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A lean approach to improve the organisation of unplanned intensive care admissions: A before-after analysis. / Spaan, I. T.; van der Sluijs, A. F.; Boelens, A. D.; Binnekade, J.; van Lieshout, E. J.; Juffermans, N. P.; Mudde, R.; Bouter, P.; Dongelmans, D. A.; Vlaar, A. P. J.

In: Netherlands journal of critical care, Vol. 28, No. 3, 2020, p. 134-138.

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@article{f75ff3bdcb3e4564885a96187be67fa6,
title = "A lean approach to improve the organisation of unplanned intensive care admissions: A before-after analysis",
abstract = "Background: Unplanned admissions of intensive care patients demand well-organised team work. Lack of an intensive care unit (ICU) admission protocol may lead to insufficient preparations or unclear task allocations. It was hypothesised that using a Lean approach, the organisation and perceived quality of care of unplanned ICU admissions could be improved. Methods: Using Lean, the organisation of unplanned admissions was analysed by measuring the perception of the quality of care amongst physicians and nurses. These results led to a new protocol describing logistical and organisational measures. After six months of implementation, a survey was performed to evaluate the effect using a modified t-test. Results: After implementation, 27 questionnaires were filled in and compared with 27 baseline questionnaires. The satisfaction of nurses with the quality of admission, expressed in the admission score (M, on a scale of 1-10) improved (pre: M=7.4; SD=1.3; post: M=8.2; SD=0.9; p=0.001). On a scale of 1-5 the score for clear task allocation improved (pre: M=3.3; SD=1.2; post: M=4.3; SD=0.9; p < 0.001) as well as the score for effective communication (pre: M=4; SD=0.8; post: M=4.4; SD=0.7; p=0.01). Physicians reported an improvement in the score for clarity about task allocation (pre: M=3.2; SD=1.2; post: M=4.1; SD=1.3; p=0.001) and the content of task (pre: M=3.6; SD=1.1; post: M=4.1; SD=1; p=0.001). Conclusion: By using a Lean approach, the implementation of a survey-based protocol resulted in a perceived improved quality of unplanned admissions at the ICU.",
keywords = "CRM, Crew resource management, Lean, Organisation, SAQ, Safety attitudes questionnaire, Unplanned admissions",
author = "Spaan, {I. T.} and {van der Sluijs}, {A. F.} and Boelens, {A. D.} and J. Binnekade and {van Lieshout}, {E. J.} and Juffermans, {N. P.} and R. Mudde and P. Bouter and Dongelmans, {D. A.} and Vlaar, {A. P. J.}",
note = "geen DOI beschikbaar",
year = "2020",
language = "English",
volume = "28",
pages = "134--138",
journal = "Netherlands journal of critical care",
issn = "1569-3511",
publisher = "Netherlands Society of Intensive Care",
number = "3",

}

RIS

TY - JOUR

T1 - A lean approach to improve the organisation of unplanned intensive care admissions: A before-after analysis

AU - Spaan, I. T.

AU - van der Sluijs, A. F.

AU - Boelens, A. D.

AU - Binnekade, J.

AU - van Lieshout, E. J.

AU - Juffermans, N. P.

AU - Mudde, R.

AU - Bouter, P.

AU - Dongelmans, D. A.

AU - Vlaar, A. P. J.

N1 - geen DOI beschikbaar

PY - 2020

Y1 - 2020

N2 - Background: Unplanned admissions of intensive care patients demand well-organised team work. Lack of an intensive care unit (ICU) admission protocol may lead to insufficient preparations or unclear task allocations. It was hypothesised that using a Lean approach, the organisation and perceived quality of care of unplanned ICU admissions could be improved. Methods: Using Lean, the organisation of unplanned admissions was analysed by measuring the perception of the quality of care amongst physicians and nurses. These results led to a new protocol describing logistical and organisational measures. After six months of implementation, a survey was performed to evaluate the effect using a modified t-test. Results: After implementation, 27 questionnaires were filled in and compared with 27 baseline questionnaires. The satisfaction of nurses with the quality of admission, expressed in the admission score (M, on a scale of 1-10) improved (pre: M=7.4; SD=1.3; post: M=8.2; SD=0.9; p=0.001). On a scale of 1-5 the score for clear task allocation improved (pre: M=3.3; SD=1.2; post: M=4.3; SD=0.9; p < 0.001) as well as the score for effective communication (pre: M=4; SD=0.8; post: M=4.4; SD=0.7; p=0.01). Physicians reported an improvement in the score for clarity about task allocation (pre: M=3.2; SD=1.2; post: M=4.1; SD=1.3; p=0.001) and the content of task (pre: M=3.6; SD=1.1; post: M=4.1; SD=1; p=0.001). Conclusion: By using a Lean approach, the implementation of a survey-based protocol resulted in a perceived improved quality of unplanned admissions at the ICU.

AB - Background: Unplanned admissions of intensive care patients demand well-organised team work. Lack of an intensive care unit (ICU) admission protocol may lead to insufficient preparations or unclear task allocations. It was hypothesised that using a Lean approach, the organisation and perceived quality of care of unplanned ICU admissions could be improved. Methods: Using Lean, the organisation of unplanned admissions was analysed by measuring the perception of the quality of care amongst physicians and nurses. These results led to a new protocol describing logistical and organisational measures. After six months of implementation, a survey was performed to evaluate the effect using a modified t-test. Results: After implementation, 27 questionnaires were filled in and compared with 27 baseline questionnaires. The satisfaction of nurses with the quality of admission, expressed in the admission score (M, on a scale of 1-10) improved (pre: M=7.4; SD=1.3; post: M=8.2; SD=0.9; p=0.001). On a scale of 1-5 the score for clear task allocation improved (pre: M=3.3; SD=1.2; post: M=4.3; SD=0.9; p < 0.001) as well as the score for effective communication (pre: M=4; SD=0.8; post: M=4.4; SD=0.7; p=0.01). Physicians reported an improvement in the score for clarity about task allocation (pre: M=3.2; SD=1.2; post: M=4.1; SD=1.3; p=0.001) and the content of task (pre: M=3.6; SD=1.1; post: M=4.1; SD=1; p=0.001). Conclusion: By using a Lean approach, the implementation of a survey-based protocol resulted in a perceived improved quality of unplanned admissions at the ICU.

KW - CRM

KW - Crew resource management

KW - Lean

KW - Organisation

KW - SAQ

KW - Safety attitudes questionnaire

KW - Unplanned admissions

UR - http://www.scopus.com/inward/record.url?scp=85086364810&partnerID=8YFLogxK

M3 - Article

VL - 28

SP - 134

EP - 138

JO - Netherlands journal of critical care

JF - Netherlands journal of critical care

SN - 1569-3511

IS - 3

ER -

ID: 11982631