Abstract: SA-PO974
Andon System in Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Barcellos, Franklin Correa, Universidade Católica de Pelotas, Pelotas, Brazil
- Bohlke, Maristela, Universidade Católica de Pelotas, Pelotas, Brazil
- Ribeiro, Larissa Ribas, Universidade Católica de Pelotas, Pelotas, Brazil
Background
Maintenance hemodialysis is a treatment that imposes clinical challenges and expenses to the health care system. Patients with end stage renal disease (ESRD) require disproportionately high use of health care in the USA, with <1% of the population using about 7% of the Medicare resource. Similar data have been reported in the other countries. The health care system have unchanged cost trajectories over the past 20 years, often neglecting one of the essential elements of successful innovation: a disciplined approach to meeting consumers' needs. Evolving to new service models on hemodialysis (e.g. encouraging automation of process) may be important. Currently the dialysis service is organized in shifts counting on own teams (doctors, nurses,and cleaning staff). Waiting time between shifts is often long, resulting in an excessive number of working hours for the staff and poor quality of life for patients. Our aim was to minimize "waiting time" for patients on in-center HD, in southern Brazil through the Andon System, method pioneered in the Toyota Production System and part of the Lean approach.
Methods
This incenter HD takes care of about 130 ESRD patients, performing more than two thousand HD session/month. An external totem attached to an inward video monitor was installed to record the patient arrival and to allocate it in the queue. The patient is identified by the system through a barcode card printed by the hospital. The admission process is done using the Andon method. The order of arrival is arranged on the computer screen from the hemodialysis room, sparing the staff work of calling the patient.
Results
Before implantation, the Lead time was one hour and thirty minutes. After the automation, the minimum transition time between HD sessions has been reduced to 30 minutes. Currently the unit starts working at 6 a.m., with the closing time around 9 p.m. (before the intervention it was 11 p.m.). Around one thousand and six hundred hours/year was spared, with an estimated savings of almost $ 80,000.
Conclusion
Examining the patient needs rather than the available delivery-system resources, can lead to the exploration of more efficient and effective ways of provide the services.
The wages of health-care professionals are a key contributor to the high cost of in-center HD. Turning the dialysis service into a continuous flow mapping can be a true innovation agenda in hemodialysis care.