phase 2 paper

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Western Governors University *

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C854

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Mechanical Engineering

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Dec 6, 2023

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pdf

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17 Phase II: Designing and Building Entity Relationship Diagram (ERD) An entity relationship diagram (ERD) is illustrated in Figure 2 and is a visual representation of the relationships between entities. The ERD not only includes entities but also attributes and cardinalities. Cardinality denotes the occurrences of data on either side of the relation. It specifies the minimum and maximum number of relationship instances that an entity can participate in. Each entity can have as many attributes as it needs but only has one primary key. On the other hand, a foreign key is an attribute in a table that links it to another table. The data elements are listed in a surgeons table, surgery expenses table, procedures table, and supply list table. These tables are used to track key performance indicators. The surgeons table has a primary key (Vascular_surgeons) and shows the relationship of one or more vascular surgeons to one or more procedures and vice versa , as shown by the crow’s foot notation. Attributes of the surgeons table are the four separate vascular surgeons. The surgeons table also shows the relationship of one and only one surgeon to one and only one surgery expense and vice versa, as shown by the crow’s foot notation. The surgery expenses table has a primary key (Surgery_expenses) and one foreign key (Disposable_supplies) and shows the relationship of one and only one surgery expense to one and only procedure, as shown by the crow’s foot notation. The attributes of the surgery expense table are the disposable supplies, OR time, employee salaries, medications used, surgeon fees, and anesthesia fees. The procedures table has a primary key (Procedure_name) and shows the relationship of one and only one procedure to one and only one supply list and vice versa. The

18 attributes in the procedure table are the abdominal aortic aneurysm repair procedure and the femoropopliteal bypass procedure. The supply list table has a primary key (Disposable_supplies) and shows the relationship of one and only one supply list to one and only one surgery expense and vice versa. The attributes of the supply list are the sutures, sponges, dressings, catheters, syringes, blades, gloves, drapes, ligating clips, vessel loops, and hemostatic agents used during a procedure. The surgeons table, procedures table, and supply list table are all used to monitor and track key performance indicators. Dashboard The dashboard, which is illustrated in Figure 3, displays the key performance indicators (KPIs) used to measure the progress of the system optimization proposal. Using a dashboard allows for data to be easily displayed and understood and helps to identify trends in the data. The first two bar graphs illustrate the estimated savings that can be made if a standardized preference card was used for a femoropopliteal bypass and an abdominal aortic aneurysm repair that included a proposed open cost of $2100 and $2175, respectively. An average savings of 8.9% can be seen for a femoropopliteal bypass and an average savings of 30.5% can be seen for an abdominal aortic aneurysm repair. The next set of bar graphs illustrate the inventory of supplies inside the supply cabinets before and after case, compared to the OR log of what was actually used and charted during the case. These measurements were then used to calculate the discrepancy of supplies. On average, 5.0 supplies were unaccounted for and assumed to be wasted. KPI and Data Element Descriptions

19 Standardizing the preference cards for a femoropopliteal bypass and an abdominal aortic aneurysm repair is a cost reduction metric used to predict savings using a proposed open cost. This meets one of the Triple Aim objectives of reducing the per capita cost of healthcare. By blinding the data within this metric, the group of stakeholders can see the variation in the data in an unbiased way. Illustrating the discrepancies seen in the inventory of supplies shows a contribution to waste when using the current manual supply cabinets. This metric can show stakeholders the potential benefits of implementing the use of smart cabinets by reducing waste and meets the Triple Aim objective of reducing the per capita cost of healthcare. The data elements were surgeons’ total current cost of disposable supplies during a femoropopliteal bypass and an abdominal aortic aneurysm repair compared to a standardized preference card, the names of disposable supplies inside the cabinets, and the total inventory of these supplies. The cost reduction seen after standardizing the preference cards proves beneficial and was instrumental in including this data. Additionally, the discrepancies in supplies used versus the inventory proved that the current supply cabinets can be a source of inefficiencies and waste. Phase III: Implementing and Testing Gantt Chart The Gantt chart is a visual timeline of the phases of the SDLC and is maintained by the project manager to track the tasks, owners, task duration with start and end dates, and project milestones. The Gantt chart was created using a template within Microsoft Visio and covers all

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