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      Monitor Turnaround Time and Time Efficiency in Hemodialysis Delivery – A Global Comparison

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          Abstract

          Background/Aims: Increasing cost pressure has forced shortening of dialysis treatments. The aim of this study was to benchmark the hemodialysis (HD) delivery monitor turnaround time and time efficiency in a global comparison. Methods: 683 HD deliveries in 26 Gambro Healthcare clinics in Europe, Taiwan and the USA were assessed using the Treatment Mapping methodology. Results: Consolidated mean monitor turnaround time was 324.4 min. On average, 69% consisted of the HD treatment and 31% (102.8 min) of other activities: monitor preparation, monitor disinfection and monitor waiting – roughly one third each. USA had the shortest monitor turnaround, dialysis treatment and disinfection times. However, time efficiency – the percentage of monitor turnaround time on dialysis – was the lowest in the USA (68 vs. 69 and 74% in Europe and Taiwan) as monitor preparation, undress and waiting were the longest in USA. Conclusion: A monitor/disposable design to minimize time for preparation, undress and disinfection would reduce the cost of operational time without compromising quality.

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            To review the literature on manufacturing process design and demonstrate applicability in health care. Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers. It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments. Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services.
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                Author and article information

                Journal
                BPU
                Blood Purif
                10.1159/issn.0253-5068
                Blood Purification
                S. Karger AG
                0253-5068
                1421-9735
                2009
                October 2009
                14 August 2009
                : 28
                : 3
                : 234-238
                Affiliations
                aMedical and Safety Office, Gambro AB, and bMedical Office, Diaverum Renal Services Group, Lund, Sweden; cMedical and Safety Office, Gambro AB, Washington, D.C., USA
                Article
                231987 Blood Purif 2009;28:234–238
                10.1159/000231987
                19684389
                2f9d0750-6240-438a-b71f-01fbae6c9886
                © 2009 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 03 February 2009
                : 04 June 2009
                Page count
                Figures: 2, Tables: 2, References: 13, Pages: 5
                Categories
                Original Paper

                Cardiovascular Medicine,Nephrology
                Hemodialysis delivery process,Treatment mapping,Monitor turnaround times,Turnaround time efficiency

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