Help pull the red wagon

Riley Perioperative Care Unit

Quality efficacy analysis J tip device for IV start Malik Nouri MD

Nothing to Disclose No Conflict of Interest

Goal reduce /eliminate needle pain

Drag picture to placeholder or click icon to addNeedle pain:Fear

Anxiety

Maladjustment behaviors PTSD

Distrust, Medical Non Compliance…..

The I Idea

* 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 ?

* 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

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 

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 ?

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

NY times Aug 25,2013 how to charge $546for 6l of saltwater

What do we use now ? Cost of IV Pain relief

$40

$4

$50-$80

$2-$4

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 ?

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 ?

What does it cost to try ?