Using lean operations to reduce wastes in the medication administration process at the Gertrude’s Children’s Hospital, Nairobi, Kenya
Date
2019
Authors
Nyarangi, Wambugu Naomi
Journal Title
Journal ISSN
Volume Title
Publisher
Strathmore University
Abstract
Lean operations can help to reduce waste and improve workflow, resulting in fewer medical errors, cost savings, reduced medication turnaround times, and reduced product verification and delivery time in the healthcare industry. This study sought to describe the current medication processes at Gertrude's Children’s Hospital, to identify wastes in the medication administration processes, and, to develop and validate a novel medication process that minimizes identified wastes and improves safety and quality throughout the process. The study employed a descriptive cross-sectional design. The study employed a census approach in the recruitment of study respondents. Both quantitative and qualitative data. Data were obtained using a self-administered structured questionnaire from the frontline staff involved medication administration process and via in-depth interviews. Value Stream Mapping tool was used to analyze the medication administration process and process mapping was done to display the process flow. Data were analyzed using descriptive and inferential statistics. Regression analysis was done to identify factors contributing to waste in the medication process. Statistical Package for Social Sciences (SPSS) was used to analyze quantitative data. Qualitative data from the in-depth interviews were analyzed thematically and a framework approach was used in the analysis. Overall, the targeted population was all employees involved in the frontline of the medication administration process (n=60). The study excluded two staff on leave schedule and together with a non-response rate of 10.3% (6) a total of 52 staff (18 pharmacists, 18 nurses, and 16 doctors) were enrolled in the study. Among the respondents 63.5% (n=33) were females and 36.5% (n=l9) were males. The results of the study established that there was a positive relationship between organizational, people (staff and patients), technological, environmental, and task-related factors with timely medication administration but the relationship was insignificant. Thematic analysis revealed that process engineering on the technology system by putting process alerts will help in reducing medication turnaround times. In conclusion, the factors leading to medication delays were poor communication, lack of teamwork, and inadequate staffing. The study, therefore, recommended there is a need for the hospital management to look into outpatient staffing ratios to have adequate staff, to enhance a culture of teamwork among staff, and put in place in the technology system, some process alerts in the system to give prompts for action on the computerized order system
Description
Submitted in partial fulfillment of the requirements for the award of a degree in Master's in Business Administration Health Care Management