Stock Management Improvement in a Nursing Ward Using Lean Approach and Mathematical Modelling.

Reducing the costs associated with health care services is on the agenda, if possible, improving their quality. The Lean management approach has proven to provide good results in creating value and reducing waste. This paper is based on an exploratory case study in the logistic operations of a Northern Portuguese hospital, focusing on the delivery plans of products needed between the central warehouse and the internal medicine ward. Using PDCA improvement cycles and other lean tools, this study analyzed the actual delivery system, identified inefficiencies, and proposed and evaluated some solutions. The aim was to address different types of waste, such as the time the ward head nurse spent to launch orders and perform the reception/arrangement of the products or the excess of products leaving the central warehouse. Although a daily delivery with a fixed stock level seems to be a good delivery system for a large group of products, the recorded or possible failures have led us to devise an optimization model to improve the deliveries. The preliminary results suggest that a weekly plan with a daily delivery of products (to be repeated every week) is even more optimal, not only because it relieves the head nurse of logistical tasks but also because it takes into account the units of products per package. Although this model can be generalized to other nursing wards, some limitations are addressed, namely its non (daily) standardization, leading to some complexity in its handling by the logistic central warehouse operators.