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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.
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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
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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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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
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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
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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