Using the model for improvement and microsystems analysis methodological framework to examine variation in the pressure transducer management process

Abstract

Background: The pressure transducer is a device used commonly in the critical care areas of a hospital in order to monitor the hemodynamic stability of a patient, in particular the critically ill patient. Because pressure transducers are commonly used, and because of the importance of the monitoring associated with the device, the ability to effectively set up and manage a pressure transducer is important. As such, the process should be examined for consistency, accuracy, and safety. Unfortunately, based upon an appraisal of the current research, there is no evidence in the literature detailing a standardized process for managing the pressure transducer set-up, nor is there a specific recommendation regarding the type of provider who should establish and manage these systems.

Methods: The microsystem analysis and model for improvement (MFI) three guiding questions were used as the methodological framework for determining the extent and organizational risk associated with process variation in the pressure transducer management workflow. In critically ill adult intensive care patients, aged 18 and above, how does variation in the type of provider (Registered Nurse versus Anesthesia Lab Personnel) and workflow process (workflow variation, provided by process flow) for managing pressure transducers impact patient outcomes (rates of infection), process efficiency (measured by staff time for transducer set up and process cost for supplies/equipment), and direct cost of hemodynamic monitoring in a 12-month timeframe?

Results: Process variation in the set-up and management of the pressure transducer throughout the healthcare organization was identified through process and pattern analysis. The results of the analysis highlighted operational inefficiencies and un-necessary workflow variations.

Conclusions: The set-up and management of the pressure transducer process within a healthcare organization is a workflow that should be standardized and reviewed for operational and clinical outcomes. From a broader perspective, this project highlights the importance of analyzing workflow and the importance of decreasing workflow variation.