Desarrollo de la metodología lean Healthcare como estrategia de mejora y reducción de desperdicios en la bodega de medicina y farmacia del IESS Ambato

Abstract

In investigating the wastes at the Instituto Ecuatoriano de Seguridad Social (IESS) Ambato, specifically the request for medications outside the scheduled dispatch day in the medicine warehouse and errors in the preparation of medication cassettes in the inpatient pharmacy such as medications requiring others for administration, indicated but not prescribed medications, or under-dosing the aim is to develop the Lean Healthcare methodology as a strategy for improvement and waste reduction in both areas of IESS Ambato. Through analysis of orders, reports, and medication documentation from March and April 2024, coupled with a time study, a Value Stream Map (VSM) was created to evaluate the current situation. Various quantifications of wastes employed Pareto diagrams and U control charts for analysis. Among the wastes identified in both areas were defects, unnecessary transportation, waiting times, and overproduction (exclusively in the pharmacy). To mitigate these issues, manuals were developed explaining the use of tools such as poka-yoke for defects, the 5S methodology with continuous flow for waiting times, and kanban for unnecessary transportation and overproduction. The implementation of the Lean Healthcare methodology is an effective strategy to identify and eliminate these wastes, potentially reducing waiting times by an estimated 13% and minimizing errors in medication preparation and distribution by approximately 7%. Through the application of Lean tools, the aim is to improve operational efficiency and medical care for patients.