Presentation on theme: "4/14/2017 Using RTLS, Business Intelligence and Integrations to Improve Pump Management The use of organized team efforts to facilitate change in culture."— Presentation transcript:
14/14/2017Using RTLS, Business Intelligence and Integrations to Improve Pump ManagementThe use of organized team efforts to facilitate change in culture backed by data.Chris Gutmann, Director of Clinical EngineeringIn conjunction with Darcy Hennessey and Brooke Spadaccino (not presenting at HIMSS)
2Project Goals Ensure EVERY patient will have a pump when needed Multi Disciplinary Team:Materials ManagementNursingPharmacyClinical EngineeringInformation ServicesOperations SupportHow will we achieve this?Staff will readily release pumps when not in usePumps will be available when they call/requestPatients will arrive on units from procedure areas/OR’s /ED with pumps in place, ( receiving unit staff will give back a pump)Each area will have the appropriate “safety stock” for unexpected situationsIdentify the “safety stock" needed at entry points in the care continuum
4Y-NHH: A Tradition of Excellence Nursing continually looks to for opportunities of systems redesign which solidify our team approach.
5Yale – New Haven Hospital The history of Yale-New Haven Hospital extends back to 1826 when the General Hospital Society of Connecticut was chartered as the first hospital in Connecticut and the fourth voluntary hospital in the nation. The hospital rented temporary quarters and raised US$5,000 toward purchase of land and construction. A new 13-bed hospital opened in 1833 on seven and a half acres of land bordered by Cedar Street and Howard, Davenport and Congress avenues.2013:5 Million Square Feet owned and operated by YNHH4 main pavilions = 2,000,000 ft260 Operating Rooms, 25+ procedure rooms1,120 Patient BedsLevel 1 Trauma in Pediatrics and Adult Emergency MedicinePark St. - Lab and Pharmacy = 130K ft2Physicians Building and Psych. Hospital = 100K ft2Yale School of Medicine adjacent/attached to hospitalFormer Hospital of St. Raphael’s = 1,000,000 ft2
6688-9000 SOS Alert Please call the SRC for pick-up now. Continual crisis episodes sent routine alertsto the entire organization calling for pumps!Continual issues add to the alarm fatigue…Please call the SRC for pick-up now.
7Project Charter: Sigma Pump Participant/Process RepresentativesProject Description / Problem StatementProcess Scope: Start/endProject Sponsor:Sue Fitzsimons – Chief Nursing OfficerProcess Owner:Carol Just - Director, Surgical ServicesChris Gutmann – Director, Clinical EngineeringMulti Disciplinary Team Members:Clinical EngineeringInformation ServicesMaterials ManagementNursingOperations SupportPharmacyCycle of distrust: Only broken when everyone cooperatesSystem to Locate Pumps does not identify “pump in use”Inability to get a pump when needed induces lack of trust in process and hiding of pumpsHiding pumps lead to a shortage of pumpsSigma pump equipment management including:ProcurementMovement throughout the hospitalPreventative maintenanceAllocation for each clinical areaProject GoalsProcess Scope: In/OutEnsure EVERY patient will have a pump when needed. How will we achieve this?Staff will readily release pumps when not in usePumps will be available when they call/requestPatients will arrive on units from procedure areas/OR’s /ED with pumps in place, ( receiving unit staff will give back a pump)Each area will have the appropriate “safety stock” for unexpected situationsIdentify the “safety stock" needed at entry points in the care continuumIn Scope:York Street Campus, Saint Raphael CampusOut of Scope:Bridgeport and Greenwich hospitalsProject Y / Key MetricsSigma pump monthly call volumeSigma pump call volume by unit per monthAverage monthly Materials sigma pump job completion timeSIPOC / High Level Process Map for UnitCall Service Response Center and/ or Off Shift Executive and/or Off Shift Nursing Leader to deliver pumps and/or go floor by floor in the hospital to collect unused pumpsSigma pump needed but none availableCustomer CTQ’sPump(s) receivedPump available when neededStore the pumps in a safe location in case they are need for the next patientRemove the pump(s) from patient departing the unitPlace pump(s) on patient
8Defining the Available Supply 1400 pumps purchased in 2009 no additions to date!
10Do We Have Enough Pumps?All Stakeholders need to buy-in to the process…Snapshot of audit on 1/26/2012(5am contact census 923)Vicious Cycle of Distrust:No equipment churnPatient criticality not driving needEquipment not availableAn episode of delayStaff Hoard equipmentTotal in fleet – 1375Entry Points buffer - 359IR, HVC Labs, OR, PACU,L&D & EDsOncology infusionsRemote Locations - 31Ambulatory, PsychDialysis, Pedi Clinic, Urgent careMaintenance Process - 17Pumps in Waiting - 45Material’s pool for distribution1375 (total)- 452 (non-circulating)= 923 Available1500Crisis Calls per Month
11Defining the DemandData Collection through the call center for materials and Baxter pumpdata on infusions started at entry points over the course of a day.
13Streamlining the Movement Process Process for units:Rounding 3x dailySafety stock set as a profile for each unit5S storage areas to define storage location of “safety stock”Unused clean equipment placed in green binsUnits looks in green bin or safety stock before calling materials for deliveryProcess for EVS staff:Clean equipment is placed in green bin for pick up(no clean pumps to be left in rooms) Process for SOS alert:Unit leadership or assigned staff person to round as soon as alert issued and check with all staff for unused sigma pumpsPlace unused sigma pumps in green bin and call SRC for pickupProcess for materials staff:Check with charge RN that safety stock (red tape with par number) is filled before removing sigma pumps from unitsCollect equipment from green bin
14Driving Results through Culture Change In face of rising census the need to call the Service Response Center for pumps has decreased.A plateau in reducing the number of calls for sigma pumps and are look to reinforce rounding and pilot technology to continue the downward trend.14
15State Monitoring -> Utilization At Material’s storage location in WP basement ready for shipment to unitUndergoing service at clinical engineeringIn transit for useIn use at patient bedsideNot in use, at patient bedsideNot in use, in green bin or safety stock. Ready for usage by next patient
16Data Validation PilotRunning: time between the “start infusion” button is pressed and the pump completes drug delivery or is stoppedNot Running: amount of time the pump is not infusingAvailable: amount of time the pump is physically in green bin or safety stockDelivered: amount of time the pump travels from materials storage to a unit before used for an infusionPilot participants: SP 6-1, SP 6-4 and EP 7-7
17Dashboard Concept – Info @ Front Lines Pilot Studies on clinical units for profile setting of departments.Actionable DataManagement ReportManagers can view multiple floors to see a snapshot of the past 24 hours.
18Demand is a function of Patient Acuity Worked with units individually to understand flow and patient acuity mix to set the proper PAR levels.SICUNot all units created equal…Step DownORTHO
19Improved UtilizationTrust of the front line patient care groups feed a process which allows for less “stagnant” assetsStep Down 71.5%SICU 69.6%ORTHO 68%SICU 50.6%Step Down 47.2%ORTHO 41.2%
20Questions? Chris Gutmann, Director of Clinical Engineering 4/14/2017Questions?Chris Gutmann, Director of Clinical EngineeringIn conjunction with Darcy Hennessey and Brooke Spadaccino (not presenting at HIMSS)