Speeding things up through equipment design
Ever been at a cardiac arrest resuscitation where someone’s opening and closing drawers at great speed but failing to retrieve the drugs or equipment you’ve asked for urgently?
What if your resus trolley were designed by team of clinicians, engineers, and designers? Such a project was achieved through a collaboration between Imperial College London and the Helen Hamlyn Centre for Design, and the award-winning result was called the ‘Resus:Station’.
The trolley separates into three trolleys for airway, drugs and defibrillation, and circulation. The contents are visible from the outside.
Image from Pubmed Free Full Text Article
As well as improving access to equipment, the trolley can log the team’s actions during each resuscitation attempt. It can also provide an instant display of its readiness for use by recording the removal and replacement of each item.
In a randomised comparison with a standard resus trolley, a number of measures of efficiency and team performance were significantly better using the Resus:Station during simulated cardiac arrest resuscitations.
It appears to be specifically designed for cardiac arrest situations rather than ‘resus’ in its wider context. The most recent article (cited below) reports that a newer prototype is being developed prior to the manufacture of the final product.
For an in depth discussion of how resus room layout can optimise efficiency, check out Minh Le Cong’s PHARM blog and podcast with James French and Scott Weingart on Clinical Logistics
BACKGROUND AND AIM: Inadequately designed equipment has been implicated in poor efficiency and critical incidents associated with resuscitation. A novel resuscitation trolley (Resus:Station) was designed and evaluated for impact on team efficiency, user opinion, and teamwork, compared with the standard trolley, in simulated cardiac arrest scenarios.
METHODS: Fifteen experienced cardiac arrest teams were recruited (45 participants). Teams performed recorded resuscitation simulations using new and conventional trolleys, with order of use randomised. After each simulation, efficiency (“time to drugs”, un-locatable equipment, unnecessary drawer opening) and team performance (OSCAR) were assessed from the video recordings and participants were asked to complete questionnaires scoring various aspects of the trolley on a Likert scale.
RESULTS: Time to locate the drugs was significantly faster (p=0.001) when using the Resus:Station (mean 5.19s (SD 3.34)) than when using the standard trolley (26.81s (SD16.05)). There were no reports of missing equipment when using the Resus:Station. However, during four of the fifteen study sessions using the standard trolley participants were unable to find equipment, with an average of 6.75 unnecessary drawer openings per simulation. User feedback results clearly indicated a highly significant preference for the newly designed Resus:Station for all aspects. Teams performed equally well for all dimensions of team performance using both trolleys, despite it being their first exposure to the Resus:Station.
CONCLUSION: We conclude that in this simulated environment, the new design of trolley is safe to use, and has the potential to improve efficiency at a resuscitation attempt.