Help pull the red wagon
Riley Perioperative Care Unit
No Conflict of Interest
Needle pain:
Fear
Anxiety
Maladjustment behaviors PTSD
Distrust, Medical Non Compliance…..
* 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
* 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
* Based on the 100 uses per month minimally, our costs would look like
this:
* Injectors:
* $102.50/bx/25 = $410.00 for 100 patients
* $410 x 12 months = $4920 per year
$4.10 /unit
* 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
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 ?
*
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
*
*
*
*
Latex Free Tourniquet $0.08
Smart Site infusion Set $3.35
Small Bore 2 site injection site tubing with
stopcock and t- connector $2.47
ChloraPrep bullet $0.32
22 gauge Autoguard Angiocath $1.61
Total $8.62
* (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
NY times Aug 25,2013 how to charge $546for 6l of saltwater
$40
$4
$50-$80
$2-$4
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
Acquisition (Hospital)
Can we try new things ?
* Purchasing
* Pharmacy +/* Storage
* Disposal
* Fill or not fill with LA ?
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 ?
FACES pain score
VAS
Time Lines :
Torder- Tinsertion
Time Personnel Involved
RN,CNP,MD
Feed Back:
Patient + Parent survey
Medical personnel
Cost comparison & analysis