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Southern Indiana CAH applies 5S Lean tool to reduce supply ordering errors

Wednesday, August 26 2015

Administrators at Harrison County Hospital, a Critical Access Hospital in Corydon, Ind., had a problem with supply delivery to nursing departments. They had been grappling with a new software system and the way it generated re-order lists for items charged to patients, such as feeding tubes, IV fluids, needles, catheters,  wound dressings and the like. Bad weather was exacerbating the problem by causing issues with supply delivery, so Purdue Healthcare Advisors (PHA) was called in to help the hospital better understand why supplies kept getting depleted.

A Lean Team was formed at the hospital consisting of the Materials Manager, three nursing managers (from the ER, ICU/TCU, and Med-Surg), two floor nurses, and two central supply techs. PHA guided the team in creating their project charter, educated the team on Lean philosophy, explained 5S, and helped them work through their current-to-future state workflow. Team Leader Denise Mathes (shown right), the hospital’s materials manager, said, “Having the floor nurses on the team made all the difference because we got to see their point of view and they began to understand the challenges we were facing in getting them the supplies they needed.”

The team focused its efforts on three departments and also added the Respiratory Therapy and the PICC cart. They discovered that the re-ordering process in the new system depended on the 100% accuracy by the person ordering. Delays in receiving supplies forced the central storage staff to make multiple trips to the units and to adjust the orders manually with paper lists; and it led to hoarding/hiding supplies by each of the nursing departments for fear they would not be there when needed.

Implementation of the Lean Team plan began in May and by July the positive feedback was overwhelming.  The plan started with a 5S organization project in which they filled ten tables with supplies that the floor staff had shoved in cabinets throughout the units. Using Lean tools such as color-coding and item separation, the team made the supplies easier for nurses to find, and was able to reduce the steps necessary to re-stock the units from 11 to 5. Central storage has not had to make any further manual adjustments but continues to monitor the supply flow through documentation of how often nurses request additional supplies on nights and weekends as well as a call log for daytime requests. Trust between the nursing staff and central storage has been restored.

Because the changes are working so well, the hospital plans to expand their Lean initiative to three other departments: the OB unit, Surgery and Wound Care. Central storage also has taken over the ordering of much of the non-chargeable supplies (i.e. soap, lotion, toothbrushes, tissues, etc.), which has lessened the workload of nurses so they can spend more time with patients.

This Lean project was funded by a grant from the Indiana State Office of Rural Health (INSORH). 

Writer: Jeanine Parsch, 765-337-7047,

Tags: Process & Cost Improvement (LEAN)

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