Improving supply management in wards with automated Kanban & PAR solutions – CASE STUDY

Case Study: Introduction of Hybrid Kanban & PAR Inventory Management System

Executive Summary

This case study outlines how one hospital improved the management of supplies on a ward by introducing a hybrid Kanban and PAR system.

Hospital Inventory Challenges

The hospital set out to tackle several challenges:

• re-orders were based on manual checks that were time consuming for busy nurses, as well as logistics staff.
• excessive orders resulted in high levels of admin but did not result in a balanced inventory.
• store rooms were over-crowded and disorganized
• nurses had to undertake supply chain tasks which had a negative impact on job dissatisfaction.

The hospital wanted to address all of these problems by re-organizing the ward store room and introducing a smart inventory management solution.

Kanban and PAR Solution

The hospital implemented IDENTI’s Kanban and PAR hybrid inventory management solution.

This included three elements:

• Autonomous PAR Weight-Based Bins
• Digital Restock Tags
• Scan and Restock App

All three methods fed into a cloud-based management system that provided metrics, data insights and reports – giving the hospital real-time stock visibility and accurate usage data. The automated system significantly reduced manual tasks relating to inventory management.

The Results of the Hybrid Kanban and PAR system implementation

IDENTI’s automated Kanban and PAR solutions for all of the challenges identified:

• time spent by logistics staff on the ward reduced by more than 50%
• time spent by nurses on inventory orders reduced to 0
• nurse satisfaction increased from 53% to 90%
• consolidation of orders led to a decrease of 57% in the number of orders
• the hospital embraced data-driven ordering, resulting in restocks that matched demand.

Conclusion

The IDENTI Kanban and PAR solution added efficiency and automation into the logistics process. It resulted in significant time and resource savings. The hospital are currently looking to roll out this model to other departments.

The full Hybrid Kanban System Case Study

This case study is designed to share best practice in the management of hospital supplies, and follows one hospital’s attempt to remove all logistics activities from the workload of clinical staff. It showcases the newest addition to IDENTI’s hybrid Kanban & PAR solution – the autonomous, weight-based PAR bin.

The findings of this case study are based on a pilot conducted at Sheba Medical Center, one of the largest hospitals in Israel.

We look at how Sheba hospital introduced a new integrated, hybrid Kanban and PAR system to a ward, then measured the success of this solution.

Goals:

Sheba’s top goal was to remove nursing staff from supply chain activities, while adding efficiency to the materials management service.

The measures for project success, as defined by the hospital’s Procurement Department, were:

1. To reduce nursing time spent on logistics:

• • to eliminate nursing time spent on supplies orders – reducing it to 0%
  • to reduce nursing time spent on supplies organization by 85%

2. To increase job satisfaction for nurses – by a minimum of 90%
3. To maintain a balanced inventory on wards – by at least 90% (as defined by stock shortage reporting).

Hospital Inventory Challenges:

The hospital wanted to improve the availability of supplies on the ward, by achieving and maintaining a balanced inventory – without relying on the involvement of clinical staff. Releasing busy nursing staff from logistics tasks would require the implementation of an automated Kanban and PAR system, including a newly-launched autonomous weight-based PAR bin. There were three main challenges that the hospital wanted to address.

Challenge 1:  Ordering was based on the experience and discretion of nursing staff

Problem:  Orders generated by the Supervising Nurse or Deputy Nurse were a ‘best guess’ that did not reflect the full level of need and resulted in inaccurate and high-frequency orders. The hospital identified the following recurring issues:

• • managing supplies was a time-consuming burden for nursing staff – in part due to the wide range of SKUs
  • there were stock outs and surpluses
  • nurses needed to hunt down missing supplies in other departments, where these were not available from the Logistics Department.
  • irregular restock patterns and excessive orders were common

Challenge 2: Disorganized store rooms

Problem: The department suffered from crowded storerooms; issues included:

• • new stock not being checked or approved by the clinical department staff, leaving the MMIS hanging with incomplete data.
  • delays in staff unpacking orders resulted in boxes being left outside the store room, this blocked the corridor and risked items going missing.
  • lack of inventory storage space led to items being stacked on carts in the middle of the supplies room, or in inaccessible places such as top shelves.
  • nurses needed to spend excessive time searching for the items they required.

Challenge 3: Reducing nurse involvement in materials management

Problem: Busy nurses want easy access to supplies and an end to stock-outs but they want the Logistics Team to manage this.

• • they don’t want their time taken up with supply chain tasks
  • logistics tasks reduce the time available for patient care
  • materials management activities have a negative impact on nurses` job satisfaction.

Kanban and PAR Solution:

The hospital selected IDENTI’s Kanban and PAR hybrid inventory management suite as the best way forward. This hybrid system is made up of several automated solutions:

• PAR Weighing Bins – wireless, autonomous and digital scale bins that self-replenish
• Restock Tags – a digital tag with a restock button – just one click to generate an order
• Scan and Restock App – creates and monitors orders via a mobile app

Methodology

The hospital carried out a pilot study over a three-month period (March – June 2022) – with the new Kanban and PAR inventory bin system in place for the final 7 weeks of the study.

The pilot took place in one ward and the methodology included data collection, staff interviews and the mapping of processes and store rooms. This provided a benchmark to compare performance before and after the arrival of the new system.

Pilot Methodology Summary

• Data collection and analysis
• Satisfaction surveys
• Measurement of execution time
• Additional conclusions and recommendations for application in departments

Pilot Action Taken:

139 SKUs were chosen to be tested in the pilot and were each managed by one of IDENTI’s Kanban and PAR solutions. The split of SKUs by solution is noted below:

Results of Kanban and PAR bins system pilot:

1. Order Distribution Before and During the Pilot

During the 7-week pilot of the new Kanban and PAR system the hospital achieved:

• • A decrease of 57% in the number of orders – a reduction from 51 orders down to 22 for the same timescale (Table 1)
  • A decrease of 4 orders per week; reducing from an average of 7 orders a week down to 3 – consisting of one main order and two small supplementary orders (Table 1)
  • On the main order day of the week, a decrease from three orders down to one – demonstrating order consolidation and increased efficiency in accurately identifying supplies needs (Table 1,2)
  • An increase in SKUs ordered – 297 individual SKUs were ordered during the pilot, as opposed to 277 in the same period prior to the pilot. This could indicate that past orders did not fully reflect demand, resulting in shortages and supplementary orders (Table 2)
  • A regular pattern was established – orders during the pilot were quite consistent in terms of their size, whereas past orders were more sporadic (Table 2).

2. Satisfaction Survey Results

Following the introduction of the new Kanban and PAR system:

• • The level of nurse satisfaction increased from an average of 53% before the pilot to 90% afterwards (Table 3)
  • All logistics tasks previously undertaken by nurses were no longer required due to the introduction of the new autonomous system. In addition, logistics workflows were streamlined. (Table 3)

A satisfaction survey was conducted among ward staff including: the Chief Nurse, the Deputy Chief Nurse and the rest of the registered nursing team.

The survey showed that nurses satisfaction improved as follows:

1. 1. How satisfied are you with the general service you received?
   2. To what extent are you satisfied with the convenience and ease of ordering with the system?
   3. How satisfied are you with the way changes and updates to orders were dealt with?
   4. How satisfied are you with the level of missing items?
   5. How satisfied are you with delivery timescales?
   6. How satisfied are you with the new layout of stock in storerooms?
   7. What is your level of satisfaction in terms of your preoccupation with orders and logistics?

3. Time spent improvement:

During the trial nurses no longer had any responsibilities relating to ordering stock:

• • Nursing staff time spent on stock orders dropped from 2 hours 39 minutes to zero
  • There was a reduction of 86% in nursing time spent on supplies organization
  • Time spent by logistics staff decreased from 2 hours 41 minutes to 1 hour 13 minutes.

Conclusion:

1. Having a fully automated Kanban and PAR solution resulted in the elimination of logistic tasks for nurses and significantly improved their job satisfaction.

• • Nurse satisfaction increased from 53% to 90%
  • A nurse survey taken after the introduction of the IDENTI Kanban and PAR inventory management system found improved satisfaction across a range of metrics.
    • The highest spike in satisfaction related to flexible configuration which resulted in better-organized stock rooms. Other positive feedback related to increased satisfaction with the materials management service and better delivery times.
    • The ease of accessing supplies, the improved turnaround of stock and the release of nursing staff from involvement in material management matters had a big impact on levels of satisfaction among nursing staff.

2. The time logistics staff spent in the department reduced by more than 50% during the pilot

• • The new hybrid Kanban and PAR solution added accuracy and visibility into supplies management, leading to a balanced inventory. Supplies were more readily accessible to nurses – locating stock becoming an easier task without surplus stock cluttering up storage spaces. Precise ordering also reduced stock-outs ensuring items were at hand when needed.

3. Having a hybrid, flexible solution enabled the reconfiguration and reorganization of the supplies room.

• • better layout, increased storage capacity and optimized shelf space – creating order in previously disorganized spaces.
  • less time required to restock the better-organized supplies rooms.
  • it was quicker and easier for nurses to find and access supplies.
  • there was more flexibility in terms of bin placement – in particular for the weight-based PAR bin, as it is an individual, portable unit that comes in 3 sizes – as opposed to being part of a fixed wall unit.

4. This pilot focused on operational improvements and did not measure financial metrics.

However, it can be seen that there is a large reduction in the time needed to manage inventory since the introduction of IDENTI’s automated Kanban bin system, and this will of course result in cost and resource savings. Cost savings would also be expected in relation to restocking, as unnecessary orders would no longer be placed.

5. The hospital realized the value of data-driven decision making, taking the guesswork out of ordering. They are now using accurate usage data to achieve more precise ordering.

The data provided by the management system is being used to support planning and deliver:

• • fewer, more consistent, more accurate orders, as opposed to the erratic orders of the past
  • SKU-specific restock orders, slashing the time taken by logistics staff to process reorders
  • data metrics and insights that provide materials managers with historical and real-time data – giving a clear picture of inventory informing inventory management decision making

6. The hospital is currently reviewing the further roll-out of the IDENTI Kanban and PAR solutions in other departments based on the successful results of the pilot.

Contact Us to discover a more efficienty and profitable way to manage your bulk medical supplies in the department.