Episode 32: Lean Thinking & Time Management in Pharmacy With Oscar Santalo


What is Lean Thinking About?

It is a way of managing a company or institution ensuring continuous improvement small changes in processes to deliver value to customers

Defined as: Any operations system that can reduce waste without compromising quality or productivity

Guiding Principles of Lean Management

Benefits of Lean Thinking

Kaizen 5S Framework

Healthcare Kaizen is a lean tool that focuses on small, continuous improvements throughout the workplace. Each small change results in a minor improvement. As time passes, these minor improvements add up to significant steps forward in efficiency, quality, safety, and workplace culture.

  • Streamline workflow (having our bags capped ready to be sent)
  • Improving organization
  • Increasing Safety  (barcodes)
  • Properly using resources

Examples of Lean Application

In the morning, for example, Disney employees are encouraged to communicate in a more inspirational style, which resonates with eager families just starting out their day at the park. In the late afternoon (when children are tired and nerves become frayed), employees aim for a more calming and supportive style of communication. The integration of these psychological insights with Disney’s operating philosophy allows the company to eliminate waste of a dilerent sort: employee behavior that would not be desired by customers and might inadvertently alienate them at certain times of the day.

How is this applicable to our practice ?

What is Time Management?

Is the process of organizing and planning how to divide your time between specific activities

Top Rules of Time Management

1. Know how you currently spend your time. The simplest way to do this is to keep a log of what you do each day for a period time. While this may initially feel like a time waster, it is a necessary planning step. Just like you can’t budget your money without knowing where you’re currently spending it, you can’t budget your time without knowing where it’s going either. By keeping a log you’ll become more aware of stress times and down times, and will be better equipped to plan your time. 

2. Identify your “prime time.” Your “prime time” is your most productive time.  For many people that time tends to be in the morning while others find it take a while to get going. By scheduling your most important tasks for the times you’re at your best, you’ll be able to get them done faster and more effectively. 

3. Do tomorrow’s planning tonight. Being prepared for the coming day will enable you to get more work done, and be more effective at what you do. As you wind down at the end of the day use this time to create a simple, prioritized to-do list, so you’ll be better able to focus on what needs to be done the next day. 

4. Continually ask yourself “Why am I doing what I’m doing right now?” If you cannot answer this question, you are not being as productive as you could be. Make sure that you are doing something for a specific reason, and simply not wasting your valuable time spinning your wheels. 

5. Handle each piece of paper or e-mail once. When you have completed a task, either file it away or pass it on to someone else. When doing tasks and making decisions, make the decision and then stick to it. Do not put off making a decision, and don’t make vague, wishy-washy decisions. Being more decisive will free you up to move on to other tasks, making you more productive. 

6. Plan your work, then work your plan. It is important that you always follow through with what you intend to do, otherwise you are making your plan irrelevant and negating the value of the planning time. 

7. Delete whenever possible. It is important that you frequently revisit your plan and task list. Always cross off the tasks and projects you have completed, and eliminate or delegate those that are no longer important. 

8. Delegate wisely. When you delegate a task to another person, make sure the person you are delegating it to has clear instructions on how to complete the task, has enough resources for the task, and has the authority to make any decisions that might affect the outcome of the task. 

9. Identify your high-payoff items. Make sure that you concentrate on the right tasks, which will generate results for you and your company.  Stephen Covey suggests first addressing tasks that are both Important and Urgent.  Effective time management is not about being busy, but about getting results. 

10. Work from a prioritized action list. You need to determine what your work priorities are, both short term and long term. I suggest using a standard method like the Formula for Success  to prioritize your action list for the greatest success.

Major Endpoints & Takeaways

•Lean management is not a short term cost-reduction effort, but more a way of life or culture

•Continuously work to improve their quality measures, minimize waste, and change their set processes to improve efficiency throughout the organization

•Transition must be undertaken as a cultural shift or movement, requiring employee buy-in and encourage them to actively search for areas of improvement within their positions and wheelhouse


Holden, Richard J. “Lean thinking in emergency departments: a critical review.” Annals of emergency medicine 57.3 (2011): 265-278.

Duncan, Ewan, and Ron Ritter. “Next frontiers for lean.” McKinsey Quarterly 2 (2014): 82-89.

Mango, Paul D., and Louis A. Shapiro. “Hospitals get serious about operations.” The McKinsey Quarterly 2 (2001): 74.


Jimmy L. Pruitt III, PharmD, BCPS, BCCCP

The Pharm So Hard Podcast is a show focused primarily on emergency medicine and hospital pharmacy related topics. To empower healthcare providers with the knowledge and skills they need to provide evidence-based, safe care for critically ill patients.

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