Inventory Management in Healthcare

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    I am a performance improvement nurse in a hospital and trained in Lean methodologies as well as improvement science in general. But, I have little experience with inventory management. I am currently involved in a project to implement a new Human Milk Program in our Neonatal Intensive Care Unit (NICU). Mothers of these pre-term, very fragile patients are expected to pump their own breast milk at home and bring it in to the NICU so that we can feed their babies. This extremely nutritive breast milk is like gold and can be the difference between life and death for their babies. The problem is that we often have too much breast milk in the fridge or freezer for these babies because the babies are not always ready/able to take feedings. But, later on the baby may need more milk than the mother can produce. We can’t tell moms to stop pumping because they will dry up but we also struggle with having enough room for the inventory. Plus, as I said the milk is considered gold. So, I am going to start by analyzing just how much inventory we have/need. But, are there any tools or ideas that you might have to help me with this?



    There are a lot of tools and methods to balance supply and demand. All of them require data. So the first thing I’d advise you to do is collect data. It sounds like you’re already on track for doing that. Are the times when demand doesn’t match supply random or is there a pattern? If there’s a pattern that’s something you really need to investigate.



    This was an intriguing problem reading through it. I agree with @straydog you will need a very good data collection plan to work through this.

    Variables and data to consider are in three tracks in my thoughts.

    1) Milk Production – The spread of max and minimum daily/hourly volume by the mothers
    2) Consumption – The spread of max and minimum volume each baby consumes
    3) Storage – Both the space you have available, and using the data above, how often do you have overages and shortages. What, if any, is the spoilage factor as well.

    You should be able to use the data to then predict ‘normal’ supply and demand needs moving forward.

    Another question, just curious – is this a one-one utilization or can you use one mother’s milk for a different infant? I think of like Blood, you have types and can distribute based on types.


    Mike Carnell

    Shannon You stated “This extremely nutritive breast milk is like gold and can be the difference between life and death for their babies. The problem is that we often have too much breast milk in the fridge or freezer…….”

    This may seem a little to simplistic. Buy a bigger refrigerator. If this is as important as you say it is fix the storage.



    A separate stand alone freezer can store breast milk for up to six months. When a mother’s supply gets beyond a certain point- say enough for a defined number of feedings- then you begin to freeze -and date it so you are pulling out the oldest from the freezer first.

    Find the optimum amount to keep thawed and refrigerated and the rest goes into the freezer. Not knowing this field I cannot suggest how many feedings you need on hand- q2 hours? maybe no more than one day’s worth in the fridge- then when one is used- pull another from the freezer to make sure there is always a certain number of ounces available.

    I am also not sure what these are stored in, that would make a difference also.


    Jason Farley

    The issue is probably not wasting space and other resources on storage to Carol and Mike’s point. So a freezer was probably obvious to you. The issue might be knowing when to remove from freezer reserves to available stock. So a number of questions need to be answered as John and Stayer indicate. I would just add the following to your data collection consideratioins:
    1. You cannot control demand, but you can get an average and standard deviation… immediately available milk could be stocked to meet demand 95% of the time.
    However, stratification may be an issue here and with supply. I would look at the demand by day, week, month and year and then by type if that is an issue.
    2. Same with provided milk… as you said, it is gold, so you will take it when you can get it. So, the question is, how much should I store in freezer verses to available stock. Then it becomes a FIFO issue.
    3. Replenishing available stock from freezer… what is the time needed to thaw? Are there any batch considerations? This brings to mind that as you establish your pull system, you want to know the process… so map it if you haven’t (although I am sure you have). The VSM data boxes can be updated as you move from current to future state.
    Not sure if I’ve thought this all the way through, but maybe this is helpful when added to what the others have already said.


    Chris Seider

    What a need issue to address. Don’t forget to gather data and not rely on instincts.



    Neat project; I can attest to some of the difficulties of BF timings, up to our eyeballs right now with baby number 3!

    As per comments above, storage capacity could be key here. Although it would be good to know more. From reading is it correct to assume that the tricky part here is that there is no way of knowing which Mothers will be able to produce enough milk later on and which Mothers will require more of the stored milk for feeds. What I mean is that if we were to store X volume for each Mother, there is no way we can tell in advance that Mother A will require 10% of her stored milk while mother B will require 90%?

    In the event of running out of a particular Mothers milk is it acceptable to subsite with a donor Mothers milk?




    You can try investing in a hospital tracking system. This lets you to label assets and add inventory locations in your database. Therefore, you will be able to keep tags on your inventory at any given time, and hopefully cut back on equipment expenditure.

    Good luck.

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