Applying lean principles to continuous renal replacement therapy processes

Area of Science:

• Nephrology
• Healthcare Management
• Process Improvement

Background:

• Continuous renal replacement therapy (CRRT) processes can be prone to medication waste.
• A significant amount of CRRT solution was being discarded in an academic medical center.
• Optimizing CRRT workflows is crucial for efficiency and cost savings.

Purpose of the Study:

• To describe the application of lean principles to CRRT processes.
• To examine the workflow for CRRT preparation and implement an intervention.
• To reduce medication waste and improve staff satisfaction in CRRT.

Main Methods:

• Lean principles were applied to analyze the CRRT preparation workflow.
• An educational program was developed to enhance communication between nursing and pharmacy.
• The CRRT solution reordering workflow was shifted from nurses to pharmacy technicians.

Main Results:

• A manual audit revealed 133 discarded 5-L bags of CRRT solution over six weeks.
• The mean number of CRRT solution bags dispensed per day of CRRT decreased substantially post-intervention.
• Projected annual cost savings exceeded $70,000 due to reduced solution waste.

Conclusions:

• Lean principles effectively identified and reduced medication waste in the CRRT workflow.
• Shifting workload to pharmacy technicians improved CRRT workflow efficiency.
• Staff satisfaction increased following the implementation of lean principles and workflow changes.