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Using Lean methodologies to streamline processing of requests for durable medical equipment and supplies for children with complex conditions

机译：利用精益方法简化了用于具有复杂条件的儿童的耐用医疗设备和供应的要求

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ABSTRACT Background An improvement team from the Complex Care Center at our large pediatric medical center participated in a 60-day initiative to use Lean methodologies to standardize their processes, eliminate waste and improve the timely and reliable provision of durable medical equipment and supplies. Methods: The team used value stream mapping to identify processes needing improvement. Improvement activities addressed the initial processing of a request, provider signature on the form, returning the form to the sender, and uploading the completed documents to the electronic medical record. Data on lead time (time between receiving a request and sending the completed request to the Health Information Management department) and process time (amount of time the staff worked on the request) were collected via manual pre- and post-time studies. Results: Following implementation of interventions, the median lead time for processing durable medical equipment and supply requests decreased from 50 days to 3 days (p < 0.0001). Median processing time decreased from 14 min to 9 min (p < 0.0001). The decrease in processing time realized annual cost savings of approximately $11,000. Conclusions: Collaborative leadership and multidisciplinary training in Lean methods allowed the CCC staff to incorporate common sense, standardize practices, and adapt their work environment to improve the timely and reliable provision of equipment and supplies that are essential for their patients. Implications: The application of Lean methodologies to processing requests for DME and supplies could also result in a natural spread to other paperwork and requests, thus avoiding delays and potential risk for clinical instability or deterioration.
机译：摘要背景从我们的大小儿科医疗中心的复杂护理中心的改善队参加了60天的倡议，使用精益方法来规范他们的流程，消除浪费，完善耐用医疗设备和供应的及时可靠地提供耐用的医疗设备和供应。方法：该团队使用价值流映射来识别需要改进的进程。改进活动解决了请求的初始处理，表单上的提供商签名，将表单返回给发件人，并将已完成的文档上载到电子医疗记录。关于提前期的数据（在收到请求和向健康信息管理部门发送完成的请求之间的时间）和过程时间（请求的工作人员工作的时间）由手册预先及时研究收集。结果：实施干预措施后，加工耐用医疗设备和供应请求的中位数提前时间从50天降至3天（P <0.0001）。中值处理时间从14分钟降至9分钟（P <0.0001）。处理时间减少实现年度成本节省约为11,000美元。结论：精益方法的协作领导和多学科培训允许CCC工作人员融入常识，标准化实践，并调整其工作环境，以改善对其患者至关重要的及时可靠的设备和供应。含义：精益方法应用于处理DME和供应的请求也可能导致自然扩散到其他文书工作和要求，从而避免临床不稳定或恶化的延迟和潜在风险。

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