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结合精益和人因学原理提高儿科急救推车的可用性

Improving Usability of the Pediatric Code Cart by Combining Lean and Human Factors Principles.

作者信息

Frazier Maria, Webster Kristen, Dewan Maya, Hutson Tamara, Collins Kelly, Fettig Tina, Grooms Taylor, Cordray Mary, Tegtmeyer Ken

机构信息

From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Patient Safety, Regulatory, and Accreditation, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

出版信息

Pediatr Qual Saf. 2023 Aug 7;8(4):e676. doi: 10.1097/pq9.0000000000000676. eCollection 2023 Jul-Aug.

Abstract

UNLABELLED

Cardiac arrests are common in hospitalized children. Well-organized code carts are needed during these events to help staff efficiently find supplies and medications for the patient. This study aimed to improve the efficiency and utilization of the code cart at a major academic pediatric medical center.

METHODS

This quality improvement project used a phased approach to redesign the code cart. A multidisciplinary team used Lean and Human Factors principles to improve the efficiency and intuitiveness of the redesigned cart. Nurses and respiratory therapists participated in simulations asking for certain supplies with the original and redesigned code cart and filled out surveys for feedback on each code cart. Facilitators measured retrieval times during each simulation.

RESULTS

We performed 10 simulations with the original code cart and 13 with the redesigned code cart. Staff could find intraosseous access equipment more quickly (23.9 versus 46.4 seconds; = 0.003). In addition, staff reported they were less likely to open the wrong drawer or grab the wrong equipment and that the redesigned code cart was overall more well organized than the original code cart. Finally, the redesigned code cart reduced the cost by over 800 dollars per full cart restock.

CONCLUSION

Revising the code cart using Lean and Human Factors improves efficiency and usability and can contribute to cost savings.

摘要

未标注

心脏骤停在住院儿童中很常见。在这些情况下,需要有组织有序的急救推车来帮助工作人员高效地为患者找到用品和药物。本研究旨在提高一家大型学术性儿科医疗中心急救推车的效率和利用率。

方法

这个质量改进项目采用分阶段方法重新设计急救推车。一个多学科团队运用精益和人因工程学原理来提高重新设计后推车的效率和直观性。护士和呼吸治疗师参与了使用原始急救推车和重新设计后的急救推车索要特定用品的模拟,并填写调查问卷以反馈对每个急救推车的看法。协调员在每次模拟过程中测量取用时间。

结果

我们使用原始急救推车进行了10次模拟,使用重新设计后的急救推车进行了13次模拟。工作人员能更快找到骨髓腔内通路设备(23.9秒对46.4秒;P = 0.003)。此外,工作人员报告称他们打开错误抽屉或拿错设备的可能性降低,并且重新设计后的急救推车总体上比原始急救推车更有条理。最后,重新设计后的急救推车每次整车补货成本降低超过800美元。

结论

运用精益和人因工程学原理修订急救推车可提高效率和可用性,并有助于节省成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5336/10402944/dcaadccd2501/pqs-8-e676-g001.jpg

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