Six Sigma [Green Belt Project] Continuous Quality ImprovementPurchasing Justification ProcessEMT-P Jason AusmanFTO Jim BonhamLT. Michael HamelEMT Robert HofstetterEMT-P Angela HolbrookTeam: Sponsor:Chief Chris HansenFacilitators:DC Kim DickersonCapt. Art Garcia

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

Business CaseDevelop 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

Business CaseGoal 2Make 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.

Business CaseGoal 4Answer: 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.

Define PhasePrevious Expenditures CCEMT-P course$30,000 budgetedActual expense closer to $300,00011/05 5 Students CCEMT-P Pittsburg, PA $18,830.201/06 5 Students CCEMT-P Augusta, GA $15,320.754/062 Students CCEMT-P Augusta, GA $ 7122.48 Total $41,273.43

Define Phase Previous ExpendituresNarcotic Bags- 8/200550 Narc.Personal/Safe Boxes (Koons Locksmiths) @ $11.95 ea $597.50 No provision for cost to continue programNo implementation evaluation/validation

Define PhasePrevious ExpendituresAmbulance Cameras40 Kodak Easy Share C310 Digital Zoom Camera $87.00 Each $3,480.0040 Kingston Flash Memory Card-128MB-SD $14.50 Each 580.00 Total $4,060.00No provision for cost to continue programNo implementation evaluation /validation

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

Result = risk avoidance

The Project ScopeRequest made to purchase the Auto PulseDo we really need it?How will it make a difference?Is it financially achievable and sustainable?Periodic evaluation and validation.

Previous ExpendituresCameras:Mandate NoPatient care/employee driven Trauma Services requestImmediate implementation required NoEvidence based questionableNon-evidence based Trauma Services opinionRefer to CQI committee noFinancial resources available non-budgeted itemOther financial resources July spendingRecurring resources accounted for - noTraining/Educational resources minimal Can we get what we need in a timely manner yes Acceptable overall risk - yes Purchase - yes

Previous ExpendituresNarcotic Bags:Mandate NoPatient care/employee driven Pine Island and Alva deploymentImmediate implementation required YesEvidence based questionableNon-evidence based Opinion generatedRefer to CQI committee noFinancial resources available non-budgeted itemOther financial resources July spendingRecurring resources accounted for - noTraining/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

Previous ExpendituresCCEMT-P course:Mandate NoPatient care/employee driven Pediatric Services request (LMH)Immediate implementation required NoEvidence based questionableNon-evidence based Pediatric Services opinionRefer to CQI committee noFinancial resources available $30,000.00 budgeted Other financial resources noneRecurring resources accounted for - noTraining/Educational resources not accounted for Can we get what we need in a timely manner yes Acceptable overall risk - yes Purchase - yes

Measure PhaseAuto Pulse$15,000 per unit$750,000 for 50 ambulances$125 per chest strap$7 bio-shield526 cardiac arrests in 2006$69,432 disposable cost

ConclusionDefineProject Implementation: March 1, 2007MeasureProject Completion after 25 Cardiac ArrestsAnalyzeAnalyze data collected against current process of manual CPR during the same time frameImproveDetermine justified need for purchase ControlProject referred to Continuous Quality Assurance/ Improvement CommitteeDesign By: FTO Dominick C. Watts, NREMT-P, FP-C