Observations on autonomous adoption of industrial and systems engineering practices by caregivers in the home environment

摘要

Caregivers of children using invasive therapies like home mechanical ventilation (HMV) and total parenteral nutrition (TPN) often train to use life-sustaining equipment. This training does not include everyday logistical concerns families inevitably encounter once the hospital discharges their child. This leaves families with the unenviable task of developing strategies for living day-to-day lives that integrates the child's condition. In a preliminary study of families of children using HMV and TPN pumps, we noted many families developed industrial and systems engineering practices autonomously or with little input from either the hospital or other families. This included Kaizen, 5S, and Kanban practices, in order to improve the quality of care, to reduce the potential of infection, and to enable better quality of life for the child and the family. In this paper, we juxtapose industrial and systems engineering practices with those of families we interviewed and present a preliminary case for helping families adapt industrial and systems engineering practices to the home as part of invasive therapies in HMV and TPN.