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Six Sigma [Green Belt Project]

Continuous Quality ImprovementPurchasing Justification Process

EMT-P Jason Ausman

FTO Jim Bonham

LT. Michael Hamel

EMT Robert Hofstetter

EMT-P Angela Holbrook

Team: Sponsor: Chief Chris Hansen

Facilitators: DC Kim Dickerson

Capt. Art Garcia

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Problem Statement

The current CQI process is inconsistent with new product evaluation, justification, implementation, and validation.

DefineMeasure

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Business Case

Develop a process that involves research justification of a demonstrated need for new equipment. The process will include timely training as well as periodic evaluation and validation.

Alignment to Business Strategy • BoCC FY 2007 Goals

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Business Case

Goal 2

Make Lee County Government the benchmark county in Florida for innovation and excellence in customer service and technological operations.

Objective 1 – Continue assessment of organizational practices

through continuous improvement techniques.

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Business Case

Goal 4

Answer: “What is the business of Lee County Government?” by identifying and defining, periodically evaluating, and maintaining, core levels of services that can be shared and understood by the public.

Objective 2 – Early on in the annual budget development process, identify – through a fact based analysis – a target percentage for operational increases for the coming fiscal year that will be communicated, as a goal, to county departments an Constitutional Officers.

Objective 6 – Continue fiscal solvency by monitoring, evaluating and maintaining core services. Assure a full and complete evaluation of any changes in levels of core services, including budgetary impacts.

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Define Phase

Previous Expenditures CCEMT-P course• $30,000 budgeted• Actual expense closer to $300,000• 11/05    5 Students CCEMT-P

Pittsburg, PA                                     $18,830.20• 1/06     5 Students CCEMT-P

Augusta, GA        $15,320.75• 4/06      2 Students CCEMT-P

Augusta, GA         $  7122.48•                    Total                $41,273.43

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Define Phase

Previous Expenditures• Narcotic Bags- 8/2005

• 50 Narc.Personal/Safe Boxes

(Koons Locksmiths) @ $11.95 ea    $597.50   • No provision for cost to continue program• No implementation evaluation/validation

DefineMeasure

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Define Phase

Previous Expenditures• Ambulance Cameras• 40 Kodak Easy Share C310 • Digital Zoom Camera $87.00 Each     $3,480.00• 40 Kingston Flash Memory

Card-128MB-SD       $14.50 Each           580.00

                                  Total                 $4,060.00• No provision for cost to continue program• No implementation evaluation /validation

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Preliminary Goal

To develop a process that results in enhanced patient care, demonstrates fiscal need and provides for long term sustainability.

Result = risk avoidance

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The Project Scope

•Request made to purchase the Auto Pulse•Do we really need it?•How will it make a difference?•Is it financially achievable and

sustainable?•Periodic evaluation and validation.

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DefineMeasure

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DefineMeasure

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Previous Expenditures

Cameras:• Mandate – No

• Patient care/employee driven – Trauma Services request

• Immediate implementation required – No

• Evidence based – questionable

• Non-evidence based – Trauma Services opinion

• Refer to CQI committee – no

• Financial resources available – non-budgeted item

• Other financial resources – July spending

• Recurring resources accounted for - no

• Training/Educational resources – minimal

• Can we get what we need in a timely manner – yes

• Acceptable overall risk - yes

• Purchase - yes

DefineMeasure

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Previous Expenditures

Narcotic Bags:• Mandate – No

• Patient care/employee driven – Pine Island and Alva deployment

• Immediate implementation required – Yes

• Evidence based – questionable

• Non-evidence based – Opinion generated

• Refer to CQI committee – no

• Financial resources available – non-budgeted item

• Other financial resources – July spending

• Recurring resources accounted for - no

• Training/Educational resources – minimal (non-budgeted)

• Can we get what we need in a timely manner – yes

• Acceptable overall risk – yes (questionable at this time)

• Purchase - yes

DefineMeasure

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Previous Expenditures

CCEMT-P course:• Mandate – No

• Patient care/employee driven – Pediatric Services request (LMH)

• Immediate implementation required – No

• Evidence based – questionable

• Non-evidence based – Pediatric Services opinion

• Refer to CQI committee – no

• Financial resources available – $30,000.00 budgeted

• Other financial resources – none

• Recurring resources accounted for - no

• Training/Educational resources – not accounted for

• Can we get what we need in a timely manner – yes

• Acceptable overall risk - yes

• Purchase - yes

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Measure Phase

Auto Pulse$15,000 per unit

$750,000 for 50 ambulances

$125 per chest strap

$7 bio-shield

526 cardiac arrests in 2006

$69,432 disposable cost

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Conclusion

Define Project Implementation: March 1, 2007 Measure Project Completion after 25 Cardiac Arrests Analyze Analyze data collected against current

process of manual CPR during the same time frame

Improve Determine justified need for purchase Control Project referred to Continuous Quality

Assurance/ Improvement Committee

Design By: FTO Dominick C. Watts, NREMT-P, FP-C