title: Dialyzer reprocessing: improved treatment quality and increased dialyzer reuse using a team approach.
abstract: Use of the performance improvement process can yield unexpected positive results. Through the implementation of performance improvement concepts, the Dialysis Centers of Dayton LLC East was able to increase the average dialyzer reuse number and achieve economical benefits while improving the quality of patient care delivered. Employment of the team approach, staff education, and communication was vital to the success of this Over the last 10 years, the use of dialyzer reprocessing has steadily increased in dialysis units across the country. If the reuse average was down in a unit, it was not uncommon to look to the reuse staff for an explanation, since it is "their" job to keep the numbers up. After consultation with a Minntech representative, the Dialysis Centers of Dayton LLC East staff discovered that the most effective methods to increase the average reuse number were those implemented on the dialyzer before it ever reached the reprocessing area. Several technical changes were initiated, including the use of standardized heparin protocols, all of which contributed to the improvement in the reuse average. Although some of these changes had been done previously, they were not implemented and reviewed according to the formal performance improvement model. Two methods for calculating the reuse average were employed. Over a 12-month time frame, reuse numbers increased from 7.1 and 7.5 to 36.6 and 18.1, respectively (utilizing the Hartline [1996] and conventional method of reuse calculation). Review of patient adequacy showed no detrimental effects and a slight improvement in the percentage of patients with a Kt/V of more than 1.2. Focusing on performance improvement in the reprocessing area has yielded many benefits to both patients and staff.
authors.affiliation: Division of Dialysis and Transplantation, Miami Valley Hospital of Dayton, OH, USA.
authors.forename: T
authors.initials: T
authors.lastname: Slyby
authors.forename: G
authors.initials: G
authors.lastname: Huff
authors.forename: M J
authors.initials: MJ
authors.lastname: Henger
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D004203:Disinfection / Q000458:organization & administration; D004782:Environmental Health / Q000706:statistics & numerical data; D017743:Equipment Reuse / Q000592:standards* / Q000706:statistics & numerical data; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007688:Kidneys, Artificial / Q000706:statistics & numerical data*; D017744:Medical Waste Disposal / Q000706:statistics & numerical data; D009820:Ohio; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D015397:Program Evaluation; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D017749:Total Quality Management / Q000458:organization & administration*
chemical_list: D000925:Anticoagulants; D017744:Medical Waste Disposal; D006493:Heparin