Redesigning an airway cart using lean methodology.

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.