Related Experiment Video
Updated: Jun 6, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Lean methodology in i.v. medication processes in a children's hospital
Timothy L'Hommedieu1, Karl Kappeler
1Nationwide Children's Hospital, Columbus, OH, USA. timothy.lhommedieu@baycare.org [corrected]
Summary
Lean methodology significantly reduced wasted intravenous (IV) medication doses and costs in a children's hospital. This process optimization improved efficiency and drug expenditure by 2.6%.
Area of Science:
- Healthcare Management
- Process Improvement
- Pediatric Pharmacy
Background:
- Intravenous (IV) medication processes are critical in pediatric care.
- Inefficiencies in medication preparation can lead to waste and increased costs.
- Lean methodology offers a framework for optimizing healthcare processes.
Purpose of the Study:
- To evaluate the impact of implementing lean methodology on IV medication processes in a children's hospital.
- To identify and reduce non-value-added tasks in IV medication preparation and dispensing.
- To quantify the effect of lean process changes on medication waste and costs.
Main Methods:
- Analysis of medication orders to identify peak change/discontinuation times.
- Value-stream mapping to define current IV medication preparation processes.
- Development of an optimization model for batch size and preparation timing.
- Collection and analysis of returned IV medications before and after lean implementation.
Main Results:
- Wasted IV doses decreased from 16.6% to 8.6% of total dispensed doses.
- Projected annual savings of $426,244, representing a 2.6% reduction in drug expenditure.
- Significant reduction in wasted doses and associated costs (p < 0.05).
Conclusions:
- Lean concepts positively impacted efficiency in IV medication preparation.
- Implementation of lean methodology led to significant reductions in drug costs.
- The study demonstrates the value of lean process optimization in pediatric hospital pharmacy settings.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:28IV Infusion to Oral Dosing: Conversion Methods
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...