It takes time, commitment, persistence and investment to truly embed operational excellence (OpEx) in healthcare organizations; it is indeed a long-term project. The healthcare industry is ripe for Six Sigma and Lean efforts.

The industry shares many of the same challenges as a for-profit company, with the addition of culture and hierarchy barriers. There have been 12 reform attempts by the U.S. government since the onset of the healthcare crisis in the early 20th century. Using these methods can improve operational efficiency and increase patient satisfaction. An example of operational excellence in the healthcare industry is the referral to listing process for heart transplant patients. Most patients seeking a heart transplant are suffering from severe heart failure, heart disease, or other environment-related conditions.

To implement a successful OpEx strategy, organizations should begin by assessing their current status. The goals must be SMART (specific, measurable, achievable, relevant, and time-bound). They should include broad objectives as well as specific KPIs. This will make it easier to implement the strategy. As with any change initiative, operational excellence programs require resources and education from all employees. Once everyone is on board, the next step is implementing the program.

One example of a healthcare company's use of Lean Six Sigma processes is the implementation of a safety checklist. These checklists help to reduce the number of hospital-acquired bloodstream infections by more than 80%, resulting in a lower cost per infection. Other examples of operational excellence include SickKids Hospital in Toronto Canada, which has created a culture that empowers departments to act on problems.

Organizational excellence programs need to be implemented by empowering team members. These teams need to be empowered and encouraged to come up with ideas and bring suggestions to management. By empowering employees, you can improve the customer experience and the overall knowledge of your team. Ultimately, operational excellence is a journey, and your organization will always improve. Therefore it is crucial to invest in a robust training program for your employees.

Metrics for operational excellence are vital to measuring progress and providing meaningful information to employees. They help them focus on their work and help them determine where they need to make more effort. Metrics should be specific, measurable, and timely, so that the team can make changes as they see fit. The company should measure customer satisfaction and the overall patient experience to ensure operational excellence. The results of the metrics can be used to prioritize priorities and improve operations.

Surgical services are a major source of revenue in many hospitals and health systems. However, many healthcare systems do not use their key assets in the most efficient way possible. For example, when it comes to data migration, a lot of employees are not willing to switch to new methods. Therefore, the implementation of an OpEx program should be supported by a serious commitment from top-level management. The results should be visible in a matter of months.

To know more about how to bring a culture of operational excellence at your organization, checkout- Top Ten Strategic Decision-Making Tools for Operational Excellence

​Implementing Lean methodology is a great way to increase your chances of success. The Lean methodology offers proven solutions that are based on gathered facts and work in the real world. Additionally, Lean solutions can be transferred to other facilities, which will result in continuous improvement. Many modern healthcare organizations face the challenge of staff utilization. By improving staff management processes, Lean healthcare organizations will be able to use their resources more efficiently and boost patient safety.

Related Reading:​

1. Kaizen for pharmaceutical, medical device and biotech industries
2. How to cut costs strategically using Kaizen
3. Streamline processes and workflows with Gemba Walk.
4. Top Ten Strategic Decision-Making Tools for Operational Excellence

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​Today, September 29th is World Heart Day! Wish you all a Happy Heart, dil se …
 
Few days back, I read, that a company in The Netherlands launched a fully automated blood bank robot. The group claims that this robot simplifies the process of processing hundreds of blood donations each day. 
 
According to the news report, this fully automated system can take over manual tasks such as sorting by blood groups and ingredients, sticking labels, scanning codes, etc. It automates the entire process and prevents any potential contamination or damage to the donated items. It is also highly ergonomic. Moreover, the system automates all process activities and saves time.
 
My take on this news is that a blood bank robot will surely improve healthcare process efficiency, especially- The Red Cross platelet shipping box, stem cell research, targeted drug delivery via RBC carriers, handling hospital emergencies and surgeries.
 
Advances in trauma care and open-heart surgery have increased the need for blood. As blood bank robot shortens the blood donation process; hopefully, this will translate in overall cardiac care process efficiency improvement.
 
As a passionate scientist in cardiac therapeutic research as well as a process efficiency expert, a fully automated blood bank robot is a welcoming news!

Lastly but not in the least, I take a moment to pay my regards to the ‘Father of the blood bank’- Dr. Charles Richard Drew, renowned surgeon and pioneer in the preservation of life-saving blood plasma.

Related Reading:

1. Kaizen for pharmaceutical, medical device and biotech industries​
2. How to cut costs strategically using Kaizen
3. Top 30 Continuous Improvement Tools
4. How to Improve Operational Excellence in the Pharma Industry
5. Top 10 Change Management models
6. Continuous Improvement for Drug Industry: Part 1: Introduction to Digitalization in Pharmaceutical and Medical Device R&D.

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​Many times, people are unaware of the effects of drinking alcohol and fruit juices while on medications. 

Certain medications such as anti-depressants, anti-blood pressure, anti-diabetics should never be mixed or consumed along with alcohol (not even 1-2 social drinks). Similarly, certain anti-blood pressure medicines and antibiotics should never be consumed along with fruit juices especially grape-fruit juice. Why so? There are three main reasons: 

Firstly because many drugs inherently interact with alcohol and/ or fruit juices (including natural juices). In technical terms this is called as drug-food interaction. What this means is that, the drug’s behavior on a patient’s body changes and it may not show the desired beneficial effect or cure. This is called In other cases, it may also show single or multiple adverse effects including vomiting, head ache, flushing, paralysis or even death.

Secondly, if a patient takes multiple medications (including vitamins and supplements), consuming alcohol or fruit juice along with medications can lead to potential drug-drug interactions inside a patient’s body. This can aggravate effect of one drug while minimizing effect of other drugs, producing toxic effects of one drug while the other drugs show no effect at all !  

Thirdly, if a patient takes a ‘Time Release” medication, consuming alcohol along with such medications might prove to be fatal. 

A time-release medicament is a hi-tech product. It typically contains 2 or more doses of the drug (or medicament) in a single tablet or capsule, which is programmed to automatically release appropriate drug doses at programmed time intervals. Alcohol damages this programming and the patient gets all doses in one go, scientifically referred to as ‘dose dumping’. And the adversity of toxic effects as a result of dose-dumping, will directly be dependent upon the extent of dose-dumping and may include headache, vomiting, skin rashes, difficulty in breathing, loss of vision, memory loss, paralysis and death. Since, each person’s body reacts differently to alcohol initiated dose-dumping, it is absolutely impractical to predict severity of adverse effects. 

Synonymous time-release formulations include- Extended release (ER), Modified release (MR), Controlled release (CR), Sustained release (SR), Prolonged release (PR), Delayed release (DR) etc. 

Time-release medications are available both as Prescription (for example Sedatives, Marijuana, Antidepressants, Opiates, Anti-diabetic, Anti-blood pressure, Antibiotics etc.) as well as Over- the-counter (OTC) products (such as Cold, Flu, Anti-allergy, Aspirin, Pain remedies etc). 

Regardless of the medicament being regular or a time-release product, if you take prescription or over-the-counter medications, ask your health care provider for advice about alcohol, fruit juice intake. An important point to note is that even herbal medicines and supplements can have adverse interactions with alcohol and/or fruit juices.

Such information about a particular drug product's potential interaction with alcohol, fruit juices, or any other hot or cold beverage can be displayed on the pharma manufacturing company's website. This is an un-met opportunity in Continuous Improvement of patient engagement process. 

Disclaimer- Readers are advised to please note that, the information contained in this article is NOT a substitute for medical advice. It is intended to empower general public to understand the pharmaceutical world and consider ideas and alternatives while discussing their specific health scenario with medical and pharmaceutical professionals. Please discuss your specific scenario with a qualified Medical Doctor and ONLY follow health advice given by a qualified medical professional. Also, please note that each country has its own health care related regulation(s), readers are therefore expected to over-ride any information presented here to adhere to rules of their land.

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About Shruti Bhat PhD, MBA, Certified Lean Six Sigma Black Belt
 
Dr. Shruti Bhat is an award-winning Business Excellence Leader, Global Continuous Improvement Mastermind, Best-selling Author and Speaker. She is Continuous Improvement Advisor to several start-ups, mid-size and growing firms in Canada, USA, India, Africa and Emerging markets. She has authored eight business books and is an invited speaker at several national and international conferences, symposia and workshops.

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Today I read a report in Stat News about the first ‘digital pill’ that has been rolled out at a Cancer Treatment center in Minnesota US. The report mentions how chemotherapy pills taken by cancer patients are packaged with a sensor that can alert a physician, pharmacist, or caregiver after the pill has been swallowed.

The report highlights that seven patients — all of whom have colorectal cancer in stage 3 or stage 4 and are being treated in Minnesota — have been provided with this treatment. The idea is that, by tracking when patients take their drugs, health care providers will be better able to ensure medication adherence and to provide treatment guidance, with the goal of improving health outcomes.

How does digital pill work?:

After patients swallow a chemo capsule, the sensor gets activated once capsule gets damp in the stomach fluids. The sensor then pings a signal to a patch worn by patients on their torso; which transmits data on the time of day, the size of the dose, and the type of medication taken to an online portal that the patient can view. If patients choose to allow it, their support team can access this database portal too.

This program in Minnesota appears to be the first one in which a digital pill has been used in oncology. So far, neither patients nor insurers pay anything beyond the typical cost of the medication for this high-tech upgrade.

This news sparked my interest for several reasons-

1. As there is high proliferation of cancer disease world-wide, such digitization of cancer therapy will hopefully bring benefits to a wider population of cancer patients.
2. Despite advances in Oncology, not everything about cancer is understood by researchers, doctors, patients and care givers. The resulting effect is that there is no cure for cancer, especially once cancer has metastasized or is beyond stage 2. Another peculiarity of cancer is that no two types of cancer are same, hence medications and their dosages administered to cancer patients are different. For example, dosage of Tarceva tablets prescribed for a lung cancer patient is different from what is prescribed for a patient with pancreatic cancer. However, the digitization platform done for chemotherapy of colo-rectal cancer can be researched further to extend to other cancer types, which can yield better patient compliance, superior therapeutic modeling and better treatment outcomes to a wider patient population.
3. Additionally, this concept of  'digital pill' can be extended to other disease types too, where patient compliance has always been a problem; for example Tuberculosis, Schizophrenia, hypertension etc. Drug-resistant tuberculosis is worse to treat than regular TB. Hence, a digital TB pill will be  a boon for patients and doctors alike. Similarly, patients forgetting to take their blood pressure pill is usual, especially among older folks. Such non-compliance issues can hopefully be nipped in the bud with digital pharmaceuticals for hypertension.  
4. Such digital pills can substitute the health system services which invest in phone calls and other reminders to patients to help them stay on track with their medications.

'Digital' pill is not only an impressive step in Continuous Improvement for Cancer Therapy, it is a significant step in Continuous Improvement for Health System services too! and, hopefully pave way for Continual Improvement in TB care, hypertension management and patient-centric drug product design.

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Healthcare is a service-based business sector. Unlike other businesses, healthcare has a lot of human angle to it, since it deals with patients; people who are already traumatized with their ailing condition; sometimes having terminal illnesses. Hence, business process management in healthcare assumes significance. Conventional continuous improvement methodologies have known to decrease patient wait time, make efficient use of doctor's time in clinics, increased turnovers from operation theaters etc.

However, a limitation of conventional continuous improvement methodologies for healthcare is that they can deal with administrative or service processes only. Conventional continuous improvement methodologies either don't work for healthcare facility improvement or prove to be unpracticable due to high cost. That's where Kaizen steps in. Checkout this video ...

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