학술논문
Improving Usability of the Pediatric Code Cart by Combining Lean and Human Factors Principles.
Document Type
Academic Journal
Author
Frazier M; From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Webster K; Patient Safety, Regulatory, and Accreditation, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Dewan M; From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Hutson T; Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Collins K; From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Fettig T; From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Grooms T; Department of Pediatrics, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Cordray M; 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.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Department of Pediatrics, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Tegtmeyer K; From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Source
Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101702480 Publication Model: eCollection Cited Medium: Internet ISSN: 2472-0054 (Electronic) Linking ISSN: 24720054 NLM ISO Abbreviation: Pediatr Qual Saf Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
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; P = 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.
Competing Interests: The authors have no financial interest to declare in relation to the content of this article.
(Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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; P = 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.
Competing Interests: The authors have no financial interest to declare in relation to the content of this article.
(Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)