Operational Excellence

Document Type


Publication Date



Pharmacy, Maine Medical Center

MeSH Headings

pharmaceutical, pharmacy, academic tertiary medical center, root cause, goals, hurricane, Island of Puerto Rico



In September of 2017, Hurricane Maria struck the island of Puerto Rico where over 50 pharmaceutical factories had previously operated. The impact of this was felt not only in the drastic reduction of products that are produced on the island, but it also exacerbated the supply chain issues for key drugs nationwide.

The pharmacy department and supply chain in an academic tertiary care medical center did not have a consistent and reliable process for communication, planning and real-time updates. This resulted in a tremendous amount of wasted staff time at their drug/IV shortage meeting. A team was formed to develop mitigation strategies for navigating these shortages.

A root cause analysis was conducted to determine the causes for the inefficient management of the daily information for all drugs considered to be on a shortage. A number of countermeasures were established with the goals to reduce the time spent in shortage meetings and eliminate unnecessary communication between the pharmacy and supply chain outside of the shortage meetings.

Through implementation of performance improvement strategies, the target reduction in meeting time was met and a significant reduction in salary cost was realized.

Next steps include ongoing use of the newly developed mitigation strategies and interval assessments for sustaining the processes.



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