Simulation

Performance Management and Benchmarking Simulation

NAME

University of Phoenix

Barbara Smith

COURSE

Root Causes

LHAC was right to express concern about a rate of nosocomial infection that already came close to 5 for this is a prevalent problem not only in hospitals but across all health care facilities as well . Vincent (2003 ) cited astounding morbidity rates of 30 of ICU patients , for instance , as well as many studies having traced the problem to certain patient types and the use of such invasive equipment as catheters

I decided on inefficient

equipment management ' as the root cause because I was impressed by the disparities in equipment utilization across the different departments . This suggested unsystematic distribution , itself the reason why nurses seem to spend more hours caring for each patient than planned

Mr . Watts congratulated me for identifying the correct root cause . His feedback in this regard did mention the variance in nosocomial morbidity across departments . I had noticed that , as well as the high utilization of invasive equipment in those departments evincing nosocomial infections at around 1 of Given this result , I would of course not have done anything differently

Establishing an Airway

I needed to choose enforced terminal cleaning as the primary process improvement because the leading cause of a nosocomial infection is always contaminated or improperly-sterilized equipment , particularly the invasive type . In one stroke , I achieve effectiveness , focus reliability , efficiency , quality management and progress toward strategic aims . These advantages are demonstrated in achieving a JCAHO Compliance Index of 79 .1 right away at what seems to be a modest impact on adjacent processes (principally staff time

So important is terminal cleaning in the management of nosocomial outbreaks that the authoritative protocols for the irritatingly widespread and persistent Acinetobacter spp cover thorough cleaning of beds , mattresses , railings , shelves , bathroom surfaces , utility rooms for both clean and soiled linens , mop heads and handles themselves , I .V poles , wheelchairs , glucometers , and of course , all shared equipment (Johns Hopkins Medicine , n .d

By comparison , switching to all-disposable equipment is not as successful in matching JCAHO standards (77 .75 ) and fails to make really efficient use of resources since it is not yet practical to source disposable versions of some equipment . So a process improvement that encompasses terminal cleaning of , say , forceps and ventilators , achieves quality objectives better and protects LHAC reputation more firmly

For the other improvement , appointing inventory clerks seemed the best possible option . Though this step causes considerable disruption in adjacent processes and absorbs the rest of the CFO 's budget , it maximizes compliance with JCAHO standards in terms of minimizing the clinical risk of equipment . As well , it assigns responsibility for monitoring compliance with the primary process improvement , enforced terminal cleaning

Once again , Ian Watts sent kudos for identifying the optimal mix of steps for improving the LHAC equipment management process . However , the CEO evaluated my metrics set as correct solely for 3 below

I opted for these metrics

Equipment incidents resolved (most critical for LHAC Utilization versus cleaning log ratio...