Bridging Care Support and Care Delivery with Engineered Logistics and Technology

通过工程物流和技术桥接护理支持和护理提供

• 批准号: 8550887
• 负责人: Seth T Hostetler
• 金额: $ 73.85万
• 依托单位: GEISINGER CLINIC
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8550887
• 关键词: Bridging; Care; Support; Delivery; Engineered

Abstract Geisinger Clinic's Supply Chain Services has developed 'Project HELP' (Healthcare Enabled Logistics Program) that is based on successful manufacturing and engineering workflow processes and proposes a lean redesign of supply delivery, support service operations, and the clinical workflow on inpatient units. Project HELP's goal is to remove clinicians from support services activities, and, reinvest this time in patient care activities. Support services are being defined as non-clinical departments in the hospital that support the delivery of care (e.g., pharmacy, lab, and linen services). Our preliminary research has estimated that approximately 16.8% of nurses' time (6.72 hours per 40-hour week per inpatient nurse) is wasted in logistics activities that they should not have to engage in, an amount that is common in the industry. This led to the project hypothesis that by improving the care delivery support system, we can remove nurses from support service activities, thereby allowing redirection of the clinician to patient care activities and enabling improved quality of care. This study represents a way to improve the value of health care - i.e., reduce waste or unnecessary costs while improving quality. Project HELP will engineer a proactive support service system to replace the current, healthcare industry-standard, reactive system, thereby eliminating wasted logistics trips and non-value added support service activities. The new processes will increase support service efficiencies and consolidate the numerous independent and silo-operated departments. In addition, we plan to design workflows which provide frontline logistics support to the clinical staff. The frontline support will be coordinated by a new team member who will be the bridge between the clinical staff and all support services. This person will be tasked with coordinating most, if not all, of the support service activities for a given work area (e.g. 1 or 2 nursing units). To support these efforts, we will also develop a care support information system that captures the nurses' knowledge of support activities required to prepare for and perform care. The information system developed will guide the workflow for the logistics staff by providing the required information to proactively prepare all resources (i.e., equipment and supplies) for defined clinical procedures. This system will include information such as number of consumable supplies needed for common procedures (e.g., dressing change) performed on a nursing unit. We propose to perform a three-year project to engineer efficient and effective care delivery support processes and to reduce or eliminate nursing involvement with routine logistics activities through the use of discrete event simulation modeling and by applying established manufacturing and engineering practices (Aim 1), as well as develop an information system to support the new processes (Aim 2). The project will also include a pilot implementation on two nursing units (one general medical/surgical unit and one progressive care unit) and the evaluation of implementation on several key performance indicators (Aim 3).

摘要 Geisinger Clinic的供应链服务开发了“项目帮助”（医疗保健物流 计划），该计划基于成功的制造和工程工作流程，并提出了一个精益 重新设计供应交付、支持服务业务和住院单位的临床工作流程。项目 HELP的目标是将临床医生从支持服务活动中移除，并将这些时间重新投入到患者护理中 活动支持服务被定义为医院的非临床部门， 护理的递送（例如，药房、实验室和床单服务）。我们的初步研究估计， 大约16.8%的护士时间（每名住院护士每周40小时6.72小时）浪费在后勤上 他们不应该从事的活动，这在行业中很常见。这导致 项目假设，通过改善护理提供支持系统，我们可以消除护士的支持 服务活动，从而允许临床医生重定向到患者护理活动，并实现改进的 护理质量。这项研究代表了一种提高医疗保健价值的方法，即，减少浪费或 不必要的成本，同时提高质量。 Project HELP将设计一个主动支持服务系统来取代当前的医疗保健系统 行业标准的反应系统，从而消除了浪费的物流行程和非增值支持 服务活动新流程将提高支助服务效率，并整合众多 独立和孤立运作的部门。此外，我们计划设计工作流程， 为临床工作人员提供后勤支持。前线支援将由一名新队员负责协调， 成为临床人员与所有支援服务之间的桥梁。此人将负责协调 给定工作区域的大多数（如果不是全部）支持服务活动（例如1或2个护理单元）。支持 这些努力，我们还将开发一个护理支持信息系统， 支持为护理做准备和开展护理所需的活动。开发的信息系统将指导 通过提供所需信息来主动准备所有资源（即， 设备和用品）。该系统将包括诸如号码等信息 普通程序所需的消耗品（例如，换药）。 我们建议执行一个为期三年的项目，以设计高效、有效的护理提供支持 流程，并通过使用 离散事件仿真建模和应用既定的制造和工程实践（Aim （目标1），以及开发一个信息系统，以支持新的进程（目标2）。该项目还将 包括在两个护理单位（一个是普通内科/外科单位，一个是渐进式护理单位）试行 护理单位）和评价几个关键绩效指标的执行情况（目标3）。