Simplivia Blog

As an innovative company, we keep our eye on the big picture. We focus on new perspectives and leading approaches to healthcare that deliver safety and inspire confidence.

Lean Management Principles For Hospital Administrators: How They Apply to CSTD Use

Hospital administrators have a key role in overseeing the organizational side of hospitals and medical facilities. Hospital administrators must ensure that their facility is using the most efficient and effective practices to provide optimal healthcare.

Lean management principles are five steps that hospital administrators can use to improve workplace efficiency. These steps create a framework for efficient workflow.

One area attracting lean management principles in healthcare is the use of closed system drug-transfer devices (CSTDs) and the training of pharmacists who perform compounding procedures.2

Simplivia CSTD Hazardous Drugs

Lean Attributes and CSTDs

The first step toward incorporating the benefits of lean management principles with hospital pharmacies and CSTDs is understanding the basics. Lean management for hospital administrators consists of the following five principles:2

  • Defining value
  • Mapping the value stream
  • Creating flow
  • Using a pull system
  • Pursuing perfection

How do these lean attributes mesh with healthcare principles, pharmacy regulations, and the use of closed system drug-transfer devices?

Defining Value

The first of the lean principles is value, which requires hospital administrators to consider what value means to their medical facility and customers. Once value is determined, delivering it becomes much easier.3

Value is the quality of product and service plus the customer's satisfaction at a defined cost. Technology such as a CSTD must meet the needs of those using it. Healthcare organizations should select the optimal product for their facilities. They must also ensure that the CSTD system can effectively and efficiently integrate into their pharmacy and nursing practices. In addition, the price must be amenable to their budget.

Closed System Drug-Transfer Device

Mapping the Value Stream

Mapping the value stream refers to determining ways the CSTD adds value to the organization. This step also helps to define methods to achieve the value specified in the first step. Consider at all the elements contributing to the value of the CSTD and its use. Make note of those that add to its value. Use of the CSTD in ways that don't contribute to value could be wasted effort.3

For example, reducing the risk of needle sticks in compounding improves employee safety. At the same time it decreases incidences of over-pressurized drug vials resulting in sprays or spills. It also prevents breaks in the aseptic technique by standardizing how workers use compounding tools. Reducing waste and increasing safety add value to the CSTD and the organization.1

Creating Flow

Next, determine how compounding can be optimized for maximum quality and minimum interruptions or delays. Once a CSTD is connected to a vial, it is considered to be in a "flow state." That flow runs from compounding to delivery to the nursing unit. Then it carries through to the patient and bedside administration. The last stage of the flow is disposal after the treatment. CSTDs minimize concern around needle sticks, drug vapors and sprays. They also reduce the risk of breaks in aseptic technique, and line disconnections and spills. All of these events can cause delays in treatment and loss of revenue.2

Pull-Based System

One of the most significant causes of waste in any system is unused or dated inventory. The purpose of a pull-based system is to limit the amount of inventory and work-in-progress items. A pull-based system further ensures that required materials and information are at hand for a smooth flow.

CSTD systems differ in construction and operation from each other. It is therefore essential for staff to understand how the CSTD works and the components required to handle and administer medications properly. Value stream mapping allows pharmacists and nursing staff to gauge the steps and components necessary for proper CSTD use. The pull-based system ensures they have the proper inventory on hand to optimally utilize the CSTD.

In Pursuit of Perfection

Active pursuit of perfection means your facility has correctly identified the value of your CSTD system, refined and merged the value stream, set in motion a smooth flow of work product, and met the needs and demands of your patients. It requires the correct products and the right amount of inventory to be on hand precisely when needed.3

When It All Comes Together

When hospital administrators combine lean management techniques with CSTDs, the result is reduced waste, increased safety, and higher quality of service. The ideal CSTD smoothly integrates into a hospital’s pharmacy and nursing practices, while meeting the efficiency needs of these departments. It offers meaningful benefits including saving time, cost control, line-item minimization and efficient staff training.2

Simplivia’s Chemfort™ closed system drug-transfer device keeps hospital pharmacy and nursing professionals, as well as patients and visitors, safe from exposure to hazardous drugs. The Chemfort™ CSTD includes a complete vial-to-vein portfolio of products for any handling protocol. To find out more, contact us.

1. What Is Lean Healthcare? Virginia Mason Institute [August 2021]
2. Massoomi, F.; Eisenberg, S.; Jorgenson, J. Lean Thinking for CSTDs. Pharmacy Practice News [December 2021]
3. Lean Thinking: Overview, Origins, Basic Principles, Benefits, and Applications Explained. Simplilearn [October 2021]
4. Hazardous Drug Exposure in Healthcare: Overview. The National Institute for Occupational Safety and Health (NIOSH). Centers for Disease Control and Prevention
5. Our Products. Simplivia


Recent Posts