Six Sigma Green Belt Project Continuous Quality Improvement

Six Sigma [Green Belt Project] Continuous Quality Improvement Purchasing Justification Process D efine M easure A nalyze I mprove C ontrol Sponsor: Facilitators: Chief Chris Hansen DC Kim Dickerson Capt. Art Garcia Team: EMT-P Jason Ausman FTO Jim Bonham LT. Michael Hamel EMT Robert Hofstetter EMT-P Angela Holbrook

D Problem Statement The current CQI process is inconsistent with new product evaluation, justification, implementation, and validation. M A I C efine easure nalyze mprove ontrol

D Business Case M A I C l 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. l Alignment to Business Strategy • Bo. CC FY 2007 Goals efine easure nalyze mprove ontrol

D 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. M A I C efine easure nalyze mprove ontrol

D Business Case M A I C efine easure nalyze mprove ontrol 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.

D Define Phase l Previous Expenditures CCEMT-P course • $30, 000 budgeted • Actual expense closer to $300, 000 • 11/05 5 Students CCEMT-P Pittsburg, PA • 1/06 5 Students CCEMT-P Augusta, GA • 4/06 2 Students CCEMT-P Augusta, GA • Total $18, 830. 20 $15, 320. 75 $ 7122. 48 $41, 273. 43 M A I C efine easure nalyze mprove ontrol

D Define Phase l 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 M A I C efine easure nalyze mprove ontrol

D Define Phase l Previous Expenditures • • Ambulance Cameras 40 Kodak Easy Share C 310 Digital Zoom Camera $87. 00 Each $3, 480. 00 40 Kingston Flash Memory Card-128 MB-SD $14. 50 Each 580. 00 Total $4, 060. 00 • No provision for cost to continue program • No implementation evaluation /validation M A I C efine easure nalyze mprove ontrol

D Preliminary Goal To develop a process that results in enhanced patient care, demonstrates fiscal need and provides for long term sustainability. Result = risk avoidance M A I C efine easure nalyze mprove ontrol

D 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. M A I C efine easure nalyze mprove ontrol

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D Previous Expenditures l 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 M A I C efine easure nalyze mprove ontrol

D Previous Expenditures l Narcotic Bags: • • • • Mandate – No Patient care/employee driven – Pine Island 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 M A I C efine easure nalyze mprove ontrol

D Previous Expenditures l 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 M A I C efine easure nalyze mprove ontrol

D 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 M A I C efine easure nalyze mprove ontrol

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D Conclusion M A I C efine easure nalyze mprove ontrol Define Project Implementation: March 1, 2007 l Measure Project Completion after 25 Cardiac Arrests l Analyze data collected against current process l of manual CPR during the same time frame Improve Determine justified need for purchase l Control Project referred to Continuous Quality l Assurance/ Improvement Committee Design By: FTO Dominick C. Watts, NREMT-P, FP-C