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Surgical instrument reprocessing in a hospital setting analyzed with statistical process control and data mining techniques

Description
In a healthcare setting, the Sterile Processing Department (SPD) provides ancillary services to the Operating Room (OR), Emergency Room, Labor & Delivery, and off-site clinics. SPD's function is to reprocess reusable surgical instruments and return them to their home departments. The management of surgical instruments and medical devices can impact…

In a healthcare setting, the Sterile Processing Department (SPD) provides ancillary services to the Operating Room (OR), Emergency Room, Labor & Delivery, and off-site clinics. SPD's function is to reprocess reusable surgical instruments and return them to their home departments. The management of surgical instruments and medical devices can impact patient safety and hospital revenue. Any time instrumentation or devices are not available or are not fit for use, patient safety and revenue can be negatively impacted. One step of the instrument reprocessing cycle is sterilization. Steam sterilization is the sterilization method used for the majority of surgical instruments and is preferred to immediate use steam sterilization (IUSS) because terminally sterilized items can be stored until needed. IUSS Items must be used promptly and cannot be stored for later use. IUSS is intended for emergency situations and not as regular course of action. Unfortunately, IUSS is used to compensate for inadequate inventory levels, scheduling conflicts, and miscommunications. If IUSS is viewed as an adverse event, then monitoring IUSS incidences can help healthcare organizations meet patient safety goals and financial goals along with aiding in process improvement efforts. This work recommends statistical process control methods to IUSS incidents and illustrates the use of control charts for IUSS occurrences through a case study and analysis of the control charts for data from a health care provider. Furthermore, this work considers the application of data mining methods to IUSS occurrences and presents a representative example of data mining to the IUSS occurrences. This extends the application of statistical process control and data mining in healthcare applications.
ContributorsWeart, Gail (Author) / Runger, George C. (Thesis advisor) / Li, Jing (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2014
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Harm during hospitalizations for heart failure: adverse events as a reliability measure of hospital policies and procedures

Description
For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations…

For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations are unknown. There were 1,722 patients discharged with a primary diagnosis of HF from an academic hospital between January 2005 and December 2007. Three hundred eighty-one patients experienced 566 AEs, classified into four categories: medication (43.9%), infection (18.9%), patient care (26.3%), or procedural (10.9%). Three distinct analyses were performed: 1) patient's perspective of SOPP reliability including cumulative distribution and hazard functions of time to AEs; 2) Cox proportional hazards model to determine independent patient-specific risk factors for AEs; and 3) hospital administration's perspective of SOPP reliability through three years of the study including cumulative distribution and hazard functions of time between AEs and moving range statistical process control (SPC) charts for days between failures of each type. This is the first study, to our knowledge, to consider reliability of SOPP from both the patient's and hospital administration's perspective. AE rates in hospitalized patients are similar to other recently published reports and did not improve during the study period. Operations research methodologies will be necessary to improve reliability of care delivered to hospitalized patients.
ContributorsHuddleston, Jeanne (Author) / Fowler, John (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Gel, Esma (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012