Redesigning an airway cart using lean methodology

Weigel, Wade

doi:10.1016/j.jclinane.2016.04.025

Cited by 15 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 One author described a difficult airway cart with over 220 items. 26 On the other hand, our inclination towards minimalism is supported by robust research in psychology. A 2000 study by Iynegar and Lepper shows that decreasing the amount of choices available significantly decreases the time to decision while increasing satisfaction with the choice.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomised simulation trial comparing our novel AIR-BOX to standard airway equipment storage modalities

Piechowski

Clapper

Park

et al. 2020

BMJ Simul Technol Enhanc Learn

View full text Add to dashboard Cite

BackgroundThere is little evidence guiding equipment handling during emergency endotracheal intubations (EEI). Available evidence and current practice are either outdated, anecdotal or focused on difficult—not emergency—intubation. In this study, we describe and evaluate our equipment handling unit: the AIR-BOX.MethodsThis is a proof-of-concept, prospective, randomised simulation trial. A convenience sample of 50 airway course participants voluntarily underwent randomisation: 21 to the AIR-BOX group, 14 to the intubation box group, and 15 to the crash cart group. The volunteers were asked to intubate a manikin using the equipment from the storage unit of their randomisation. Outcome measures included time-to-readiness, time-to-intubation, first-pass success, and subjective operator experience.ResultsThe mean time-to-readiness was 67.2 s with the AIR-BOX, 84.6 s with the intubation box, and 115 s with the crash cart. The mean time-to-intubation was 105 s with the AIR-BOX, 127 s with the intubation box and 167 s with the crash cart. A statistically significant difference was achieved between the AIR-BOX and the crash cart. No statistically significant difference was found between the three groups with regard to first-pass success or the time between intubation readiness and intubation.ConclusionsThis study supports the AIR-BOX as a viable tool that can improve and simplify access to emergency intubating equipment. It also opens doors for multiple future innovations that can positively impact equipment handling practices. Future studies can focus on assessing whether applying the AIR-BOX will yield a clinically significant impact on patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

A prospective randomised simulation trial comparing our novel AIR-BOX to standard airway equipment storage modalities

Piechowski

Clapper

Park

et al. 2020

BMJ Simul Technol Enhanc Learn

View full text Add to dashboard Cite

show abstract

“…When a DART was activated, the charge nurse brought the DART cart to the site of call, and the respiratory therapist set up the fiberoptic scope so that it was ready for use upon airway experts' arrival. Well‐designed difficult airway carts have been shown to reduce nonvalue‐added time and walking distance to retrieve the equipment . Whereas the number of difficult airway carts needed in operating suites has been recommended as one cart for every 15 to 20 anesthesia sites, the number of difficult airway carts needed outside the operating suites and how they should be strategically located have not been formally studied …”

Section: Discussionmentioning

confidence: 99%

Management of difficult airway among patients with oropharyngeal angioedema

et al. 2018

View full text Add to dashboard Cite

Objective The objective of our study was to assess the impact of a multidisciplinary difficult airway response team (DART), a quality improvement program, in the management of patients with difficult airway associated with oropharyngeal angioedema patients. Methods Individual retrospective cohort study. Retrospective review of patient charts from July 2003 to June 2008 (pre‐DART) and retrospective review of prospectively collected data from July 2008 to June 2013 (post‐DART). Patients with angioedema were identified using International Classification of Disease codes 995.1 and 277.6. Patients were included in the study if an otolaryngologist was consulted for airway management. Patients were excluded if they had a history of angioedema but no active issues. Patient characteristics, airway evaluation, and interventions (intubation/surgical airway) were compared between the pre‐DART and post‐DART cohort. Results The DART team attended to 27 patients with advanced oropharyngeal angioedema. Response time averaged 3.36 minutes. Preintubation fiberoptic airway evaluations were performed in 81% of the post‐DART cohort and 56% of the pre‐DART cohort. The incidence of patients requiring intubation was higher in the post‐DART cohort (18 out of 27 [67%]) than the pre‐DART (14 out of 36 [39%]) cohort. One emergency cricothyroidotomy was performed in each of the post‐DART and pre‐DART cohorts. Conclusion Angioedema of the larynx is a predictor of intubation or cricothyroidotomy. Fiberoptic‐guided intubation is primarily used for establishing airway in angioedema patients. A multidisciplinary standardized approach such as the DART program offers adequate time and resources for airway evaluation prior to intervention and allows fewer number of attempts to secure an airway. Level of Evidence 3 Laryngoscope, 129:1360–1367, 2019

show abstract

“…DELMIA is the virtual simulation technique used in the application "production planning and control-improvement" to simulate the implementation of a Drum-Buffer-Rope pull system (Darlington et al, 2015). Simulation game is the type of simulation that has been applied by one reference to design an airway cart in "process re-engineering in healthcare" (Weigel, 2016). Besides, 3D simulation of using Simio has been applied for assessing the impact of just in time and lean principles in construction project (Bamana et al, 2019) and specific simulation models, such as SimpLean and VILLEGO were applied for human resource management (Faloughi et al, 2014;Salazar et al, 2018).…”

Section: Facilitation and Evaluation Of Lean Implementationmentioning

confidence: 99%

The application of simulation in lean production research: a critical review and future directions

Shou

Jun

2021

ECAM

View full text Add to dashboard Cite

PurposeSimulation has attracted increasing attention in lean production research as a response to address the complexities of the production environment and difficulties of dealing with changes within a system. Considerable growth of using simulation to facilitate lean acceptance and implementation has been observed across different projects and sectors. However, a thorough review of the development and use of simulation in lean production research is limited.Design/methodology/approachThis study aims to address this gap by reviewing 311 journal papers published in the past two decades on this specific research area and identify the state-of-the-art development and propose future research directions.FindingsThe review shows that current studies related to simulation in lean production research can be categorised into two major research streams, namely, simulation assisted lean facilitation and evaluation, and simulation-based lean education and training. Under the first research stream, a total of 19 application areas have been identified which applied both lean and simulation in their studies. The evolution of the simulation techniques used in these studies has been analysed as well. Meanwhile, four types of simulation games have been identified in the stream of simulation-based lean education and training and the impact and applicability of the different simulation and games have been discussed. A framework for engaging lean and simulation is suggested based on the review of the existing studies. The analysis in both streams also highlights the importance of stakeholder engagement and the utilisation of information technologies for future studies.Practical implicationsThe findings of this study are expected to provide useful references for the future development and application of simulation in lean production research.Originality/valueThis paper conducted a broad and extensive review of simulation integrated lean production research. An in-depth examination of the retrieved papers was conducted through a structured and quantitative analysis to understand the current body of knowledge.

show abstract

Redesigning an airway cart using lean methodology

Cited by 15 publications

References 13 publications

A prospective randomised simulation trial comparing our novel AIR-BOX to standard airway equipment storage modalities

A prospective randomised simulation trial comparing our novel AIR-BOX to standard airway equipment storage modalities

Management of difficult airway among patients with oropharyngeal angioedema

The application of simulation in lean production research: a critical review and future directions

Contact Info

Product

Resources

About