Using Lean tools to improve the efficiency of awake fibreoptic intubation setup

Area of Science:

• Anesthesiology
• Healthcare Management
• Process Improvement

Background:

• Awake fibreoptic intubation is a critical but time-consuming procedure for managing difficult airways.
• The setup process for this technique was historically variable and prone to errors.
• Inefficiency and potential errors may limit the adoption of this advanced airway management strategy.

Purpose of the Study:

• To enhance the efficiency and accuracy of the awake fibreoptic intubation setup process.
• To implement Lean methodologies for optimizing complex medical procedures.
• To reduce setup time and minimize errors in preparing for awake fibreoptic intubation.

Main Methods:

• A 2-day Lean improvement event involving a multidisciplinary team was conducted.
• Standardized work documents were developed and implemented after solution testing.
• Twenty simulations of awake fibreoptic intubation setup were performed pre- and post-intervention.

Main Results:

• The average setup time for awake fibreoptic intubation decreased by approximately 50% (from 23 min to 11 min).
• Setup process variability was reduced by standardizing procedures and locations.
• The accuracy of equipment setup improved significantly, from 59% to 85%.

Conclusions:

• Lean tools effectively improved both the efficiency and accuracy of awake fibreoptic intubation setup.
• Standardization and process optimization are key to enhancing complex anesthetic procedures.
• This Lean approach offers a valuable model for improving other challenging anesthesia techniques.