P097: Making emergency room crash carts useful

Abstract

Introduction: Human factors are a neglected when it comes to crash cart design and function. Using observational assessments and in-house surveys, the process improvement team found that staff use of the crash carts in the University of Alberta ED had significate redundancy, inefficiency and often leading to confusion during use. The process improvement team assessed the layout of the adult crash cart and redesigned the cart format based on observational problems/inefficiencies staff had during resuscitations. It was hoped that staff found the new design more efficient and effective during resuscitations when compared to the old cart. Methods: To effect change, the Rapid result change theory method was utilized to implement the new crash cart prototype. The model was used to evoke excitement and staff participation in front line process improvement. With input from senior staff, the cart was redesigned and placed in resus area where it stood the greatest chance of being used frequently. Once a prototype crash cart had gone live, surveys, based on a 7 point Likert scale compared the old and new cart systems. The resus area housed both old and new carts to facilitate the comparison. The survey assessed 6 domains; visibility of the medications, locating medications, overall organization, time savings, mixing medications and comfort level of using each cart. Results: After the trial, the surveys were collected and analyzed using T-test; the results were significant. There was an overwhelming positive result within all domains when comparing the two carts. There was mean difference ranging from 1.7 to 3.5 comparing when comparing the two carts to each domain. Conclusion: The results were so positive; all seven carts were changed to the same format. The overall impact of the new cart design saved time in both application and turnaround time in restocking.