Title: System analysis and process redesign for quality improvement of sepsis resuscitation

Authors: Sura K. Alqudah; Yue Dong; Huitian Lu; Susan Lu

Addresses: Systems Science and Industrial Engineering Department, State University of New York at Binghamton, Binghamton, NY 13902-6000, USA ' Mayo Clinic College of Medicine, Multidisciplinary Simulation Center, Mayo Clinic, 200 First Street SW Rochester, MN 55905, USA ' Department of Construction and Operations Management, South Dakota State University, Room SSO 311, Box 2223, Admin Lane 901, Brookings, SD 57007-0001, USA ' Department of Systems Science and Industrial Engineering, State University of New York – Binghamton, Parkway East, Binghamton, NY 13902-6000, USA

Abstract: Severe sepsis and septic shock are serious medical emergencies that require timely treatment. The Sepsis Resuscitation Bundle was implemented to frame the resuscitation time within 6 h of onset. Missing this goal has a major impact on treatment outcomes and cost. This study demonstrates the potential of applying a systems engineering approach to improve resuscitation compliance. Root cause analysis, an industrial engineering tool, was used to analyse the existing process and identify sources of delay. Simulation modelling was performed to study event dynamics and propose alternatives. Sensitivity analysis was used to test the proposed alternatives. Results showed that improvements could be achieved by adopting major event adjustments. Applying these adjustments is projected to increase compliance from 50% to 71% and reduce average patient cycle time by 32%, improving the quality of sepsis and septic shock resuscitation in the ICU.

Keywords: severe sepsis; septic shock; industrial engineering tools; root cause analysis; simulation; sensitivity analysis; quality improvement; sepsis resuscitation; system analysis; process redesign; medical emergencies.

DOI: 10.1504/IJCENT.2014.065053

International Journal of Collaborative Enterprise, 2014 Vol.4 No.1/2, pp.83 - 100

Available online: 09 Oct 2014 *

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