Figure 4.

Hospital units above periodic automatic replenishment (PAR) level before vs after introduction of a quality improvement initiative to increase availability of infusion pumps in The Johns Hopkins Hospital, and timeline of events key to implementation. PAR level is the minimum amount of infusion pump inventory needed to meet the daily infusion therapy demand while providing a buffer in case of unexpected demand. (A) The percentage of hospital units that are above PAR level for PC unit (PCU)–type infusion pumps while (B) large-volume pump (LVP)–type infusion pumps. Individual data markers represent the average percentage of hospital units above PAR level at 7 a.m. displayed by week; solid lines represent predicted percentage from segmented regressions, including 95% confidence intervals. The arrows indicate key dates in the development and implementation of the quality improvement initiative. The asterisk indicates that segmented regressions include hourly bed occupancy and total number of pumps seen in the real-time location system (RTLS) as fixed effects. The letter a indicates the start of biweekly multidisciplinary discussions about how to increase infusion pump availability in hospital units through improved fleet management. The letter b indicates observation of infusion pump underutilization in units in which patients are commonly disconnected from infusion therapy and over utilization in units in which patients are commonly initiated on infusion therapy. The letter c indicates biweekly discussions about infusion pump utilization held with the infusion pump work workgroup. The letter d indicates that the electronic redistribution system is implemented for all hospital units. The letter e indicates the weekly electronic report to hospital operations leadership about the number of units at their required infusion pump inventory levels.