Treatment Mapping – A Systematic Methodology to Assess Quality, Efficiency and Variability in the Hemodialysis Delivery Process

Abstract

Background/Aims: Radical thinking about the design of industrial processes has greatly improved the quality and efficiency of manufacturing and services. Applying similar methods in healthcare to deliver quality care at lower costs would be valuable. Methods: We have developed and validated a methodology – Treatment Mapping – to analyze the hemodialysis (HD) delivery as an operational process. Results: The methodology was well applicable in the 26 Gambro Healthcare clinics studied (Europe, Taiwan, USA). Monitor process, patient process and dialysis treatment times (mean ± SD) were 324.4 ± 46.0, 272.2 ± 34.5 and 221.6 ± 28.8 min, respectively. In general, significant variability in process cycle times was found in the clinics studied. Conclusion: HD delivery is a complex process influenced by patient characteristics, monitor/disposables design, staff skills and clinic practices and physical layout. The Treatment Mapping methodology is a useful tool to analyze the HD delivery from a process quality and process operational perspective.

Monitor Turnaround Time and Time Efficiency in Hemodialysis Delivery – A Global Comparison

“…The basic framework for this methodology is the HD delivery process map that outlines the steps in the HD delivery process in two 'semi-parallel' pathways, that of the patient and that of the monitor. A detailed description of the methodology with evaluation of its applicability has previously been published [10] .…”

“…Delivering dialysis is a complex process influenced by many factors such as clinic structure and physical layout, clinical policies and procedures, staff skills, design of dialysis monitors and disposables, and patient characteristics [10] . This complexity is expected to result in variation in process outputs, such as treatment quality and operational efficiency.…”

“…The aim of the current study, using the treatment mapping methodology [10] , was to benchmark the HD delivery monitor turnaround time, its variability and potential unproductive time, and to make a comparison of these variables in Gambro Healthcare clinics on a global basis.…”

Sağlik Sektöründe Yalin Felsefe

“…Yalın düşünce ve uygulamaları ortaya çıkışından itibaren geliştirilerek bütün sektörlere yayılmış ve özellikle 2000 yılından sonra sağlık sektöründe maliyetlerin düşürülmesi, hasta memnuniyetinin arttırılması için uygulanmaya başlamıştır. Alquist & Bosch (2008) Heinbuch (1995), Jacobs & Palfrey (1995, Whitson (1997) sağlık işletmelerinde yalın düşünce sisteminin ilkeleri ilk kullanan isimler olarak karşımıza çıkmaktadır (Yıldız, 2015). Ülkemizde de bu konuda yapılan çalışmalar yetersiz olmakla birlikte, son zamanlarda ihtiyaç ve ilgi duyulan alanlardan biri haline gelmiştir.…”

Dialysis Prescription: A Modifiable Risk Factor for Chronic Kidney Disease Patients

“…Selecting simple pertinent indicators of dialysis efficacy, focusing on patients outside guidelines and correcting causes of excursion would significantly improve the patient dialysis survival rate [80] .…”