Background:
Effective, reliable and speedy decontamination of endoscopes is key
to supporting the effective running of a Day Services endoscopy list
and facilitate unplanned “add in-patients” onto the daily list without
over running or cancelling a patients procedure. Maximising the
reliability and efficiency of the decontamination process is a critical
factor in delivering safe, effective care every time for every patient.
Aim:
To provide one additional high level disinfected endoscope to
facilitate an extra endoscope procedure slot each working list day by
January 2018.
Walk/Observe the pathway of the patient :
Methods for Improvement :
The team used the data from the National Tracking System to measure for
improvement and the IHI Model for Improvement to implement change using
Plan Do Study Act (PDSA) cycles.
Results
The Team provided a minimum of
one additional scope by improving
the efficiency of the decontamination
process allowing one additional patient
to be treated every day .
National Quality Improvement Project in Decontamination of Reusable Endoscopes Marina Byrne Corbett (CNM2), Mark Spencer (HCA), Marie Gorman (CNM1) Naas General Hospital
Driver Diagram :
Our Decontamination Project Improvement Driver Diagram identified
Primary and Secondary Drivers and specific ideas to bring about
change.
Endoscope Washer Disinfector ( EWD) Upgrade
WD 440 (Old EWD) WD 440 PT (New EWD )
New EWD Cycle Times /Endoscope Type
Variation in Endoscope
Reprocessing Capacity per Day Scope Activity and Utilisation
Mapping the process identified multiple factors
which may impact on maximising the efficient
running of the Day Services endoscopy list.
In November 2017 the Team met with the
Endoscopy User Group. The project team used,
run charts, pareto charts and process mapping to
highlight the patient referral pathway:
demonstrate to the User group the baseline
scope utilization per day and highlight areas
where utilization could be increased through
efficiencies.
The Quality improvement Foundation Programme
Project Proposal was introduced to the
Endoscopy User Group , together with their smart
aim; to “provide equipment to allow one extra
procedure to be performed per day”.
Mapping of the process opened discussions
around clinical and operational factors which may
influence the provision of “add in-patient slots” to
the daily list for example, referral form review,
patient criteria review, protected procedure slots .
Inpatient Referral Process
Mapping the process
Conclusion/Benefit’s:
Measurable benefits our project has delivered and is forecast to deliver:
Patient Experience:- Waiting times for inpatients have been reduced
Patient Outcomes:- Speedy diagnosis based on procedure result
Patient Access & Flow:- Quicker access to procedure and shorter hospital stay .
Staff: - Morale improvement ,better “buy in “ reduced feeling of
being overwhelmed by waiting procedures – everyone working together !
Waste reduction: - endoscope disinfection capacity is maximised due
to increases efficiencies as a result of new Endoscope Washer Disinfector.
reduced cycle times.