How to Find a Pharmacy that Specializes in Compounding

Posted by dayat on September 8, 2024 in Healthcare

Exploring how to find a pharmacy that specializes in compounding opens up a world of possibilities for those seeking personalized medication solutions. This guide will navigate through essential factors, research tips, and the importance of communication with pharmacists in this specialized field.

Delving deeper into the realm of compounded medications unveils a unique approach to healthcare that prioritizes individual needs and preferences.

Factors to Consider When Finding a Pharmacy Specializing in Compounding

Finding a pharmacy that specializes in compounding medications can be crucial for individuals with specific needs that cannot be met by commercially available drugs. Here are some key factors to consider when searching for a pharmacy that offers compounding services:

Accreditation and Licensing

Ensure the pharmacy is accredited by a recognized organization and holds the necessary licenses to operate.
Accreditation ensures that the pharmacy meets certain quality standards and follows best practices in compounding.
Licensing is essential to guarantee that the pharmacy complies with state and federal regulations.

Experience and Expertise

Look for a pharmacy with experienced pharmacists who specialize in compounding medications.
Experience plays a vital role in ensuring the accuracy and safety of compounded medications.
Pharmacists with expertise in compounding can provide personalized solutions tailored to individual needs.

Quality of Ingredients and Equipment

Verify that the pharmacy uses high-quality ingredients and follows strict guidelines for sourcing and handling them.
Quality ingredients are essential for the effectiveness and safety of compounded medications.
State-of-the-art equipment and facilities are crucial for maintaining the integrity of the compounding process.

Communication and Customer Service

Choose a pharmacy that values clear communication and offers excellent customer service.
Effective communication ensures that your needs and preferences are understood and addressed properly.
Good customer service creates a positive experience and fosters trust in the pharmacy’s services.

How to Research Pharmacies Specializing in Compounding

Researching pharmacies that specialize in compounding services is essential to ensure you find a reputable and reliable pharmacy that meets your needs. Below is a step-by-step guide on how to conduct your research effectively.

Utilize Online Resources

Start by searching online for compounding pharmacies in your area.
Check websites like the Professional Compounding Centers of America (PCCA) or the International Academy of Compounding Pharmacists (IACP) for directories of accredited compounding pharmacies.
Read reviews and testimonials from previous customers to gauge the quality of services provided by the pharmacy.

Consult Your Healthcare Provider

Ask your healthcare provider or pharmacist for recommendations on reputable compounding pharmacies.
They may have insights or knowledge about local pharmacies that specialize in compounding.

Check Credentials and Reviews

Verify the pharmacy’s credentials, including accreditation and licensing.
Look for reviews and ratings on platforms like Google, Yelp, or Healthgrades to get an idea of other customers’ experiences.
Consider the overall reputation of the pharmacy and the qualifications of the pharmacists who will be compounding your medications.

Evaluating the Expertise of a Compounding Pharmacy

When looking for a pharmacy that specializes in compounding, it is crucial to assess the expertise of the pharmacists working there. Here are some key factors to consider:

Qualifications and Certifications

Look for pharmacists who have completed additional training in compounding, such as a certification from the Professional Compounding Centers of America (PCCA) or Accreditation Council for Pharmacy Education (ACPE).
Check if the pharmacy complies with state regulations regarding compounding practices and if the pharmacists are licensed and have relevant certifications.

Experience and Specialization

Experience is key when it comes to compounding pharmacy as it involves creating customized medications based on specific patient needs.

Consider how long the pharmacy has been offering compounding services and the variety of compounds they have experience in preparing.
Specialization in certain areas such as hormone replacement therapy, dermatology, or veterinary compounding can also indicate a higher level of expertise.

Understanding the Types of Compounded Medications Offered

Compounding pharmacies can offer a wide range of customized medications tailored to meet individual needs. These medications are specifically formulated by pharmacists to address unique requirements or preferences that may not be met by commercially available medications.

Types of Compounded Medications

Topical Preparations: These are creams, gels, lotions, or ointments applied to the skin for conditions like pain management, dermatological issues, or hormone replacement therapy.
Oral Suspensions: Liquid medications formulated for patients who have difficulty swallowing pills or need precise dosages not available in commercially manufactured forms.
Capsules and Troches: These are alternative dosage forms for patients who cannot take traditional pills or need customized drug combinations.
Suppositories: Rectal or vaginal preparations used for conditions like hormonal imbalances, gastrointestinal issues, or pain management.

Conditions Requiring Compounded Medications

Children with specific dosage requirements or flavor preferences.
Pets needing medications in forms or flavors not commercially available.
Patients allergic to dyes, preservatives, or other ingredients in standard medications.
Individuals requiring unique drug combinations not available in commercial products.

Benefits of Personalized Compounded Medications

Customized dosages to meet individual needs.
Elimination of allergens or intolerable ingredients.
Ability to combine multiple medications into a single dosage form for convenience.
Alternative dosage forms for patients with swallowing difficulties.

Importance of Communication with the Pharmacist

Effective communication with the compounding pharmacist is crucial to ensure the accurate preparation of compounded medications. This open dialogue allows you to convey your specific needs and preferences, leading to a customized medication solution that meets your individual requirements.

Tips for Effective Communication:

Clearly explain your symptoms and medical history to the pharmacist to ensure they have all the necessary information.
Discuss any allergies or sensitivities you may have to certain ingredients to prevent any adverse reactions.
Be open about your preferences regarding dosage forms, flavors, and any other specific requirements you may have.
Ask questions if you are unsure about anything and seek clarification to ensure you have a clear understanding of the compounded medication.
Provide feedback to the pharmacist after using the compounded medication to help them adjust the formulation if needed.

Insurance Coverage for Compounded Medications

When it comes to compounded medications, navigating insurance coverage can be a bit more complex compared to traditional prescriptions. Insurance coverage for compounded medications works differently due to the customized nature of these prescriptions.

Factors Affecting Insurance Reimbursement for Compounded Prescriptions

Formulary Restrictions: Some insurance plans may have restrictions on the types of compounded medications they cover.
Ingredient Cost: The cost of specific ingredients used in the compounded medication may affect reimbursement.
Pharmacy Network: Insurance plans may have specific pharmacies in their network that they work with for compounded medications.
Prior Authorization: Some insurers may require prior authorization before covering compounded medications.

Tips for Navigating Insurance Coverage for Compounded Medications

Check with Your Insurance Provider: Contact your insurance provider to understand what is covered under your plan.
Ask Your Pharmacist: Your pharmacist specializing in compounding can help you navigate insurance coverage and provide information on reimbursement.
Keep Detailed Records: Maintain records of your compounded medication prescriptions, receipts, and any communication with your insurance provider for reimbursement purposes.
Appeal if Necessary: If your insurance denies coverage for a compounded medication, you can appeal the decision with supporting documentation from your healthcare provider.

Quality Control and Safety Measures in Compounding Pharmacies

Compounding pharmacies play a crucial role in providing personalized medications to patients with specific needs. To ensure the quality and safety of compounded medications, these pharmacies implement rigorous quality control measures and adhere to strict safety protocols.

Quality Control Measures

Compounding pharmacies follow stringent quality control measures to guarantee the potency, purity, and consistency of compounded medications. These measures include:

Regular testing of ingredients for potency and purity
Verification of proper compounding techniques by trained professionals
Maintaining a clean and sterile compounding environment
Regular calibration and maintenance of compounding equipment

Safety Protocols in Compounding

Ensuring the safety of compounded medications is paramount in compounding pharmacies. Safety protocols are put in place to prevent contamination, errors, and ensure the correct formulation of medications. These safety measures include:

Strict adherence to standardized compounding procedures
Labeling and packaging medications accurately
Performing regular quality checks and inspections
Proper disposal of expired or unused medications

Regulatory Standards

Compounding pharmacies must adhere to regulatory standards set by organizations such as the US Pharmacopeia (USP) and the Food and Drug Administration (FDA). These standards ensure that compounded medications meet specific requirements for safety, quality, and efficacy. Regulatory standards cover aspects such as:

Proper documentation of compounding processes
Training and qualifications of compounding pharmacists and technicians
Storage and handling of ingredients and finished products
Reporting and handling of adverse events or quality issues

Seeking Recommendations from Healthcare Providers

When looking for a compounding pharmacy, seeking recommendations from healthcare providers can be a valuable step in finding the right one for your needs. Healthcare professionals, including doctors, nurses, and pharmacists, can provide guidance based on their knowledge and experience, helping you make an informed decision.

Role of Healthcare Professionals

Healthcare providers play a crucial role in guiding patients to the right compounding pharmacy. They can recommend pharmacies that have a good reputation, specialize in the specific type of compounded medications you need, and adhere to quality and safety standards.

By collaborating with healthcare providers, you can benefit from their expertise and ensure that you receive high-quality compounded medications tailored to your individual requirements.

Collaborating for Better Health Outcomes

Collaborating with healthcare providers when choosing a compounding pharmacy can lead to better health outcomes. Healthcare professionals can work closely with pharmacists to communicate your unique healthcare needs, preferences, and any special requirements for compounded medications. This collaboration helps ensure that the medications are customized to suit your specific health condition, increasing the likelihood of achieving positive results and improving your overall well-being.

Last Word

In conclusion, the journey to finding a pharmacy specializing in compounding is a meticulous yet rewarding process that ultimately leads to tailored healthcare solutions and improved patient outcomes.

FAQ Resource

What are the key factors to consider when searching for a pharmacy specializing in compounding?

Key factors include expertise, types of medications offered, communication with the pharmacist, insurance coverage, quality control, and recommendations from healthcare providers.

Where can reliable information about compounding pharmacies be found?

Reliable information can be found on websites of pharmacy organizations, healthcare provider recommendations, and through online reviews.

What qualifications and certifications should one look for in a compounding pharmacist?

Look for certifications from organizations like the Pharmacy Compounding Accreditation Board (PCAB) and qualifications in pharmaceutical compounding.

What types of conditions may require customized compounded medications?

Conditions like allergies, hormone imbalances, pediatric needs, and pain management often require customized compounded medications.

How does insurance coverage work for compounded medications?

Insurance coverage for compounded medications varies, and factors like the type of insurance plan and specific medication can affect reimbursement.

How to navigate healthcare options after a diagnosis: A Comprehensive Guide

Posted by dayat on July 30, 2024 in Health

Embarking on the journey of navigating healthcare options after a diagnosis can be overwhelming yet crucial. From exploring traditional medical treatments to delving into alternative therapies, the choices can seem endless. This guide aims to shed light on the various pathways available and empower you to make informed decisions about your health.

As we delve deeper into each aspect, you’ll uncover valuable insights that can guide you towards a more holistic approach to healthcare post-diagnosis.

Healthcare Options Post-Diagnosis

After receiving a diagnosis, it’s crucial to explore the various healthcare options available to effectively manage your condition and improve your overall well-being. These options can range from traditional medical treatments to alternative therapies, each offering different approaches to address your health needs.

Traditional Medical Treatments

Traditional medical treatments are based on scientific evidence and commonly prescribed by healthcare professionals. These treatments may include medication, surgery, physical therapy, or other conventional interventions. It is essential to follow your healthcare provider’s recommendations and adhere to the prescribed treatment plan to achieve the best outcomes.

Regular check-ups and monitoring are also necessary to track progress and make any necessary adjustments to your treatment.

Alternative Therapies

Alternative therapies encompass a wide range of approaches that are not considered conventional medical treatments. These may include acupuncture, chiropractic care, herbal remedies, yoga, meditation, and other holistic practices. While alternative therapies may not always have the same level of scientific evidence as traditional treatments, some individuals find them beneficial in managing symptoms and improving their quality of life.

It’s important to consult with your healthcare provider before trying any alternative therapies to ensure they are safe and complement your existing treatment plan.

Navigating Addictions and Treatment

Addiction is a serious issue that often requires professional treatment and support to overcome. When navigating addiction treatment options post-diagnosis, it’s essential to consider various factors to find the most suitable program for your needs.

Finding Addiction Treatment Programs

Start by consulting with a healthcare provider or addiction specialist to assess your specific needs and recommend appropriate treatment options.
Research different types of addiction treatment programs, such as inpatient, outpatient, or residential programs, to determine which aligns best with your recovery goals.
Consider the location, cost, and available therapies offered by each program to ensure it meets your individual requirements.
Seek recommendations from trusted sources, such as medical professionals, support groups, or online reviews, to gather insights on the effectiveness of different treatment programs.

The Role of Support Groups in Addiction Recovery

Support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), play a crucial role in addiction recovery by providing a sense of community, understanding, and encouragement.
Joining a support group can help you connect with others who are facing similar challenges and share experiences, strategies, and coping mechanisms for overcoming addiction.
Attending regular support group meetings can offer ongoing motivation, accountability, and emotional support throughout the recovery process.
Engaging with a support group can also help you build a strong network of individuals who can provide guidance, empathy, and solidarity in your journey towards sobriety.

The Benefits of Holistic Approaches to Addiction Treatment

Holistic addiction treatment approaches focus on treating the individual as a whole, addressing not only the addiction but also the underlying physical, emotional, and spiritual aspects of the person.
Integrating holistic therapies such as mindfulness meditation, yoga, art therapy, and nutrition counseling can enhance the overall well-being and recovery outcomes of individuals struggling with addiction.
Holistic treatment programs often emphasize self-care practices, stress management techniques, and lifestyle changes that promote long-term sobriety and overall health.
By taking a holistic approach to addiction treatment, individuals can develop a comprehensive set of tools and strategies to manage cravings, cope with triggers, and maintain a balanced and fulfilling life free from substance abuse.

Exploring Alternative Treatment Modalities

When facing a diagnosis, exploring alternative treatment options beyond conventional medicine can provide additional avenues for healing and symptom management. These alternative therapies can complement traditional medical approaches and offer a holistic approach to healthcare.

Potential Benefits of Complementary Therapies

Complementary therapies such as acupuncture, massage therapy, and meditation can help reduce stress and anxiety commonly experienced post-diagnosis.
Alternative treatments like herbal remedies, dietary changes, and supplements may support the body’s natural healing processes and overall well-being.
Modalities such as yoga, tai chi, and chiropractic care can improve flexibility, balance, and physical strength, contributing to a better quality of life.

Importance of Consulting Healthcare Professionals

Before trying any alternative treatments, it is crucial to consult with healthcare professionals, including your primary care physician or specialist. They can provide guidance on the safety, efficacy, and potential interactions of alternative therapies with your current treatment plan. Additionally, healthcare providers can help you navigate the vast array of alternative treatment options available and tailor a holistic approach that best suits your individual needs.

Beauty and Cosmetics Considerations

When navigating healthcare options after a diagnosis, it is essential to consider how treatments may impact your skincare and beauty routines. Maintaining self-care practices can help boost your confidence and overall well-being during this challenging time.

Skincare Concerns

Some medical treatments, such as chemotherapy or radiation therapy, can have side effects that affect the skin. It is important to communicate any changes in your skin to your healthcare provider to address them effectively.

Stay hydrated by drinking plenty of water to keep your skin moisturized.
Use gentle skincare products to avoid irritation, especially if your skin is sensitive due to treatment.
Protect your skin from the sun by wearing sunscreen and protective clothing, as some treatments can make your skin more sensitive to UV rays.

Beauty Regimens

Adjusting your beauty routine to accommodate your healthcare needs is crucial. Here are some tips to help you maintain your self-care practices:

Opt for gentle makeup products that are suitable for sensitive skin.
Practice good hygiene to prevent infections, especially if your immune system is compromised.
Experiment with wigs, scarves, or hats if you experience hair loss due to treatment, and embrace your natural beauty.

Insights from Natural and Physical Sciences

Understanding the principles of natural and physical sciences can provide valuable insights for making informed healthcare decisions. These disciplines offer essential knowledge that can guide individuals in managing their health post-diagnosis.

Role of Physical Activity in Overall Health

Physical activity plays a crucial role in promoting overall health, especially after a diagnosis. Regular exercise can improve cardiovascular health, strengthen muscles, boost immunity, and enhance mental well-being. Engaging in physical activities tailored to individual needs can help manage symptoms, increase energy levels, and improve quality of life.

Connection Between Nutrition and Physical Well-being

Nutrition is closely linked to physical well-being and plays a significant role in healthcare management post-diagnosis. A balanced diet rich in essential nutrients can support the body’s healing process, boost immune function, and optimize overall health. Proper nutrition can help manage symptoms, reduce inflammation, and improve the body’s ability to recover from illness or treatment.

Understanding the Role of Medicine

Medications play a crucial role in managing health conditions post-diagnosis. They are prescribed to help alleviate symptoms, treat underlying causes, and improve overall quality of life. Adherence to medication regimens is essential for successful management of health conditions.

Various Medications and Their Purposes

Antibiotics: Prescribed to treat bacterial infections by killing or inhibiting the growth of bacteria.
Anti-inflammatory drugs: Used to reduce inflammation and pain associated with conditions like arthritis.
Antidepressants: Given to manage symptoms of depression or anxiety by regulating brain chemicals.
Anti-hypertensives: Help lower blood pressure and reduce the risk of heart disease and stroke.

Importance of Medication Adherence

Adherence to prescribed medications is crucial in managing health conditions effectively. Skipping doses or not following the prescribed regimen can lead to treatment failure, worsening of symptoms, and potential complications.

Communicating with Healthcare Providers

Provide accurate information about current medications, including over-the-counter drugs and supplements.
Ask questions about the purpose of each medication, potential side effects, and how to take them correctly.
Discuss any concerns or difficulties with adhering to the prescribed regimen openly with your healthcare provider.

Mental Health Support and Resources

Seeking mental health support after a diagnosis is crucial for overall well-being. A health diagnosis can have a significant impact on mental health, leading to feelings of anxiety, depression, or stress. It is essential to address these concerns and explore different therapeutic approaches to manage mental health alongside medical treatments.

Therapeutic Approaches for Mental Health

Psychotherapy: Also known as talk therapy, psychotherapy involves discussing emotions, thoughts, and behaviors with a trained therapist to improve mental health.
Medication: In some cases, medication may be prescribed to help manage symptoms of anxiety, depression, or other mental health conditions.
Mindfulness and Meditation: Practices such as mindfulness and meditation can help reduce stress, improve focus, and promote overall well-being.
Support Groups: Connecting with others who are going through similar experiences can provide valuable support and a sense of community.
Exercise and Physical Activity: Regular physical activity has been shown to have positive effects on mental health, helping to reduce symptoms of anxiety and depression.

Navigating Nutritional Choices

Making informed nutritional choices post-diagnosis is crucial for managing health conditions effectively. A well-balanced diet can play a significant role in supporting your overall well-being and treatment plan. Consultation with healthcare professionals can help you create a personalized diet plan tailored to your specific needs and health goals.

Role of Diet in Managing Health Conditions

Nutrition plays a vital role in managing various health conditions such as diabetes, heart disease, and autoimmune disorders. A healthy diet can help control symptoms, improve energy levels, and support the effectiveness of medications or treatments prescribed by your healthcare provider.

Include a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats in your diet.
Avoid processed foods, sugary beverages, and excessive amounts of salt and saturated fats.
Stay hydrated by drinking an adequate amount of water throughout the day.
Monitor your portion sizes and practice mindful eating to prevent overeating.
Consider working with a registered dietitian to address specific dietary concerns and receive personalized guidance.

Creating a Balanced Diet Plan

In collaboration with your healthcare team, you can develop a balanced diet plan that meets your nutritional needs and supports your treatment goals. This plan may involve:

Identifying foods to include or limit based on your health condition and any dietary restrictions you may have.
Setting realistic and achievable dietary goals to gradually improve your eating habits.
Tracking your food intake and monitoring how certain foods impact your symptoms or overall health.
Adjusting your diet plan as needed to optimize your nutritional intake and well-being.
Seeking ongoing guidance and support from healthcare professionals to ensure you stay on track with your dietary recommendations.

Pharmacy Services and Medication Management

Pharmacies play a crucial role in healthcare post-diagnosis by providing access to prescribed medications and offering guidance on their safe and effective use. Understanding how to navigate pharmacy services and manage medications is essential for maintaining health and well-being.

The Role of Pharmacies in Healthcare

Pharmacies serve as a vital link between healthcare providers and patients, ensuring that prescribed medications are dispensed accurately and that patients receive proper instructions on how to take their medications. Pharmacists play a key role in educating patients about their medications, including potential side effects and interactions with other drugs.

They also help monitor medication adherence and provide valuable advice on managing chronic conditions.

Importance of Medication Safety and Storage

Ensuring medication safety and proper storage is essential to prevent accidental misuse or deterioration of medications. It is important to store medications in a cool, dry place away from direct sunlight and out of reach of children and pets. Always check expiration dates and dispose of any expired or unused medications properly to avoid potential health risks.

Organizing Medication Schedules and Refills

Organizing medication schedules and refills can help streamline the management of multiple medications and ensure consistent adherence to treatment plans. Consider using a pill organizer or setting reminders on your phone to take medications at the correct times. Keep a list of all medications, including dosages and frequencies, to easily track refills and communicate with healthcare providers about any changes or concerns.

Final Thoughts

In conclusion, the key to navigating healthcare options after a diagnosis lies in education, exploration, and communication. By understanding the different treatment modalities, embracing self-care practices, and seeking the right support, you can embark on a journey towards improved well-being and quality of life.

Expert Answers

How do I know which healthcare option is best for me post-diagnosis?

It’s essential to consult with healthcare professionals to determine the most suitable treatment plan based on your specific condition and needs.

Are alternative treatments safe to try after a diagnosis?

Before exploring alternative therapies, it’s crucial to seek advice from your healthcare provider to ensure they complement your existing treatment plan and are safe for your health.

How can I maintain a balanced diet while navigating healthcare options after a diagnosis?

Working with a nutritionist or dietitian can help you create a personalized diet plan that meets your nutritional needs and supports your overall health during your healthcare journey.

Bringing Lean Healthcare to Life

Posted by dayat on May 13, 2021 in Uncategorized

Starting Blocks

Without a doubt, Lean is set to make a big impact on the Healthcare sector over the next few years and many Healthcare organisations in both the public and private sector are already exploring how they could apply it to their patient pathways and administrative processes.

Whilst many of the tools of Lean are familiar to the people in the Healthcare sector, particularly aspects of Process Analysis, the real difference that Lean will bring is a change in the way that improvements activities are implemented rather than the use of the tools themselves.

Many people in the Healthcare sector are looking to people with Lean skills gained in manufacturing to help guide them through the maze of implementing Lean, including helping the organisation to prepare for Lean as well as undertake the specific improvement activities, including Value Stream Events, Rapid Improvement Events etc. Running alongside this is the need to develop the internal capacity of organisations to lead improvements themselves, which is achieved by developing internal Lean facilitators (or Change Agents).

However, as we already know, not every problem in Healthcare can be related to a problem encountered in Manufacturing and there are some significant differences in approach required to make for a successful improvement programme for people more familiar with leading Lean improvements in Manufacturing.

In this article we review some of the key differences that we have found in pioneering Lean transformation in Healthcare and share the structure to Lean activities that we have been developing to ensure that the organisations make sustained improvements rather than isolated Lean ‘ram raids’.

Interestingly, our work to date is also providing some useful learning that can be applied in reverse – from Healthcare back into Manufacturing!

The Same, But Different

As we have already said, Lean will make a big difference to Healthcare and will help them achieve their operational and financial targets but it needs to be applied sensitively within organisations that have been ‘pummelled’ by initiatives and legislation and have a not unreasonable cynicism towards ‘this new initiative called Lean’.

Like in many manufacturing businesses first embarking on an improvement journey, Healthcare employees are concerned about Lean being a vehicle to cut jobs. This feeling has not been helped by the recent NHS guide issued about Lean Healthcare which has chosen to use a Chainsaw as their main logo and was referred to by a Service Improvement Lead within an SHA (Strategic Health Authority) as the ‘Slash & Burn’ guide to Healthcare.

Issues such as this, along with the use of manufacturing focused terminology, photos and case studies when working with employees in Healthcare, has the effect of building up internal resistance and leads to comments such as “My patients are not cars” made by a Renal Consultant we encountered recently.

Additional differences can be seen in the attitude towards risk in Healthcare. In Manufacturing, if you make a mistake with Lean you may increase the risk of accidents but it is more likely it will just reduce productivity or profits. In Healthcare, similar mistakes can impact on Patient Safety (including increasing Morbidity or even Mortality) and can attract significant media attention.

Making this scenario even more complex is the fact that the ‘care pathways’ that patients experience often interact and overlap in a way that Manufacturing value streams do not, with patients switching between pathways and specialities dependent on their specific needs and treatment plans.

Management of these processes and pathways is complicated by the need to balance clinical concerns (such as patient safety and medical best practice) with ‘business’ concerns (availability of resources and finance), and the often uneasy balance that has to be struck between senior clinicians and organisational managers on these issues.

Whilst this sort of complexity is not alien to manufacturing, where there is a constant need to balance cashflow against sales (for example), the fact that this balancing and the resulting management of risk in Healthcare is so prevalent leads to a very different style of management – being more consultative and inclusive than Manufacturing, which slows decision making and involves a lot more analysis than many Manufacturing decisions, and the need to prove things first to sceptical clinicians.

This constant need for balance between clinical and operational concerns leads to one of the biggest differences we encounter, namely the difficulty in engaging the right people for the right amount time to make the improvements sustainable. This is not a new problem in Healthcare with many improvement initiatives having fallen foul of changing priorities, the allocation of insufficient people to an improvement process or simply having failed to move from discussion into action quickly enough.

One final difference between Manufacturing and Healthcare that we thought useful to highlight is simply the differences between what ‘customers’ think of as Value Adding in the two sectors. Giving comfort and advice to a patient is highly valued (for example, a nurse accompanying a patient being taken to theatre) but does not translate easily into a manufacturing equivalent activity.

A Holistic Approach
To counter these issues, introducing Lean into Healthcare requires a holistic approach that takes into account the following points:

1. Understanding Customer Value

Whilst the patient is the obvious (and most important) customer in a process, they may not be the only customer in a Healthcare environment; with others including (say) a Primary Care Trust that has commissioned a Hospital to undertake some activity on a patient and which will be invoiced for the activity.

However, in exploring what customer think of as value adding we do find some customers (patients) in Healthcare have become conditioned by their experiences to date. In one example we were speaking to a patient who attended clinics weekly as part of their treatment plan and was required to wait at every appointment for up to two hours. When we discussed what they valued and whether a reduced waiting time would be beneficial, they said they had come to expect the wait and would place more value on access to free coffee and better magazines to read!

2. Scoping Effectively

Identifying a compelling need for the improvement process is absolutely essential. The need to improve productivity or finances are often driving improvement initiatives in Healthcare but a compelling need based on saving money will rarely engage people from across the pathway.

Often a successful compelling need will focus on improving patient outcomes and achieving the statutory targets within public Healthcare (such as achieving an 18 Week maximum lead-time from referral by a GP to the start of treatment) as well as the need to achieve best practice rates for activity. Because of the importance of this step in the process, we have shown what we believe are the key elements required to successfully scope an improvement project in the text box opposite. It is worth stating that to be truly successful, the scoping of Lean improvements relies on having representation from across the pathway – even if, as is so often the case, that means including people who have never considered themselves as co-workers before, such as the GP and the Hospital Porter we had sitting next to each other at a recent Scoping session.

3. Effective Sponsorship

Leading a Lean project that spans such broad patient pathways requires a high degree of influencing skills. Even seeking to improve a simple administrative process like a Patient Discharge for example, could require the Project Sponsor to liaise, cajole and drive change across several stakeholder groups including GPs, consultants (the real custodians of the NHS), ward staff, medical secretaries, pharmacy staff, IT, social services and porters!

The Sponsor’s belief in Lean will be tested daily by such a large group of interested parties and so their capacity to maintain enthusiasm and motivate the Change Agents is vital. The secret weapon at their disposal, once the Scoping session has been completed is that an agreed Compelling Need will create “clarity of purpose”. Ultimately, if they engage enough people with the same message enough times, the followers will start to assemble.

4. Building Awareness & Capacity

Given the concerns of many in Healthcare that Lean is going to be used to shed jobs, it is essential that there is thought given to the communication of the ‘Compelling Need’ – what Lean is, what it is not and what will happen. Running alongside the raising of awareness will be the need to focus on developing the capacity of individuals within the organisation to enable them to lead Lean improvements.

In addition to initial awareness activities, there is also a need to build on-going communication activities to report on progress, involve others in the design of new processes and ensure that the organisation embeds the improvements achieved before (or alongside) moving onto the next challenge.

Our experience of this shows that at the start of the process a lot of people think of Lean as being just about ‘Process Mapping’ and there is a certain cynicism about it in many areas. This is quickly overcome but can be quite demoralising when first encountered and this confusion about Lean underpins the need to develop broad awareness within the organisation of what Lean truly can deliver.

In terms of capacity, many Healthcare bodies are keen to build internal capability to develop themselves as Lean organisations. Performance Improvement Teams are popping up all over the place and we have found that a large part of our work has been focused on helping these teams of change agents develop the facilitation skills and leadership attributes that will enable them to not only deliver change but make it sustainable.

5. End 2 End Understanding

We mentioned earlier that one of the ways that Lean in Healthcare is different to Lean in Manufacturing is that the pathways (value streams) interact in a different way. Another problem is often encountered through isolated events in one area having an unexpected (and often negative) impact either upstream or downstream in the pathway. Given the risk associated with making changes in different parts of Healthcare, we believe it is essential to develop an understanding of how the pathway operates from End 2 End and to review its critical constraints, current operating performance and the impact that likely changes might have elsewhere before seeking to create a suitable ‘Future State’ and implementation plan.

6. Embedding the Change

Much like Manufacturing, a large percentage of Lean projects in Healthcare are going to fail to deliver the results that organisations hoped for and many of these problems are related to the challenge of embedding the changes. So, having gathered support for an improvement programme and achieved the changes (through Focused Improvement Teams, Rapid Improvement Events etc), it is critical to also conduct the activities that will assist the embedding of the changes including:

 Publicity and communication of how the new systems/processes work
 Celebration of the improvements achieved
 Reviews of achievements (Progress Gates) which look back at what has already been done
 Auditing to ensure the changes don’t slip back to ‘the old way’
 Further events and activities (as one success often breeds further successes)
 On-going Change Agent Development
 On-going, visible Sponsorship.

No Magic Bullet
When we opened this short article, we mentioned that Lean is set to have a big impact on Healthcare as it can address the needs for improved effectiveness as well as reduced lead-times and costs, but that its application is different to the way that improvement activities are led in Manufacturing and has different risks and threats to success than in other sectors.

We do not claim to have a monopoly on good ideas about how to address these points and have written this article from the basis of real experience of delivering improvements to a variety of Healthcare organisations. We would welcome feedback on your experiences.

As a closing thought to Lean practitioners everywhere who are looking to be (or are already) involved in Healthcare – whatever the operational benefits that are possible, no-one wants to achieve these at the expense of patient safety – as it is only by addressing both operational and clinical needs that Lean Healthcare will truly come to life.