Over the past year, UAB Medicine clinicians have embraced a new mantra: “The pump stays with the patient.” Although simple in theory, the transition away from the former process of how IV pumps moved across our facilities has been a complex study in quality and process improvement. The initial problem was multifaceted; pumps were unavailable or not making it to units that needed them, surgeries were delayed because of setup issues, and one-way communication through the paging system created a serious communication issue that left staff wondering when exactly a pump would arrive, if at all.
Together, UAB nursing services, supply chain, HSIS, perioperative services, and vendor Hill-Rom set out to overhaul the established pump process and find opportunities to save time and money and improve quality. The result was a streamlined electronic system called FETCH that is safer for patients and allows employees to track pump order status. It was a multidisciplinary effort, though nursing played a large role and at the unit level established that the “pump stays with the patient.” Pumps are stocked at the main points of entry and remain with the patient for the duration of their care. As patients move throughout the organization, the pump moves too, reducing the need to connect and disconnect IV tubing. Not only is it safer, it’s easier to track.
In addition, pumps are no longer left idle in patient rooms after IV therapy is no longer needed, while nightly and mid-week roundups on the units have helped better manage equipment and ensure proper resource allocation across the hospital. Also, standards were evaluated for pump delivery and competencies for cleaning. Process mapping and education to facilitate the rollout of the new process was shared hospital-wide.
“There used to be considerable downtime for pumps that remained in the operating rooms. By using predictive methodology based on the anesthetic requirements of perioperative patients, we were able to develop an algorithm based on the surgery schedule to facilitate a lean IV pump process. The new algorithm developed in conjunction with anesthesia IT has been integral to our success in IV pump process optimization in perioperative services.” – Brooke Vining, CRNA
At the frontline of patient care, nurses knew there was a problem and asked for a solution. Putting quality and patients first, the new system is the result of a massive team effort and was fully activated in November 2018.