TREAMLINING INPATIENT DISCHARGE MEDICATION DISPENSING TO REDUCE PATIENT WAITING TIME

Abstract

Patients' satisfaction and timely service delivery are key expectations in the healthcare setting. At Miri Hospital, patient waiting time for discharge medication has been a concern. The problem is demonstrated in the mean waiting time for receiving discharge medications and the number of patients waiting at the discharge counter. Lean management strategies aim to enhance efficiency by eliminating waste and improving processes to optimise value. The current state Value Stream Mapping revealed the existing processes involving prescription screening and intervention by the inpatient pharmacists before dispensing. Addressing the time limitations faced by prescribers, this process could be time-consuming. Hence, the implementation of bedside dispensing enables ward pharmacists to expedite interventions by leveraging their indepth knowledge of patient progress and personalised medication indications, and prompt communication with prescribers, resulting in a more efficient and timely medication dispensing process. The Kaizen Burst analysis revealed factors like inefficient coordination between the discharge counter and wards, prescriber unavailability, lack of clarity in the discharge summaries, and the promotion of the Patient’s Own Medications programme. Waste of waiting and motion identified prolongs the patient waiting time. As a countermeasure for these issues and to enact a strategic plan, we have established bedside dispensing targets and devised a leave pooling system to ensure an adequate workforce. Pre-Lean data shows the mean patient waiting time was 16.65 ± 9.40 minutes. The ward pharmacist took 5.25 ± 6.59 minutes to complete an intervention, as compared to 9.61 ± 8.71 minutes at the discharge counter. Post-Lean analysis revealed significant waste elimination with a mean of 6.29 ± 7.15 minutes, approximately 10.36 minutes shorter patient waiting time. To ensure the sustainability of the improvements, regular monitoring of the bedside dispensing targets and continuous monitoring of patient waiting time to ensure seamless intervention, hence reducing patient waiting time. The lean methodology may be effective in significantly reducing patient waiting time and increasing discharge medication dispensing process efficiency.