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Improving Usability of the Pediatric Code Cart by Combining Lean and Human Factors Principles
Maria Frazier1, Kristen Webster2, Maya Dewan1,3,4
1From the Department of Pediatrics, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatric Quality & Safety
|August 8, 2023
Summary
Redesigning pediatric code carts using Lean and Human Factors principles improved emergency response efficiency. Staff retrieved critical supplies faster, reducing errors and saving over $800 per restock.
Area of Science:
- Pediatric Emergency Medicine
- Quality Improvement Science
- Human Factors Engineering
Background:
- Cardiac arrests in hospitalized children necessitate efficient emergency response.
- Well-organized code carts are crucial for rapid access to supplies and medications.
- Current code cart designs may impede timely interventions.
Purpose of the Study:
- To enhance the efficiency and usability of code carts in pediatric critical care.
- To optimize the organization and accessibility of emergency supplies and medications.
- To implement Lean and Human Factors principles in a pediatric medical center setting.
Main Methods:
- A quality improvement project involving a phased redesign of the code cart.
- Utilized Lean and Human Factors principles by a multidisciplinary team.
- Conducted simulations with nurses and respiratory therapists to assess usability and retrieval times.
Main Results:
- Reduced retrieval time for intraosseous access equipment (23.9 vs. 46.4 seconds; P=0.003).
- Improved staff-reported accuracy in locating supplies and reduced equipment errors.
- Achieved cost savings exceeding $800 per full code cart restock.
Conclusions:
- Code cart redesign incorporating Lean and Human Factors enhances efficiency and usability.
- Improved organization and accessibility of emergency equipment are key outcomes.
- The intervention demonstrates potential for significant cost savings in pediatric critical care settings.
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