Application of DOWNTIME and ECRS in In-patients Dispensing System at Roi Et Hospital
Keywords:
in-patient medication dispensing services, DOWNTIME, ECRS, waiting time for medicationAbstract
Background and Objective: The lean concept emphasizes reducing waste in every step of the process. Currently, the medication ordering process in hospitals often experiences delays, resulting in prolonged waiting times for patients. The objective was to analyze and design system that minimizes waste within the process to reduce waiting times of patients.
Methods: This study was action research, focused on in-patient medication dispensing services at Roi Et Hospital, between March to October 2021. The study subjects consisted of 30 participants, including 13 pharmacists, 8 pharmaceutical assistant, and 9 support staff, and 788 medication orders. The research process was divided into three phases: Phase 1: study workflow of in-patient medication dispensing. Phase 2: develop in-patient medication dispensing system by analyzing inefficiencies used DOWNTIME principles, and improve system used ECRS method. Phase 3: conduct trials and evaluate outcomes. Data analysis involves descriptive statistics, independent t-tests, and Chi-square tests.
Results: The study identified five steps: (1) receiving prescriptions, (2) entering data into the computer, (3) labeling medications, (4) preparing medications according to the labels, and (5) verifying the medications. The results of processing time from 788 prescription samples before improvement using DOWNTIME and ECRS analysis revealed: Time spent on individual tasks was 3.26±0.45 minutes, waiting time between tasks for prescriptions was 139.37±28.88 minutes, and overall waiting time for medication was 142.63±25.72 minutes. After system improvement, time spent on individual tasks decreased to 1.24±0.19 minutes, waiting time between tasks for prescriptions decreased to 98.22±14.53 minutes, and overall waiting time for medication decreased to 99.46±12.02 minutes. Comparison of the time spent on individual tasks, waiting time between tasks, and overall waiting time showed statistically significant reduction (p<0.001).
Conclusions: This study demonstrates that system improvement through waste analysis and adjustments based on the DOWNTIME and ECRS principles significantly reduced working time and clearly enhanced service efficiency.
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