Improvement in Multidisciplinary Provider Rounding (Surgical Rounds) in the Pediatric Cardiac ICU: An Application of Lean Methodology.

Objectives: Provider-only, combined surgical, and medical multidisciplinary rounds ("surgical rounds") are essential to achieve optimal outcomes in large pediatric cardiac ICUs. Lean methodology was applied with the aims of identifying areas of waste and nonvalue-added work within the surgical rounds process. Thereby, the goals were to improve rounding efficiency and reduce rounding duration while not sacrificing critical patient care discussion nor delaying bedside rounds or surgical start times.

Sustained Reduction in Intravenous Pump Turnaround Time Using Lean Methodology.

Unlabelled: Intravenous pumps provide essential, life-sustaining medications to patients. Pumps must be in working order and available on short notice to be effective. We identified inefficiencies in our pump management process that inflated the cost and time to complete repairs.

Improving Discharge Efficiency and Charge Containment on a Pediatric Acute Care Cardiology Unit.

Background: Hospital discharge delays can negatively affect patient flow and hospital charges. Our primary aim was to increase the percentage of acute care cardiology patients discharged within 2 hours of meeting standardized medically ready (MedR) discharge criteria. Secondary aims were to reduce length of stay (LOS) and lower hospital charges.

Therapy Workloads in Pediatric Health: Preliminary Findings and Relevance for Defining Practice.

Purpose: To measure time spent by pediatric physical and occupational therapists in performing daily work activities.

Methods: Physical and occupational therapists at an urban pediatric academic hospital were observed during a standard workday. Time studies recorded total time spent performing patient care and other workplace-specific tasks.

Reduced isolation room turnover time using Lean methodology.

Objective: To prevent environmental transmission of pathogens, hospital rooms housing patients on transmission-based precautions are cleaned extensively and disinfected with ultraviolet (UV) light. To do so consistently requires time and coordination, and these procedures must avoid patient flow delays and associated safety risks. We sought to improve room turnover efficiency to allow for UV disinfection.

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

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.

Variation inflation factor-based regression modeling of anthropometric measures and temporal-spatial performance: Modeling approach and implications for clinical utility.

Background: Understanding the relationship of underlying anthropometry to temporal-spatial performance is critical to appropriate assessment of patients with ambulatory dysfunction. The current body of literature has established the importance of limb length in this relationship. This study sought to re-examine these relationships in light of recent trends in body habitus and obesity, using Variation Inflation Factor analysis to optimize the model.