Lean Supply Chain
contribution toward Lean Health Care
Edly Ferdin Ramly
Principal for EFR Management, Malaysia edly@efrmanagement.com
ABSTRACT
Lean systems allow a supply
chain to not only to be more efficient, but also faster. We can get our
sufficient supplies at right time, right quantity without any shortage or
excess inventory with effective lean supply chain. As the culture of lean takes
over the entire supply chain, all links increase their velocity. A culture of
rapid response and faster decisions becomes the expectation and the norm. However
leans supply chain always being left out during lean implementation in health
care.
Keywords: Lean Health care,
Just in time, Value Stream Map
INTRODUCTION
Lean thinking
are applicable anywhere there are processes to improve, including the entire
supply chain. A lean supply chain is one that produces just what and how much
is needed, when it is needed, and where it is needed.
The underlying
theme in lean thinking is to produce more or do more with fewer resources while
giving the end customer exactly what he or she wants. This means focusing on
each product and its value stream. To do this, organizations must be ready to
ask and understand which activities truly create value and which ones are
wasteful. The most important thing to remember is that lean is not simply about
eliminating waste—it is about eliminating waste and enhancing value.
The objectives
of this paper is to discuss the benefit and strategy ti implement lean supply
chain effectives. This synthesis based on single action base research enables
even small supplier or contractors to participate in the results of lean
efforts.
BENEFITS OF LEAN SUPPLY CHAIN
The main issues
in health care is increase of cost in medical supplies. The supplies included scientific
supply, medical supplies, linens, dietary, medical records, Patient
transportation and many more. All this supplies need to be
deliver in many areas in hospital including ward, clinics, laboratory and
theatres.Many supplies are everywhere and duplicate in many
location. Sometime excessive stock will lead to Out-of-date stock, less stock
will have erratic ordering, too many replenishment of supplies.
What benefit
the hospital when the hospital improve the supply chain? The hospital will able
to managed the supply chain effectively hence the expected results are:
•
Reduce purchasing cost
•
Reduce inventory
•
Reduce storage area
•
Improve warehouse control
•
Reduce lead time
•
Transportation cost
•
Reduce
error
A strong supply
chain enables the hospital to align themselves with each other and to
coordinate their continuous improvement efforts. Competitive advantage and
leadership in the global marketplace can only be gained by applying lean
principles to the supply chain. Thought, commitment, planning, collaboration,
and a path forward are required. A lean supply chain is proactive and plans for
the unexpected by positioning all resources for effectiveness. Downturns in
demand can be addressed without layoffs or significant productivity losses. What benefits the
organization as a whole benefits the supply chain.
LEAN SUPPLY CHAIN
STRATEGY
Supply chains
that want to grow and continue to improve must adopt lean. Lean concepts
require an attitude of continuous improvement with a bias for action. The
concepts of lean apply to all elements of the supply chain, including support
departments such as product development, quality, human resources, marketing,
finance, purchasing, and distribution. The challenge is to bring all of these
areas out of their traditional silos and make them work together to reduce
waste and create flow. Duplication and a lack of appropriate and timely
communication run rampant in these traditional organizations. All chain
partners have to be on the same playing field, and the lean concept is intended
to let everyone reach new levels of efficiency and effectiveness. Supply chain
leaders should not delay—it's urgent to act now to implement lean concepts in
the supply chain.
The strategy
relies on VIC strategy. The first strategy is to develop the value stream
mapping (V). The value stream map (VSM) able to identify the process, the
supplier. However the supply chain detail, is not identify in first level and
second level of VSM. Additional information need to be integrate (I) to the
VSM. The detail may included the type of supply required for each process,
quantity required, pull or push system, and supermarket. The final strategy is to
control the supplies.
Figure 1: Material flow symbol (Rother and
Shook, 1999)
CASE STUDY
The
team from Hospital A are eager to implement lean. Almost all the service have been analyses using value
stream map. The first strategy has been completed. However the format of value
stream map, have the problem on identify the supplier. The solution is use the
VSM proposed by Nash and Poling (2008). The supplier sysmbol have eliminate and
start with the “patient”
Figure 2: The example of VSM for
diagnostic imaging
The second strategy was to integrate the
the supply chain information VSM. Most of common VSM don’t have space to
identify the supplies required for the process. There are suggestion to use
simple process mapping but the ideas not able to see the connection of the
supplies to the process and other department. The team decided to used the
bottom of process to list out the supplies for each process. Example during
preparation of patients, all the items are listed and quantity required is
quantified and at the same time the number stock kept and the way of the stock
replenished is added.
The last strategy is to identify the way
to control the stock. The pull with Kanban system and visual management is
always the best solution. But there were some cases where the supplies can be
eliminate at all for example film type of diagnostic change with electronic
imaging. 5S control was implemented and minimum stock especially for consumable
supplies i.e. paper table, drape exam sheet, glove, gauze; medical supplies
i.e. Kenalog, prep pad alcohol etc.
CONCLUSIONS
With VIC (VSM – Integrate - Control) strategy, the lean supply chains have
implemented effectively on the internal stock control. The value stream mapping
provide more visual diagram of the supplies flow in health care process. Since
in health care main focus is patient, and to provide more value to patient,
sometime the stock control not been capture in VSM. The additional integration
was used to capture the supplies and stock current and futire practices. The
next challenge of the hospital is extend the implementation to purchasing,
central store and lean supplier for example on just in time, reduction of batch
size (minimum order quantity) and pull system.
ACKNOWLEDGEMENTS
The author would like to thank EFR
Management, Malaysia Productivity Corporation, National Iranian Productivity
Organization, Asia Productivity Organization, and management and staff of
Hospital A, Hasheminijad Kidney Centre, Tehran, Moheb Hospital, Tehran that provide the financial and resources
support in this research.
REFERENCES
Rother M and Shock J (1999),
“Learning to See”, Lean Enterprise
Institute
Arter D.R. (2008). Mapping
the total value stream mapping”, Productivity Press
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