Redesigning an airway cart using lean methodology - 21/08/16
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | ● The lean methodology, 5S, was used to redesign a difficult airway cart. |
• | ● There was an 89% reduction in equipment in the difficult airway cart. |
• | ● The equipment reduction allowed all equipment to be stored on one cart. |
• | ● Simulations of a scripted difficult airway showed markedly reduced time to acquire equipment with the revised cart compared with baseline. |
Plan
| ☆ | The author was responsible for conception and design, acquisition of data, analysis and interpretation of data, drafting of article, revisions of article, and final approval of the version to be published. |
| ☆☆ | The author declares no conflicts of interest regarding the content of this article. |
| ★ | Sources of financial support: Virginia Mason Medical Center, Seattle, WA. |
| ★★ | Meetings presented: None. |
| ☆☆☆ | Individuals or organizations whose assistance is acknowledged: This project was supported by the Virginia Mason Kaizen office in the implementation of Virginia Mason Production System tools for improvement. In addition, the research effort to bring this Virginia Mason Production System project to publication was supported by Center for Health Services Research, a department led by Dr Craige Blackmore which promotes the publication of Virginia Mason quality and safety work. Thank you to all those who provided guidance during this project: Karen Blankenship, Val Ferris, and Robert Caplan MD. One final acknowledgement to the lead anesthesia tech at Virginia Mason, Randy Johnson, who was instrumental in all facets of product ordering and acquisition, cart building, cart modification, and cart maintenance which were critical to the success of this project. |
| ★★★ | Brief summary statement: This project describes the redesign of an airway cart using a lean tool known as 5S. The 5S process includes the steps of sort, set in order, sweep, standardize, and sustain. The revised airway included fewer pieces of equipment, which amounted to a reduced inventory cost. During simulation, collection of difficult airway equipment was procured more efficiently. |
Vol 33
P. 273-282 - septembre 2016 Retour au numéro
Article précédent
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