Journal of clinical anesthesia · 2016
Redesigning an airway cart using lean methodology.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Weigel Wade A
Аннотация
STUDY OBJECTIVE: Use lean methodology to create a more efficient difficult airway management equipment transport and setup.
DESIGN: The 5S steps of sort, set in order, sweep, standardize, and sustain were used to create a redesigned airway cart. The 5S steps provided the framework to separate the needed from unneeded equipment, logical equipment placement on the cart, and a plan to maintain improvements. Simulations were utilized to compare the revised airway cart to the previous airway equipment storage.
SETTING: Hospital operating rooms and equipment storage rooms.
PATIENTS: Simulated difficult airway scenarios without patient involvement.
INTERVENTION: Difficult airway equipment 5S process.
MEASUREMENTS: Total pieces and cost of airway equipment before and after intervention. Walking distance and time to retrieve equipment, setup equipment, and setup defect rate during a simulation.
MAIN RESULTS: Previously, airway equipment was stored in 4 locations which was reduced a single difficult airway cart. The total pieces of equipment stored was reduced 89% and the cost of disposable equipment inventory was reduced 81%. Simulations looking at the acquisition and setup of equipment during a difficult airway scenario revealed a 39% reduction in equipment set up time, a 77% reduction in non-valued-added set up time, and a 74% reduction in walking distance. There was no difference in set up defect rates.
CONCLUSION: Application of this lean method resulted in a revised single cart with equipment pared down to only what is needed, arranged according to frequency and order of use in a difficult airway. In a simulated difficult airway, there was a reduction in non-value-added time and walking distance to retrieve the equipment.
DESIGN: The 5S steps of sort, set in order, sweep, standardize, and sustain were used to create a redesigned airway cart. The 5S steps provided the framework to separate the needed from unneeded equipment, logical equipment placement on the cart, and a plan to maintain improvements. Simulations were utilized to compare the revised airway cart to the previous airway equipment storage.
SETTING: Hospital operating rooms and equipment storage rooms.
PATIENTS: Simulated difficult airway scenarios without patient involvement.
INTERVENTION: Difficult airway equipment 5S process.
MEASUREMENTS: Total pieces and cost of airway equipment before and after intervention. Walking distance and time to retrieve equipment, setup equipment, and setup defect rate during a simulation.
MAIN RESULTS: Previously, airway equipment was stored in 4 locations which was reduced a single difficult airway cart. The total pieces of equipment stored was reduced 89% and the cost of disposable equipment inventory was reduced 81%. Simulations looking at the acquisition and setup of equipment during a difficult airway scenario revealed a 39% reduction in equipment set up time, a 77% reduction in non-valued-added set up time, and a 74% reduction in walking distance. There was no difference in set up defect rates.
CONCLUSION: Application of this lean method resulted in a revised single cart with equipment pared down to only what is needed, arranged according to frequency and order of use in a difficult airway. In a simulated difficult airway, there was a reduction in non-value-added time and walking distance to retrieve the equipment.