Outsourcing the Management of Reusable Medical Devices in a Chain-Wide Care Setting: Mixed Methods Feasibility Study.

IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Bart A C Noort, Paul Buijs, Oskar Roemeling
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引用次数: 0

Abstract

Background: Managing reusable medical devices incurs substantial health care costs and complexity, particularly in integrated care settings. This complexity hampers care quality, safety, and costs. Studying logistical innovations within integrated care can provide insights to medical devices use among staff effectively.

Objective: This study aimed to establish the feasibility of a logistical intervention through outsourcing and a web portal. The goal was to provide insights into users' acceptability of the intervention, on whether the intervention was successfully implemented, and on the intervention's preliminary efficacy, thus benefiting practitioners and researchers.

Methods: This paper presents a mixed methods feasibility study at a large chain-wide health care provider in the Netherlands. The intervention entailed outsourcing noncritical reusable medical devices and introducing a web portal for device management. A questionnaire gauged perceived ordering and delivery times, satisfaction with the ordering and delivery process, compliance with safety and hygiene certification, and effects on the care delivery process. Qualitative data in the form of observations, documentation, and interviews were used to identify implementing challenges. Using on-site stocktaking and data from information systems, we analyzed the utilization, costs, and rental time of medical devices before and after the intervention for wheelchairs and anti-pressure ulcer mattresses.

Results: Looking at the acceptability of the intervention, a high user satisfaction with the ordering and delivery process was reported (rated on a 5-point Likert scale). With respect to preliminary efficacy, we noted a reduction in the utilization of wheelchairs (on average, 1106, SD 106 fewer utilization d/mo), and a halted increase in the utilization of anti-pressure ulcer mattresses. In addition, nurses who used the web portal reported shorter ordering times for wheelchairs (-2.7 min) and anti-pressure ulcer mattresses (-3.1 min), as well as shorter delivery times for wheelchairs (-0.5 d). Moreover, an increase in device certification was reported (average score of 1.9, SD 1.0), indicating higher levels of safety and hygiene standards. In theory, these improvements should translate into better outcomes in terms of costs and the quality of care. However, we were unable to establish a reduction in total care costs or a reduced rental time per device. Furthermore, respondents did not identify improvements in safety or the quality of care. Although implementation challenges related to the diverse supply base and complexities with different care financers were observed, the overall implementation of the intervention was considered successful.

Conclusions: This study confirms the feasibility of our intervention, in terms of acceptability, implementation success, and preliminary efficacy. The integrated management of medical devices should enable a reduction in costs, required devices, and material waste, as well as higher quality care. However, several challenges remain related to the implementation of such interventions.

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全链条护理环境下可重复使用医疗器械的外包管理:混合方法可行性研究。
背景:管理可重复使用的医疗设备会带来巨大的医疗成本和复杂性,尤其是在综合护理环境中。这种复杂性阻碍了护理质量、安全性和成本。研究综合护理中的后勤创新可以为员工有效使用医疗设备提供见解。目的:本研究旨在确定通过外包和门户网站进行后勤干预的可行性。目的是深入了解用户对干预的可接受性、干预是否成功实施以及干预的初步疗效,从而使从业者和研究人员受益。方法:本文介绍了荷兰一家大型连锁医疗服务提供商的混合方法可行性研究。干预措施包括外包非关键的可重复使用的医疗设备,并引入设备管理门户网站。一份问卷调查了感知的订购和交付时间、对订购和交付过程的满意度、对安全和卫生认证的遵守情况以及对护理交付过程的影响。采用观察、文件和访谈等形式的定性数据来确定实施方面的挑战。利用现场盘点和信息系统数据,我们分析了轮椅和抗压疮床垫干预前后医疗设备的使用情况、成本和租赁时间。结果:从干预的可接受性来看,据报道,用户对订购和交付过程的满意度很高(Likert量表5分)。关于初步疗效,我们注意到轮椅的使用率下降(平均使用日/月减少1106,SD 106),抗压疮床垫的使用率停止增加。此外,使用该门户网站的护士报告称,轮椅的订购时间更短(-2.7分钟)和抗压溃疡床垫(-3.1分钟),轮椅的交付时间更短(-0.5天)。此外,据报道,设备认证有所增加(平均得分1.9,SD 1.0),表明安全和卫生标准水平更高。理论上,这些改进应该转化为成本和护理质量方面的更好结果。然而,我们无法确定总护理成本的降低或每个设备的租赁时间的缩短。此外,受访者没有发现在安全或护理质量方面有所改善。尽管观察到与不同的供应基础和不同护理资助者的复杂性有关的实施挑战,但干预措施的总体实施被认为是成功的。结论:本研究从可接受性、实施成功率和初步疗效方面证实了我们干预的可行性。医疗器械的综合管理应能够减少成本、所需器械和材料浪费,以及更高质量的护理。然而,在执行这些干预措施方面仍然存在一些挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Interactive Journal of Medical Research
Interactive Journal of Medical Research MEDICINE, RESEARCH & EXPERIMENTAL-
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45
审稿时长
12 weeks
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