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      Treatment Mapping – A Systematic Methodology to Assess Quality, Efficiency and Variability in the Hemodialysis Delivery Process

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          Abstract

          Background/Aims: Radical thinking about the design of industrial processes has greatly improved the quality and efficiency of manufacturing and services. Applying similar methods in healthcare to deliver quality care at lower costs would be valuable. Methods: We have developed and validated a methodology – Treatment Mapping – to analyze the hemodialysis (HD) delivery as an operational process. Results: The methodology was well applicable in the 26 Gambro Healthcare clinics studied (Europe, Taiwan, USA). Monitor process, patient process and dialysis treatment times (mean ± SD) were 324.4 ± 46.0, 272.2 ± 34.5 and 221.6 ± 28.8 min, respectively. In general, significant variability in process cycle times was found in the clinics studied. Conclusion: HD delivery is a complex process influenced by patient characteristics, monitor/disposables design, staff skills and clinic practices and physical layout. The Treatment Mapping methodology is a useful tool to analyze the HD delivery from a process quality and process operational perspective.

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          Using industrial processes to improve patient care.

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            Can car manufacturing techniques reform health care?

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              Halting the progression of chronic nephropathy.

              The incidence of end-stage renal disease (ESRD) is increasing worldwide. In the United States alone, there were 372,000 patients requiring renal replacement therapy in the year 2000 and is expected to rise to 650,000 by the year 2010. The trends in Europe and Japan are forecasted to follow a similar path. These increases represent a significant burden to countries worldwide; not only due to the financial costs of providing ESRD care, but also because of lost productivity and significant morbidity and mortality for the affected patients. There is clearly a pressing need for the aggressive identification and early treatment of patients with nephropathy to prevent progression to ESRD. Research in the last 25 yr has made great advances in the understanding of the progression of chronic renal disease in diabetic and nondiabetic proteinuric nephropathy. There are now effective treatment options that can slow the progression of chronic nephropathies in many individuals, and ongoing research has raised the tantalizing prospect of the reversal of renal disease progression.
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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
                2008
                October 2008
                28 August 2008
                : 26
                : 5
                : 417-422
                Affiliations
                aMedical and Safety Office, Gambro AB, Lund, Sweden; bMedical and Safety Office, Gambro AB, Washington, D.C., USA
                Article
                151664 Blood Purif 2008;26:417–422
                10.1159/000151664
                18753742
                504fb043-821f-417e-b724-ec349ebcafb0
                © 2008 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
                : 02 June 2008
                : 02 June 2008
                Page count
                Figures: 3, Tables: 4, References: 11, Pages: 6
                Categories
                Original Paper

                Cardiovascular Medicine,Nephrology
                Quality,Efficiency,Variability,Hemodialysis delivery process,Treatment Mapping,Operational process

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