Applying lean principles to continuous renal replacement therapy processes.

Purpose. The application of lean principles to continuous renal replacement therapy (CRRT) processes in an academic medical center is described. Summary. A manual audit over six consecutive weeks revealed that 133 5-L bags of CRRT solution were discarded after being dispensed from pharmacy but befor...

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Publicado en:American Journal of Health-System Pharmacy Vol. 72; no. 3; pp. 218 - 224
Autores principales: Benfield, C. Brett, Brummond, Philip, Lucarotti, Andrew, Villarreal, Maria, Goodwin, Adam, Wonnacott, Rob, Talley, Cheryl, Heung, Michael
Formato: case study tables/charts Journal Article
Publicado: Oxford University Press / USA 2/1/2015
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Applying lean principles to continuous renal replacement therapy processes.
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        au:
          Benfield, C. Brett
          Brummond, Philip
          Lucarotti, Andrew
          Villarreal, Maria
          Goodwin, Adam
          Wonnacott, Rob
          Talley, Cheryl
          Heung, Michael
        affil: Ambulatory Administrative Resident, Fairview Pharmacy Services, Minneapolis, MN
      sug:
        subj:
          Quality Improvement Methods
          Continuous Renal Replacement Therapy
          Pharmacy Service Administration
          Interprofessional Relations
          Dialysis Solutions Economics
          Academic Medical Centers
          Pharmacy Technicians
          Nurses
          Quality of Health Care
          Michigan
          Staff Development
          Attitude of Health Personnel
          Communication
          Organizational Efficiency
      ab: Purpose. The application of lean principles to continuous renal replacement therapy (CRRT) processes in an academic medical center is described. Summary. A manual audit over six consecutive weeks revealed that 133 5-L bags of CRRT solution were discarded after being dispensed from pharmacy but before clinical use. Lean principles were used to examine the workflow for CRRT preparation and develop and implement an intervention. An educational program was developed to encourage and enhance direct communication between nursing and pharmacy about changes in a patient’s condition or CRRT order. It was through this education program that the reordering workflow shifted from nurses to pharmacy technicians. The primary outcome was the number of CRRT solution bags delivered in the preintervention and postintervention periods. Nurses and pharmacy technicians were surveyed to determine their satisfaction with the workflow change. After implementation of lean principles, the mean number of CRRT solution bags dispensed per day of CRRT decreased substantially. Respondents’ overall satisfaction with the CRRT solution preparation process increased during the postintervention period, and the satisfaction scores for each individual component of the workflow after implementation of lean principles. The decreased solution waste resulted in projected annual cost savings exceeding $70,000 in product alone. Conclusion. The use of lean principles to identify medication waste in the CRRT workflow and implementation of an intervention to shift the workload from intensive care unit nurses to pharmacy technicians led to reduced CRRT solution waste, improved efficiency of CRRT workflow, and increased satisfaction among staff.
      pubtype: Academic Journal
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        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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