A PRACTICAL GUIDE TO QUALITY IMPROVEMENT FOR BURN CARE in Low-Resourced Settings
Process mapping – This is a tool whereby we create a visual representation of each step or stage of “how things get done”. This detailed map then allows the users to identify areas where there are strengths and weaknesses in the current process so that improvements and resources can be targeted appropriately.
Example: Taweni made a process map of the decontamination of surgical instruments in the hospital theatres. Next to the tasks she noted her own observations about the process.
DOCUMENTATION OF SURGICAL INSTRUMENTS IN THEATRES
Move instruments to spoapy water (scrub nurse).
Scrub nurse puts instruments in chlorine for 10 minutes.
Scrub nurse disassembles instruments.
Instruments arrive in slouce from theatre.
Not always completed.
Instruments not brought to slouce room.
Instruments not disassembled, sharps not correctly disposed of.
Hospital attendants pre-make chlorine solution 7am/4pm Not always 10 minutes, can be less.
Nurse scrubs instruments with brush.
Not dried. No one responsible for this, stay in theater.
Instruments rinsed with water and dried.
Start and end of process
Activity or task
Instruments moved to packing area. (Nurse, Hospital assistant)
Instruments transported to steralisation department
Workflow diagram, also known as a spaghetti diagram, is another visual tool to help establish an the best lay out of an area, ward or department based on observations of the distance travelled by patients, staff or products. Using this observational method, we can identify areas where time could be saved by preventing unnecessary travel. For example, allocating patient assessment equipment together in the same room or on the trolley where the most frequent assessments take place to prevent having to find or travel to collect multiple pieces of equipment from different parts of the ward or unit.
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