Six Sigma [Green Belt Project]

1. Six Sigma[Green BeltProject] Continuous Quality Improvement Purchasing 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

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

3. 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

4. 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.

5. 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.

6. Define Phase • Previous ExpendituresCCEMT-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

7. 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

8. 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

9. Preliminary Goal To develop a process that results in enhanced patient care, demonstrates fiscal need and provides for long term sustainability. Result = risk avoidance

10. 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.

13. 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

14. 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

15. 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

16. 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

18. 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