Neogi Smriti, Schneider Glenn, Schaffzin Joshua K
James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Clinical Engineering, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Qual Saf. 2022 Aug 1;7(4):e585. doi: 10.1097/pq9.0000000000000585. eCollection 2022 Jul-Aug.
Intravenous pumps provide essential, life-sustaining medications to patients. Pumps must be in working order and available on short notice to be effective. We identified inefficiencies in our pump management process that inflated the cost and time to complete repairs.
Our multidisciplinary team completed a 60-day before-after trial that followed the Toyota Production System Lean methodology and evaluated the sustainability of our improvements for the following 48 months. We used value stream mapping and manual time studies to identify areas for improvement. Device turnaround time (TAT) was the number of days from receiving a device for repair to its return to service. Interventions included: establishing a reliable system to receive and track repair requests, creating a better organized, more efficient workroom, streamlining the inventory of repair parts, and tracking delivery systems reliably.
We reduced mean intravenous pump TAT by 89% and sustained TAT at 74%-97% below baseline for 4 years, including during the COVID pandemic.
We used Lean methodology to create a system to receive, track, and provide safe, functional equipment to providers promptly. Both clinical and nonclinical healthcare professionals can use Lean to produce a sustainable improved system.
静脉输液泵为患者提供维持生命的必需药物。输液泵必须正常工作且能在短时间内随时可用才能发挥效用。我们发现我们的输液泵管理流程存在效率低下的问题，这增加了维修成本和时间。
我们的多学科团队进行了一项为期60天的前后对照试验，遵循丰田生产系统的精益方法，并在接下来的48个月评估我们改进措施的可持续性。我们使用价值流映射和人工时间研究来确定改进领域。设备周转时间（TAT）是从接收设备进行维修到其恢复使用的天数。干预措施包括：建立一个可靠的系统来接收和跟踪维修请求，创建一个组织更完善、效率更高的工作室，简化维修零件库存，并可靠地跟踪交付系统。
我们将静脉输液泵的平均TAT降低了89%，并在4年时间里将TAT维持在比基线低74% - 97%的水平，包括在新冠疫情期间。
我们使用精益方法创建了一个系统，用于接收、跟踪并及时为供应商提供安全、功能正常的设备。临床和非临床医疗专业人员都可以使用精益方法来创建一个可持续改进的系统。
