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- Hammad, Yasser A., et al.
(författare)
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Quality improvement can decrease blood delivery turnaround time : Evidence from a single tertiary-care academic medical center
- 2018
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Ingår i: Middle East Journal of Anesthesiology. - : American University of Beirut. - 0544-0440. ; 25:3, s. 273-281
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Tidskriftsartikel (refereegranskat)abstract
- Context: Blood transfusion services are critical to any hospitals’ functioning, and timely blood/ component therapy resuscitation is lifesaving. Yet, few blood delivery turnaround time (TAT) studies have been undertaken. Aims: We assessed blood delivery TAT at our institution before and after implementing an intervention. Settings and Design: This before-after study assessed blood delivery TAT at our institution at baseline (first audit, December 2015 - February 2016); analyzed the causes of any delays and implemented a multipronged organizational, educational and operational remedial actions for risk mitigation for 3 months, aiming to shorten the blood delivery TAT; and then 9 months later assessed the blood delivery TAT again (second audit, November 2017 - December 2017). Methods and Material: For each of the two audits, we assessed three indices that comprise TAT: Response time (time from doctor’s request until blood is ready for collection, T1); processing time (time from the arrival of technician to blood bank and start of paperwork processing at the blood bank’s front desk until actual collection of the blood, T2); and, Transport time (time from blood bank to arrival to operating theatre, T3). Statistical analysis used: The observed proportions for categorical variables were reported as percentage and compared using Chi square test. Results: After implementing the remedial actions, the second audit confirmed considerable improvements across all three components that comprise the blood TAT. The transport time significantly decreased from an initial majority of > 15 mins duration, to a majority of < 15 mins transport time after the second audit; there was a 50% improvement in 30 mins response time; and the percentage of requests processed in < 10 mins were significantly higher after the second audit. Conclusions: Our program and its findings in terms of much improved blood delivery TAT after implementing this quality improvement approach represent an appropriate and effective solution to the challenge of making blood available fast enough to meet true hemorrhagic emergencies.
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- Hammad, Yassert A., et al.
(författare)
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Quality, safety and efficiency in practice : Risk assessment and standardisation of anesthesia equipment and supplies in operating theaters of high-volume tertiary-care academic medical center
- 2019
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Ingår i: Middle East Journal of Anesthesiology. - : American University of Beirut. - 0544-0440. ; 26:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Operating theatres (OTs) are valuable and costly resources that need to be appropriately designed and stocked for efficient, quality and safe patient care. We assessed the logistic inefficiency including the availability and location layout of necessary supplies across OTs of a high-volume tertiary-care academic medical center. Methods: A blinded observer (anesthesia technologist) was allocated to 10 OTs. For each OT, the availability, quantity and time spent to locate and obtain a set of required items were recorded (baseline values). We then developed an OT mapping plan to determine the specific item/s to be stocked in specific locations, and one OT was standardized to this configuration map. A blinded observer was then allocated to this standardized OT and time spent to obtain the same set of items was again recorded. Six of our regular OTs were then standardized to the same configuration, and the time to obtain the items by a blinded observer were again recorded for each OT. T tests compared the time required to locate items in the standardized OT vs. regular OTs; paired t tests compared the time required in each OT vs. itself before and after standardization. Results: The observer required significantly more time in each of the 10 regular OTs compared to the standardized OT. The time spent by the observer to obtain the required items significantly and considerably decreased in each of 6 OTs after their standardization, compared to the time required before their standardization. Conclusion: This quality improvement project successfully reduced the time required to identify and locate different supplies, which impacts on the efficiency and quality of patient care. For anesthesia staff moving from one anesthetizing location to another within the institution, consistencies in location and number of anesthesia equipment and supplies create higher levels of safety and professionalism.
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