Background: The risk of transferring patients on a ventilator is a significant global issue in critical care medicine. To mitigate adverse events during transfer, pre-transfer ventilator tests are imperative before MRI examinations. This study statistically demonstrates clinical delays resulting from unknown or altered examination schedules. When multiple patients require MRI scans on the same day, if the examination times are unclear or too closely scheduled, respiratory therapists (RTs) must shuttle between units, conducting tests and cleaning ventilators for transfer, a process taking about 40 min per test. Ensuring sufficient testing time for each patient often leads to delays for subsequent examinations. When the examination schedule becomes congested, patients are delayed, on average, by 30 min. Proper scheduling of MRI examinations and ventilator tests can curtail unnecessary time wastage, enhancing workplace efficiency. Methods: Data collected in ICU from November 2022 to January 2023, 133 samples for MRI examinations of ventilator-dependent patients, analyze the current status of failure rate of ventilator preparation for MRI examinations. Based on a cause-and-effect diagram and root cause verification, pinpointed the failure as ‘unknown examination times’ and ‘examination time change on the same day.’ Matrix analysis was then employed to select intervention measures: instructing colleagues to inquire about the examination room integration system and query the system for urgent examination schedules on the same day, making adjustments accordingly. After implementation, reassessment confirmed effectiveness. Results: After implementation, data collected in ICU from July to September 2023 demonstrated a decline in ventilator preparation failure rate for MRI examinations from 36.75% to 17.5%. Stratified analysis showed a decrease in unknown examination times from 21% to 9.4%, while examination time change on the same day increased from 4.5% to 5.4%. Overall, failure rate reduction exceeded 50% in both comprehensive and detailed analyses. Conclusions: Apply quality control circle activities to reduce ventilator preparation failure for MRI examinations offers various benefits: decreased patient waiting times, improved allocation of RTs’ time for critical patient care, and reduced need for additional ventilator purchases, enhancing economic cost-effectiveness. This management tool warrants clinical promotion and application, contributing to continuous improvement in healthcare quality.Figure 1. Pareto Chart before implementationFigure 2. Failure rate
Chang et al. (Tue,) studied this question.