Improved outpatient haemodialysis adequacy using queued schedules.
SUMMARY: Background: Although technical advances help achieve haemodialysis adequacy, we hypothesise remediable non‐therapy factors exacerbate patient dissatisfaction, non‐adherence to treatment time and failure to meet dialysis goals. Scheduling inefficiencies lead to the total time in the unit far...
| Publicado en: | Journal of Renal Care Vol. 46; no. 1; pp. 62 - 69 |
|---|---|
| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141720139&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141720139 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17556678 56RH jtl: Journal of Renal Care issn: 17556678 maglogo: Y pubinfo: dt: Mar2020 vid: 46 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 141720139 141720139 145821502 141720139 10.1111/jorc.12308 141720139 ppf: 62 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Improved outpatient haemodialysis adequacy using queued schedules. aug: au: Nappo, Robert W. Ross, Edward A. affil: University of Florida Shands Hospital, Gainesville Florida, USA sug: subj: Hemodialysis Outpatients Systems Theory Workflow Quality Improvement Time Management Appointments and Schedules Human Male Female Adult Middle Age Aged Aged, 80 and Over Quality Assessment Dialysis Centers Florida Implementation Science Florida Waiting Lists Patient Satisfaction Descriptive Statistics Comparative Studies Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: SUMMARY: Background: Although technical advances help achieve haemodialysis adequacy, we hypothesise remediable non‐therapy factors exacerbate patient dissatisfaction, non‐adherence to treatment time and failure to meet dialysis goals. Scheduling inefficiencies lead to the total time in the unit far greater than actual treatment time, impacting facility efficiency and patient frustration. Objectives: We used queuing theorem principles to optimise schedules by incorporating timing and workflow for every dialysis process step to design a new schedule, rather than the whole‐shift blocks at baseline. Design: The goals were to: (1) craft schedules that maximised efficiency and economics from a facility perspective, and (2) minimise total time in the dialysis unit from a patient viewpoint. As dialysis units are held to a national standard of urea clearance, reduction ratios (URRs) were measured for the 3 months before and after the new scheduling was implemented. Results: Dialysis staff and process parameters were measured to craft queued schedules of staggered small groups of patients instead of baseline blocks of 2 large shifts, 24 each. A total of 65 patients changed to groups of 8, with entry‐to‐exit at 290 minutes for four hours treatments. The URRs improved from 72.8 ± 6.9 to 75.2 ± 5.4% (p < 0.001). Before implementation, only 89% of subjects reached the URR facility compliance target of 65%, and afterwards 97% (p < 0.001). Conclusion: Queuing theorem principles can be successfully adopted to optimise haemodialysis scheduling. The resultant staggered timing increases facility efficiency, minimises the long wait time dissatisfier, and is associated with improved URRs with more patients reaching target clearance thresholds. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|