bin is a bin….the standard work takes the guessing out of the operation and allows us the flexibility to drive highly reliable system. As you will see when we walk through stage, our standards are everywhere. This is an example…if you are delivering to a clinical node, you are using this cart, and the standard work for everything you need to do is hanging right there.
- Our goal was to just completely overhaul our supply chain. It was broken in everyway…just click to next slide to explain
- The narrative here is in the text boxes.
- One of the first things you notice about the program is that it is just a rapid 5S of the work area. Everything has place, and everything is in its place. Visual systems must be highly organized. Mixing supplies and/or having different supplies stacked in front of one another (like par carts do) is not lean because it requires the end-user (the clinician) to search…and therefore delay patient care.
- What’s easier for them….maybe having the program right at point of use is what they need. Supply chain should never guess…should always ask.
- You been to Seattle, so I know you know the mechanics. They are same here. Two bin system, that when triggered hits our dashboard so we can consantly monitor and manage the performance of the program…so that it runs perfect, all the time. Clinical departments start to trust us again…and we use that trust to get them completely out of the supply chain business. You care for the patient….we’ll move the supplies.
- What’s easier for them….maybe having the program right at point of use is what they need. Supply chain should never guess…should always ask.
- If we look at where we were not even a year ago. We had a fragmented supply chain, the OR did their own thing, the lab there’s, etc. We were inventory managers, although not very good at it. There was a lot of redundancies and rework…all of which were waste, all of which drove the general dissatisfaction of what we were doing. Today, very different. We have one supply chain operation. We are data driven. Everything is standard and visually controlled. And this had led to a significant improvements in time and cost. As you will see, our clinicians now have everything they need to do their daily work…and we delivery this service much more efficiently…cost, labor, etc..
- If we look at a general inpatient node pre and post Demand Flow…the numbers just speak for their selves. On average, our par carts held 164 skus….just the volume stuff. Now, in the same footprint, the average is 278…nearly a 2X increase. This is all the stuff that the clinicians were calling down for, ordering their selves, stealing from other departments, or just doing without! If we were to bump the sku counts prior to Demand Flow, we would had have to hire a lot more staff to operate our traditional par cart methods….counting, picking, etc…you know….to muscle through all the waste that the par cart process presents. With Demand Flow, we’ve not only been able to increase what we manage on the nursing floors, we’ve also been able to service areas we never serviced before (OR, lab, etc)…all with about 40% less staff.
- You been to Seattle, so I know you know the mechanics. They are same here. Two bin system, that when triggered hits our dashboard so we can consantly monitor and manage the performance of the program…so that it runs perfect, all the time. Clinical departments start to trust us again…and we use that trust to get them completely out of the supply chain business. You care for the patient….we’ll move the supplies.
- From a numbers stand point the program, we have vastly exceeded expectation. First pic - This year the hospital will save about $700K in medical supplies, why, because everything on the program is pointed to a supplier contract…end-users are no longer ordering the 70% cost stuff, we are…and we buy standards, on contract. In addition, even though census is up, we’re buying less. Next year (with a whole year on the program) we estimate our savings to easily exceed $1M Second pic- As I mentioned, our warehouse has come down quite a bit….this battle is not over, but it is a good number. Third pic – Staff efficiency….where I had twelve on the team, I now have eight….and these eight are servicing 30% more areas than the 12 ever did. These eight do it all, Demand Flow, warehouse management, equipment rounding, etc…just a great success story! Four pic – Probably our biggest win…STAT CALLS. These are clinicians calling down to the warehouse for a rush supply delivery…because it either wasn’t stocked on their par cart, or it was stocked out, or they just couldn’t find it. Happened 3,600 times per month. If you think about the waste here….the average time it took the end-user to receive the rush order was 8 minutes…so 3,600 per month meant that the clinician (and therefore patient) waited up to 600 hours for critical supplies that should have just been there! ….7,200 wasted hours per year….eliminate!
- From a numbers stand point the program, we have vastly exceeded expectation. First pic - This year the hospital will save about $700K in medical supplies, why, because everything on the program is pointed to a supplier contract…end-users are no longer ordering the 70% cost stuff, we are…and we buy standards, on contract. In addition, even though census is up, we’re buying less. Next year (with a whole year on the program) we estimate our savings to easily exceed $1M Second pic- As I mentioned, our warehouse has come down quite a bit….this battle is not over, but it is a good number. Third pic – Staff efficiency….where I had twelve on the team, I now have eight….and these eight are servicing 30% more areas than the 12 ever did. These eight do it all, Demand Flow, warehouse management, equipment rounding, etc…just a great success story! Four pic – Probably our biggest win…STAT CALLS. These are clinicians calling down to the warehouse for a rush supply delivery…because it either wasn’t stocked on their par cart, or it was stocked out, or they just couldn’t find it. Happened 3,600 times per month. If you think about the waste here….the average time it took the end-user to receive the rush order was 8 minutes…so 3,600 per month meant that the clinician (and therefore patient) waited up to 600 hours for critical supplies that should have just been there! ….7,200 wasted hours per year….eliminate!
- I’m asked time and again….”it’s a two bin system, does that mean you need twice the space”…..that’s never the case. In every install we were able to increase the variety of supplies in the same or less space….I mean look at this….yeah, it’s one of more extreme…but the program not only increased the item variety, it did so in a third of the space! Proof again that when the end-user is managing their own supplies, they over order…and they are typically not as organized…all of which leads to waste.
- One of the first things you notice about the program is that it is just a rapid 5S of the work area. Everything has place, and everything is in its place. Visual systems must be highly organized. Mixing supplies and/or having different supplies stacked in front of one another (like par carts do) is not lean because it requires the end-user (the clinician) to search…and therefore delay patient care.