Authors (including presenting author) :
Tse WH, Lai CK, Yu KY, Ngo OL, Chan WK
Affiliation :
Adult Intensive Care Unit, Queen Marry Hospital
Introduction :
In the past, mechanical ventilators are inventories under individual departments in a hospital. This tradition has led to different operational issues including non-unified models of ventilator in use in clinical setting, high operational cost from purchase of different consumables and complex after-use processing logistics. Since October 2021, the adult intensive care unit (ICU) of a local hospital had introduced a central ventilator bank (CVB) service through a collaborative model with central sterile services department (CSSD) and different clinical departments. This paper presents the essential processes to build the service model with emphasis on work efficiency, quality and sustainability.
Objectives :
1. To control clinical risks associated with multiple ventilator models.
2. To establish a workflow on inventory management through a centralized CVB.
3. To ensure stability in supply and turnover of ventilators to cope with surge in clinical needs.
4. To develop staff expertise in the maintenance of mechanical ventilators.
Methodology :
The model of Double Diamond Design Process was adopted in this service reengineering process. Stakeholder departments were engaged early in the discovery phase to understand the problem. Convergence of information targeted at bridging the service gap was done in the definition phase. Possible logistic problems and the limitation of service provision were defined. In the development phase, prototype service model was piloted and continual process refinement ensuring seamless delivery of ventilators to designated wards and proper management of the resources were conducted. The practice was frozen in the final delivery phase. Service quality, efficiency and resource utilization data were evaluated.
Result & Outcome :
At the end of 2024, CVB manage 71 ventilators and 52 high flow oxygen therapy devices to support operation of the hospital. Between 2021 and 2024, 1,511 delivery of ventilators to general and specialty wards were accounted. Total patient ventilation time was 152,274 hours. For high flow oxygen therapy devices, CVB managed 514 deliveries to ward between 2022 to 2024. The auto-refiling system for ventilators was proved to be safe and efficient in reducing unnecessary request calls and staff documentation time. Set-up of satellite ventilator bank in different block of the hospital has facilitated ad-hoc requests for extra ventilator during non-office hours. Introducing the CVB has improved collaboration between departments and resulted in a more coordinated workflow in inventory management.
