Toyota Reduces Hospital’s Central Line Infections Down 75% Through Simulation
Rounding out today a story from Toyota, who sent Production System Support Center Staff Member Scott Dickson to work with several hospitals and help reduce their infection rates, through process analysis, performance simulation, and direct communication. Sadly, Scott suggests that “The way [Toyota] systemically breaks down a problem was completely foreign to the people at the hospitals,” says Dickson. “In the end, their reaction was: ‘Oh, my gosh. We never thought of that.’”
And you guessed it, that thinking included simulated demonstrations and simulated trainings.
Toyota Article Excerpt:
Toyota partnered with Children’s Health in Dallas, Cook Children’s Hospital in Fort Worth, Children’s Hospital in Cincinnati, and Children’s Hospital of Kings Daughter in Norfolk, Virginia. All shared a similar challenge:Central Line Associated Bloodstream Infections or CLABSIs. According to a study published in the Clinical Journal of Oncology Nursing, approximately 250,000 CLABSIs occur annually at hospitals across the country. These infections are serious but often can be treated successfully. However, such countermeasures cost more than $6 billion annually, according to a study published in the Journal of Infusion Nursing. All four of the institutions in the TSSC project were baffled and frustrated by this persistent issue. After all, doctors and nurses at each hospital were following strict hygiene protocols. Yet, somehow, harmful bacteria as well as other germs were getting past their defenses.
In keeping with the TPS principle of genchi genbutu (or “go and see”), Dickson spent time at each hospital observing and taking notes. That unbiased perspective proved to be the turning point. In each case, healthcare practitioners were following the proper steps to ensure they were germ free. But the rooms in which the children were being treated? That was a very different story. So, for example, while a nurse might don sterile gloves to operate a medical device, he or she might inadvertently place that device on a counter or blanket that was not sterile. “What they thought was the problem and what was actually the problem turned out to be very different things,” says Dickson. “There’s no way we would have figured it out if we hadn’t spent time at each site and talked with the nurses on the floor.”
Once they’d identified the culprit, Dickson said the next step was to apply Toyota’s problem solving methodology to come up with a solution. Then it applied TPS standardization principles so that everyone who might come in contact with patients knew exactly what steps to follow. That included the use of sterile pads to serve as a barrier between a potentially contaminated surface and the medical devices being used to treat the children — such as the chest hubs that are often used in such circumstances.
“The way we systemically break down a problem was completely foreign to the people at the hospitals,” says Dickson. “In the end, their reaction was: ‘Oh, my gosh. We never thought of that.’”
“It’s now been more than a year and infections are down 75 percent,” says Dickson. “They’re absolutely thrilled with the progress we’ve made and, if at all possible, looking to eliminate these infections all together.”
Lance Baily, BA, EMT-B, is the Founder & CEO of HealthySimulation.com, which he started while serving as the Director of the Nevada System of Higher Education’s Clinical Simulation Center of Las Vegas back in 2010. Lance is also the Founder and acting Advisor to the Board of SimGHOSTS.org, the world’s only non-profit organization dedicated to supporting professionals operating healthcare simulation technologies. His new co-edited Book: “Comprehensive Healthcare Simulation: Operations, Technology, and Innovative Practice” is available now. Lance’s background also includes serving as a Simulation Technology Specialist for the LA Community College District, EMS fire fighting, Hollywood movie production, rescue diving, and global travel. He lives with his wife Abigail in Las Vegas, Nevada.