help pull the red wagon riley perioperative care unit
TRANSCRIPT
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Help pull the red wagon
Riley Perioperative Care Unit
Quality efficacy analysis J tip device for IV start Malik Nouri MD
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Nothing to Disclose No Conflict of Interest
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Goal reduce /eliminate needle pain
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Drag picture to placeholder or click icon to addNeedle pain:Fear
Anxiety
Maladjustment behaviors PTSD
Distrust, Medical Non Compliance…..
The I Idea
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* Needle Free delivery injection device
* FDA approved, lawfully marketed
*>5years In use multiple US pedi Hospitals Children some use 35K Units /year
* Technology: Jet injection CO2 Cartridge
*What meds does it use ? : MPF Lidocaine
* Ease of use
* Other possible applications ?Spinal tap
??Vaccination
What is Jtip ?
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* Process began September 2014
* Anesthesia Clinical Value Analysis
Council Jan 22,2015
* Supply Chain Operation “Hiccup”
* LEAN A3 Process ???
* Trial Protocol Submission April 2015
* IRB approval June 2015
* Trial Roll out end of July 2015
* Inter institutional contractual agreements
* Data acquisition/analysis Submission
* ??? Purchasing
The Action
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Cost prediction
* Based on the 100 uses per month minimally, our costs would look like this:
* Injectors:
* $102.50/bx/25 = $410.00 for 100 patients $4.10 /unit
* $410 x 12 months = $4920 per year
* Luer adapters:
* $37.50/bx/25 = $150.00 for 100 patients
* $150 x 12 months = $1800.00
* Total supplies for the year = $6720.00 minimally
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Bring a new product and trial it
Is it efficacious
Is it economical
Is it safe
Does it have an application to our practice
How does it compare to what we already have ?Why a trial when things have already been proven ?
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IV Supplies * Here are the costs for the items used
during an IV start.
* These are IU Health costs. They are not charged to the patient but are part of the “procedure bundle”.
* 550 ml L/R $0.78
* Smart Site infusion Set $3.35
* Small Bore 2 site injection site tubing with stopcock and t- connector $2.47
* Latex Free Tourniquet $0.08
* ChloraPrep bullet $0.32
* 22 gauge Autoguard Angiocath $1.61
* Total $8.62
PERSONNEL time * (Hourly pay : time to
insert)+facility fee
*MD $$$/min
*Pharm D $$/min
*RN $/min
*Child life
*OR/IR/ER suite $$$/min
*UK €8.32 to start an IV
Unbundling The Cost of an IV
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NY times Aug 25,2013 how to charge $546for 6l of saltwater
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What do we use now ? Cost of IV Pain relief
$40
$4
$50-$80
$2-$4
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Cost Is it or not really an issue ?
What is the cost of having an IV ?
* Time start – finish
* Personnel ( MD, RN ,Phar, CL)
* Supplies
* Pt/customer satisfaction
* VAS score + Interview
* Practitioner feedback
* The Jtip is provided Free from manufacturer estimate $4/unit
Logistics Acquisition (Hospital)
Can we try new things ?
*Purchasing
*Pharmacy +/-
*Storage
*Disposal
*Fill or not fill with LA ?
What should be our focus ?
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Project Summary
FACES pain score
VAS
Time Lines :Torder- Tinsertion
Time Personnel Involved
RN,CNP,MD
Feed Back:Patient + Parent survey
Medical personnel
Cost comparison & analysis
Subjects: 100 recruits
Procedure w IV start/lab
*RSI
*MH
*Cath lab EMB
* IR Picc line : 20
*Labs preop
AGE : 6-17 yo
Consent +Assent
Time Line : <12 months ?
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What does it cost to try ?