Reducing Time Taken to Gather Equipment for Venepuncture and Cannulation: A Quality Improvement Project.

Timely gathering of equipment for venepuncture or cannulation on hospital wards is important, particularly in emergency situations. Anecdotally several doctors working at a hospital in England expressed frustration at low equipment stock, layout, and discrepancies between wards leading to significant delays in this process. This quality improvement project therefore aimed to reduce the time taken to gather equipment for venepuncture or cannulation to 20 seconds by June 2023.  Methods: Quality improvement methodology was used to define the problem, produce an aim statement, and design several interventions. A flow map was created to understand the equipment collection process, a root cause analysis identified problem areas, and a driver diagram highlighted potential change ideas. A new trolley layout was implemented as part of several plan-do-study-act cycles with the addition of several simple human interventions to maximise its usage. More widespread introduction of identical trolleys across the surgical wards was also achieved.  Results: Initial qualitative surveys and the root cause analysis identified a lack of equipment availability, and discrepancies between wards being key barriers to rapid collection of equipment. Prior to any intervention, the average time taken to gather equipment for venepuncture and cannulation was 141 and 137.5 seconds respectively. After implementing a new trolley design and layout, with clear markings and human factor optimisation, the times were reduced to 18 seconds each. Subjective feedback during a cardiac arrest scenario following the intervention was positive. Widespread implementation of the trolleys around the hospital was started following this success although the efficacy of their introduction was not measured during the study period.  Conclusion: This quality improvement project successfully reduced the time taken to gather equipment for venepuncture or cannulation on a hospital ward, with positive feedback in an emergency. The project used well-documented quality improvement methodology to achieve this and highlights the ability of empowered clinical staff in non-managerial or non-leadership positions to action change.