MST pharmacy chooses Continuous Improvement with Symbol

Symbol, specialist in change management and process optimization

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MST’s pharmacy makes good and trusted drug use accessible to everyone, from the full spectrum of care to the individual – both clinical and outpatient. Fine steps had already been taken within the pharmacy to implement Continuous Improvement, but management wanted to bring the various initiatives together and combine them – under Symbol’s guidance. “The urgency for Continuous Improvement was great. One of the pharmacy’s tasks is to control our costs. This includes eventually performing our services with fewer FTEs, while the quality of pharmaceutical care must remain the same,” says Mirije van Dijk, pharmacy department manager.

Getting certain processes in order

“However, we were struggling to get certain processes in place,” Van Dijk continued. “The process around getting certain oncology medications ready, for example. Or our collaboration with day care, a process that involves a lot of paperwork and communication. But also the process around purchasing medication, where we still do a lot on paper.” Kris Movig, hospital pharmacist and medical manager of the clinical pharmacy department, adds, “In many processes, we as pharmacists are not the only stakeholder, but we are part of a chain. All noses have to be in the same direction then. Every part in the process has to be right and has to fit together efficiently – even beyond the pharmacy. That often makes it complicated.”

Plenty of opportunities with process optimization

Another key challenge, according to Van Dijk and Movig, was to not let the delusion of the day rule. Movig says: “The challenge is to do Continuous Improvement well, especially when time is limited. That is why we engaged an external party. We couldn’t have chosen Symbol, but if the feeling prevails on the shop floor that everyone is busy enough already, doing everything ourselves is a major pitfall. Then it still gets left behind, while thinking logically about your processes saves a lot of (time).” Van Dijk adds, “Because of the high workload, improvement was always at the bottom of the agenda. But if you want to reduce the workload, you have to find time somewhere. In our view, process optimization therefore offered plenty of opportunities, because removing waste creates space. So there was actually another question behind our request, because with the deployment of Symbol we also wanted to stimulate and encourage employees’ willingness to change.”

Implement and secure Continuous Improvement.

The assignment to Symbol was therefore clear: to provide support for the further implementation, but above all to secure Continuous Improvement. In the form of improvement projects, as well as awareness. “This was handled very well by our Symbol consultant,” Van Dijk says. “We first asked him to analyze all the possibilities and based on that to determine which processes we needed to focus on. And what turned out: all the improvement projects and objectives were actually already there, they just needed to be overviewed and prioritized.” Movig: “Of course, everything can be improved – the process of clinical pharmaceutical analysis, for example, could also be optimized. But that process is running and has no priority now over other processes. That is a benefit of working with Symbol: we have prioritized and made choices.”

Improve top of mind

Another gain achieved is the daily and weekly startups initiated by Symbol. This uses an improvement board, which in turn provides input for both larger and smaller improvement initiatives. “The goal of the daily and weekly starts is that employees really get a mindset and mode from which they take ownership of their processes/work. And we see that it works,” Van Dijk says. Movig is also enthusiastic. “Because of the day start, everyone starts talking to each other first thing in the morning. Sometimes those conversations are about seemingly small things, like where a printer should be. But all those little things contribute to the big picture. It’s very nice that employees now talk to each other every day, instead of only during work meetings. This keeps improvement top of mind.” “Nice to add,” says Van Dijk, “is that less time is now spent on those regular work meetings, because they have become more efficient, and that those meetings have gone down in frequency.”

Optimization in the chain

By the way, the daily and weekly starts are cross-departmental. “What I think is one of the most important results of Symbol’s pathway is the week-long start together with the oncology day treatment in the clinic,” says Van Dijk. “It’s a very good example of optimization in the chain, which we talked about earlier. Optimizing as a pharmacy is good, but it’s better if it happens throughout the chain. After all, other departments, including the day care, also suffer from things that don’t go well with us. With the joint week start we overcome this.”

A different atmosphere

Furthermore, Van Dijk and Movig see changes in employee attitudes. Van Dijk: “In collaboration with our Symbol consultant, MST’s Black Belt provided all of our employees with White Belt training, specifically focused on pharmacy. Symbol, in collaboration with MST’s Lean team, also gave a number of Yellow Belt workshops to subject specialists, to introduce them to the Lean mindset. There was a very positive response to both, as suddenly everyone appeared to experience the same workload and see many of the same wastes. This created a different atmosphere, there is more understanding. People are also more positive about (their own role in) change and think much more about what can be done differently and what it will bring them. That makes their work more fun and lighter.”

Continued focus on Continuous Improvement

The next step for MST is clear: continue with Continuous Improvement. Van Dijk and Movig: “We asked more of employees during a very busy time. As a result, the pace of improvements to be picked up and implemented had limitations. That is not a bad thing, but it is important that there is now continued attention to it. It is up to us as management to continue to involve all employees during the daily and weekly starts. This will also allow us to reap the benefits later on from the improvement projects that have been started but not yet completed. But a number of main goals – involving employees and creating a Continuous Improvement mindset – we have already largely achieved as far as we are concerned.”