Improving the Quality of Emergency Intrahospital Transport for Critically Ill Patients by Using Toyota Production System Methods

Abstract

Objective To explore the effects of the Toyota Production System (TPS) for improving the quality of emergency intrahospital transport for critically ill patients in management. Methods Between April and June 2021, 68 critically ill patients were transported to corresponding wards, while 63 critically ill patients were transported to corresponding wards between July and September 2021. The pre-TPS and post-TPS management groups each included 30 cases based on their propensity score. The TPS management tool was combined with the PDCA method for analysing the current situation as well as determining the target for improvement, calculating the value and process efficiencies, and modifying and evaluating relevant processes. At last, the changes in transport time, receiving department, patient satisfaction, and adverse event rate of critically ill patients after TPS management were analysed. Results The total intrahospital transport time of critically ill patients decreased from 39 minutes (median) before the implementation of TPS management to 27 minutes (median) after TPS management, and the difference was statistically significant (P<0.05). Process efficiency and value efficiency both increased from 33.33% and 38.46% before TPS management to 42.86% and 40.74% after TPS management, respectively. Likewise, the satisfaction of receiving departments and patients increased from 73.33% and 76.67% before TPS management to 96.67% and 96.67% after TPS management (P<0.001). Finally, the adverse event rate decreased as a result of TPS management from 13.33% to 3.33% (P>0.05). Conclusion TPS management may significantly shorten the intrahospital transport time for critically ill patients, reduce the occurrence of adverse events in emergency care, advance patient satisfaction, and improve the overall quality and safety of emergency care.

Real emotional experience of family members of patients transported within hospital in neurosurgical intensive care unit: A descriptive qualitative study

“…For example, a standardized, evidence‐based transport process covered the following aspects: make adequate preparations before transport, it is essential to evaluate whether the patient's condition is suitable for transport in advance, prepare the drugs and equipment needed to deal with unpredictable disease changes during transport, conduct effective communication and coordination with relevant departments before transport, formulate transport routes, contact family members for cooperation and establish a professional transport team with transport qualifications (Zeng et al., 2021 ). Some foreign scholars (Lu et al., 2022 ) have explored the role of Toyota Production System (TPS) in improving the quality management of emergency IHT of critically ill patients, and combined TPS management tools with PDCA methods. Positive changes in critical patient transit times, admissions, patient satisfaction and adverse event rates are confirmed.…”

“…For example, a standardized, evidence-based transport process covered the following aspects: make adequate preparations before transport, it is essential to evaluate whether the patient's condition is suitable for transport in advance, prepare the drugs and equipment needed to deal with unpredictable disease changes during transport, conduct effective communication and coordination with relevant departments before transport, formulate transport routes, contact family members for cooperation and establish a professional transport team with transport qualifications (Zeng et al, 2021). Some foreign scholars (Lu et al, 2022) Evidence (Avci & Ayaz-Alkaya, 2022) shows that when patients are seen as partners in healthcare, significant improvements are achieved in terms of safety, patient satisfaction and health outcomes. Most Family members experience different psychological problems during the patient's ICU admission and hospitalization, currently referred to as family intensive care unit syndrome (FICUS) (Netzer & Sullivan, 2014).…”

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

“…This mode forms a circular management process by formulating a management plan, implementing a plan, checking the implementation results, and formulating a new plan after dealing with problems in the management process, making the entire management mode more service intensive, more complete. [22][23][24] When patients undergo endoscopic examination, they may experience certain discomfort and have a certain impact on their medical experience. The PDCA management model can effectively solve the above problems, optimize nursing plans, and improve nursing quality.…”

Status of knowledge, attitude and practice of clinical nurses towards the intrahospital transport of critically ill patients: A cross‐sectional study

“…In all published guidelines, the role of the medical practitioners, specifically the nurse, in preventing possible complications is pivotal (Critical Care Medicine Branch of Chinese Medical Association., 2010 ; Warren et al., 2004 ; Whiteley et al., 2011 ; Williams et al., 2020 ). To ensure the timeliness and safety of IHT for these patients, it is urgent to standardise and optimise the IHT process (Lu et al., 2022 ) and and to investigate the knowledge, attitude and practice (KAP) of nurses in this process (Alamanou & Brokalaki, 2014 ).…”