The first was called "first time right" and aimed to stop invalid prescriptions from entering the filling

process. A senior pharmacist became the first point of contact for each patient. The pharmacist

would filter out patients whose prescriptions were invalid $($because they were not yet due for refills$)$

or could not be filled because of stock shortages. Second, they removed the batch system, which

meant prescriptions were no longer dispensed in batches of ten, but were made available to be

dispensed as soon as each one was ready. Finally, the team introduced a "demand$-$pull" system,

which enabled staff actually to dispense these prescriptions to patients in a timely fashion. The

existing process began with taking in scripts as fast as possible, and then filling them. The result

was a huge buildup of filled scripts that were waiting to be labelled and dispensed to patients $($in

other words, a "push" approach$).$ The team shifted the focus to the end of the process$-$dispensing$-$

and ensuring that there was sufficient staff to distribute prepared scripts, thus "pulling" prescriptions

through the process more efficiently.

Relatedly, the team addressed false stock$-$outs, another important factor behind long wait times.

These were resolved by implementing a two$-$bin system on the pharmacy shelves with pre$-$defined

refill levels. Essentially, when one bin of medications was empty, pharmacists would begin retrieving

medications from a second bin. The refill levels for a bin$$how many medications to place inside$-$

were calculated for each medication based on dispensing frequency. The consultants also revised

each staff member's role in the process and adjusted the layout of the pharmacy to make it more

orderly. This included outfitting each workstation with laminated posters that displayed the new

process rules. They also designed management tools$-$for example, a daily roster with role

allocation and a performance dashboard$-$that the pharmacy manager was then responsible for

implementing.

Under the new system, pharmacy staff rotated between duties to ensure that there was no build$-$up

of scripts. This required knowing how many people to assign to each stage of the process and

shifting staff when someone was absent$,$ at lunch, or when there was a backlog. The team initially

oversaw these shifts, but then coached the pharmacy staff on identifying and resolving bottlenecks

quickly, with the senior pharmacist on the floor ultimately responsible for managing the workflow.

In conclusion, the teamwork and process review that was provided helped staff to work smart and

not hard. Improving the working environment of staff, listening to their concerns and supporting them

through change management has definitely improved the quality of care and the experience that the

patients and communities received from the hospital. illustrates how Lean principles can transform operations by focusing on streamlining processes and eliminating bottlenecks.