Application of quality improvement techniques to the reduction of turnaround time for "STAT" and "ASAP" orders.

This project educated a multidisciplinary team on the techniques of continuous quality improvement, which were then used to analyze the total medication cycle process in order to reduce the total turnaround time for STAT and ASAP orders. Members were trained in the appropriate analytical techniques, developed flow charts of the medication cycle, and developed and conducted a study of the turnaround time for STAT and ASAP orders. Three data collections were obtained: 1) baseline, 2) after flagging orders and medications to help quickly identify both, and 3) after implementation of guidelines for physicians to properly use the terms STAT and ASAP. The interventions seem to have resulted in system improvement based upon an overall decrease in turnaround time (70% for STAT orders, 54% for ASAP orders). The majority of the medication cycle time was on the patient care unit after medication delivery. Problems with the process were identified and recommendations made for future quality improvement teams.

Accuracy and time requirements of a bar-code inventory system for medical supplies.

The effects of implementing a bar-code system for issuing medical supplies to nursing units at a university teaching hospital were evaluated. Data on the time required to issue medical supplies to three nursing units at a 480-bed, tertiary-care teaching hospital were collected (1) before the bar-code system was implemented (i.e., when the manual system was in use), (2) one month after implementation, and (3) four months after implementation. At the same times, the accuracy of the central supply perpetual inventory was monitored using 15 selected items. One-way analysis of variance tests were done to determine any significant differences between the bar-code and manual systems. Using the bar-code system took longer than using the manual system because of a significant difference in the time required for order entry into the computer. Multiple-use requirements of the central supply computer system made entering bar-code data a much slower process. There was, however, a significant improvement in the accuracy of the perpetual inventory. Using the bar-code system for issuing medical supplies to the nursing units takes longer than using the manual system. However, the accuracy of the perpetual inventory was significantly improved with the implementation of the bar-code system.