150 American College of Emergency Physician Clinical Policy Guidelines: Close Friends or Aloof Strangers?

Abstract

anonymous, but respondents were asked to identify their title and department affiliation. Following redesign, the survey was re-administered. Chi-squared test was used to compare responses before and after the intervention; p values of <0.05 were deemed statistically significant. Results: Our "initial state" included absence of a guiding principle to the organization of supplies in the trauma cabinets, small printed labels identifying placement of supplies, and misplaced look-alike supplies. Using the A3 tool, the design team selected an organizational paradigm based on patient anatomy (head-to-toe), as well as improved visual signage to support appropriate restocking. A 10-ft. long wall sticker of a human silhouette was installed above the cabinets, and supplies were reorganized below it per the anatomical site where the equipment is used. To avoid lookalike supplies being stocked interchangeably, we replaced labels in the cabinets with laminated photographs, highlighting differences in packaging on the photos with permanent marker. Staff completed 62 "Before" surveys, and 55 "After" implementation. Four survey questions specifically focused on satisfaction with the organization of supplies. Overall, responses to three of the four questions "Before" and "After" redesign showed statistically significant improvement in satisfaction post-intervention (p-values 0.0004, 0.0109, and 0.0028 respectively); responses to the fourth question showed a trend toward improved satisfaction (p ¼ 0.28). Conclusion: Our study demonstrates increased staff satisfaction following a LEANbased reorganization of our Trauma Room supplies. A defined organizing paradigm may enhance clinicians' ability to find needed supplies during urgent situations. One universally applicable design is the use of patient anatomy (head-to-toe) to dictate the stocking. Picture labels may also be helpful, especially in distinguishing between look-alike items.