Research Snapshot Theater: Quality & Patient Safety XVI
Matthews, Simon1; Stoll, Robert2; Sternberger, Wayne2; Cox, Patrick2; Tober, Tammy2; DiMattina, Jennifer3; Dwyer, Cindy4; Barasch, Noah5; Carolan, Howard6; Romig, Mark7; Pronovost, Peter8; Barnes, John9; Ravitz, Alan10; Sapirstein, Adam11
1Johns Hopkins Hospital, Baltimore, MD
2Johns Hopkins Applied Physics Lab, Laurel, MD
3Johns Hopkins University, Baltimore, MD
4Johns Hopkins University School of Medicine, Catonsville, MD
5N/A, Baltimore, MD
6N/A, Ellicott City, MD
7Johns Hopkins University School of Medicine, Baltimore, MD
8United Health Care, Minneapolis, MN
9Johns Hopkins Applied Physics Lab, Laurel, MD
10N/A, N/A
11Johns Hopkins School of Medicine, Baltimore, MD
Learning Objectives: Reducing the incidence of pressure ulcers remains a leading priority in healthcare. Leveraging techniques from systems engineering, such as the quality function deployment (QFD) process, may provide a transparent, objective, and quantitative path to harm reduction. Specifically QFD raises awareness of potential biases and affords more granular differentiation of candidate solutions. We demonstrate how applying the QFD process can provide a systematic way of prioritizing potential solutions for implementation or development to reduce pressure ulcers.
Methods: A stakeholder group of subject matter experts including nurses, doctors, patients, engineers, industry partners, graphics designers, and others met for multiple sessions. During these sessions, the 7 steps of QFD process were followed: (1) Identify the solution goals that will satisfy the end users’ needs - Measures of Effectiveness (MOEs); (2) Select the objective parameters to assess whether a solution is successful - Measures of Performance (MOPs); (3) Weight each parameter (MOP) relative to its utility in achieving the goals (MOEs); (4) Identify or develop a list of candidate solutions; (5) Score the candidate solutions based on a pre-defined MOP rubric; (6) Determine the resource constraints applied to each candidate solution; and (7) Select candidate solutions.
Results: Seven MOEs were identified as success indicators for a pressure ulcer solution. These MOEs spanned three categories: (1) Quality of Life, (2) Pressure Ulcer Management, and (3) Pressure Ulcer Outcome. Seventeen MOPs were identified. After applying weighting of MOPs to MOEs, nine candidate solutions were identified that ranged in maturity from capabilities presently available to those requiring new research and development. The solutions were not limited to devices and spanned the categories of people, processes, and technology
Conclusions: Systems engineering tools have long been used to improve product safety and efficiency in other industries and can be used with similar results in the clinical setting to maximize patient safety and outcomes. The quality function deployment (QFD) process as applied to the prioritization of solutions for pressure examples demonstrates one useful and systematic application of this approach.
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