9 JULY 2023easy to ask someone to change how they look at a situation, but it is easy to bring in someone from the outside to observe. An individual who has little to no knowledge of your processes can observe workflow, ask questions and provide feedback. Often they can identify areas for improvement and simplification. By default, they are thinking outside of the box because they do not live and work in that box on a daily basis.Once a potential process enhancement has been identified, it is critical to obtain as much data and information as possible regarding the process. The ability to support process change with data is one of the most crucial aspects to ensure buy-in and acceptance from your staff. As I mentioned earlier, for many of us to adjust our viewpoint to identify a potentially "better" way is understandably challenging. However, when backed up by real world data (not just gut feelings or hunches), differing viewpoints can be more easily processed by those being asked to change. Data should not only be collected before an adjustment is made, but also as a follow-up to ensure the positive impact we thought we were making is in actually being seen. In addition to data, it is crucial to get feedback from the parties involved after they have worked within process changes.The following is a process enhancement that I was personally involved with at our facility. We almost exclusively utilize automated dispensing machines (ADMs), for medication delivery to clinical staff. The concept is quite simple, when the clinical staff needs medications, they go to the ADM and it is able to dispense it to them. Once enough of a particular medication has been removed, the pharmacy staff is notified that it should be restocked. Seems very straight forward, right? We thought so. However, the ADMs can only grant access to one user at a time. The potential for a problem went unnoticed until receiving the results of a survey (sent out to nursing regarding impression of pharmacy services); many responses contained inquiries as to why the pharmacy was restocking the ADMs at certain times. After consulting with pharmacy staff, they reported often having to compete for time at the machines; I decided to look into things further. I was able obtain data from the various machines across the facility quantifying dispenses and restocks over the course of several months. That data was then converted to a graphical representation so that peak times for both activities could be identified; it was obvious there was an overlap. This data clearly validated the observations from both the nursing staff and pharmacy staff. Certainly, there were differences among each nursing unit, but there were consistently times when nursing and pharmacy staff were competing for access to a machine.The data was clear and it was an easy fix, change the restocking times. We went a step further and reduced the frequency of restocks, with each restock optimized to deliver the greatest number of medications. The benefit was two-fold, we were able to reduce the number of times per day pharmacy staff was away delivering medications, and at the same time reduce the likelihood that there would be competition for the ADMs.The solution to the problem really couldn't have been simpler, but the unknown and overlooked issue was holding back the optimization of the process. Not only was the nursing staff responsible in part for identification of an issue, but they were also the out of the box thinkers when asking "why do these two processes need to overlap?" We implemented a change that at the outset did not have the full support of the pharmacy staff; it was different than what had been done for years and required a reworking of their daily routine. By presenting them with the hard data showing the competing times for the machines, we were able to get the initial buy-in required to trial the change. Within the first couple of weeks post-implementation, I was able to get anecdotal feedback from the nursing staff and the pharmacy staff; both parties reported there appeared to be fewer instances when they were competing for the ADMs. This was later verified by repeating the data analytics described previously. Many people become so comfortable with their routine they become blind to when there may be room for improvement. Do not be afraid look at processes from a different perspective. Work with other departments to help each other analyze workflows. Take the time to communicate with your employees to get their impressions on processes. Don't be afraid to reach out to the different departments you interact with to get their feedback on the services you provide. Use the feedback to make positive changes, to achieve positive patient outcomes, and to help create a positive team-first culture. TAKE THE TIME TO COMMUNICATE WITH YOUR EMPLOYEES TO GET THEIR IMPRESSIONS ON PROCESSES
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