132 ◾ Healthcare Value Proposition
The implementation of kanban in a healthcare setting requires the collaboration of everyone involved in the hospital’s supply chain—frontline staff, purchasing department or materials management, and vendors/suppliers. Hospitals deal with thousands of supplies, and each supply requires a separate set of considerations. Similarly, hospitals deal with several vendors and suppliers, each with their unique lead times for supplies. The best way to get started is to implement it for non-critical items—the ones that do not pose a safety issue. Employees should start in a small, controlled work area. To avoid running out of an item during the testing of more critical items, the use of a safety stock is recommended. Safety stock is the minimum amount of an item to keep on hand to accommodate variations in demand. There are six generally accepted rules for kanban: 1. Downstream processes may only withdraw items in the precise amounts specified on the kanban. 2. Upstream processes may only send items downstream in the precise amounts and sequences specified by the kanban. 3. No items are made or moved without a kanban. 4. A kanban must accompany each item at all times. 5. Defects and incorrect amounts are never sent to the next downstream process. 6. The number of kanbans should be monitored carefully to reduce inventories and to reveal problems and opportunities for improvement.
Steps for the Implementation of a Two-Bin Kanban System 1. Collect the usage data to decide the right levels of inventory needed for each supply item. Closely monitor the amount of inventory currently being used to know how much should be ordered when restocking. This process will take time, so an initial fluctuation in bin levels should be expected while inventory patterns and needs are being figured. 2. To help determine how many items should go into each bin, one must know how long it will take for a supplier to deliver the items. Then, that time should be built into determining how many items to put in each bin. For example, if five items are put in each bin and it takes ten days to go through each bin, the supplier needs to deliver new stock within six to eight days to avoid production delays.
