title: A waste walk through clinical pharmacy: how do the 'seven wastes' of Lean techniques apply to the practice of clinical pharmacists.
abstract: OBJECTIVE
  This study used a 'Lean' technique, the 'waste walk' to evaluate the activities of clinical pharmacists with reference to the seven wastes described in 'Lean' including 'defects', 'unnecessary motion', 'overproduction', 'transport of products or material', 'unnecessary waiting', 'unnecessary inventory' and 'inappropriate processing'. The objectives of the study were to categorise the activities of ward-based clinical pharmacists into waste and non-waste, provide detail around what constitutes waste activity and quantify the proportion of time attributed to each category.
  
  
  METHODS
  This study was carried out in a district general hospital in the North West of England.
  
  
  METHODS
  Staff were observed using work-sampling techniques, to categorise activity into waste and non-waste, with waste activities being allocated to each of the seven wastes described earlier and subdivided into recurrent themes.
  
  
  RESULTS
  Twenty different pharmacists were observed for 1 h on two separate occasions. Of 1440 observations, 342 (23.8%) were categorised as waste with 'defects' and 'unnecessary motion' accounting for the largest proportions of waste activity.
  
  
  CONCLUSIONS
  Observation of clinical pharmacists' activities has identified that a significant proportion of their time could be categorised as 'waste'. There are practical steps that could be implemented in order to ensure their time is used as productively as possible. Given the challenges facing the UK National Health Service, the adoption of 'Lean' techniques provides an opportunity to improve quality and productivity while reducing costs.
authors.affiliation: Countess of Chester Hospital NHS Foundation Trust, Chester, UK; School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Green
authors.forename: Victoria
authors.initials: V
authors.lastname: Crawford
authors.forename: Gaynor
authors.initials: G
authors.lastname: Bresnen
authors.forename: Philip H
authors.initials: PH
authors.lastname: Rowe
mesh_terms: D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D006801:Humans; D010607:Pharmacy Service, Hospital / Q000379:methods*; D011785:Quality Assurance, Health Care; D057188:Workflow
keywords: hospital; pharmacy service