You are the Chief Quality & Safety Director for Jasmine Hospital in Pine City, Colorado. The community has 80,000 people and is a fairly new community of 25-50 year old residents who have moved in over 10 years time. Your hospital is the primary acute care hospital within 10 miles. There are a large number of sporting injuries and vehicle accidents that result in a significant number of head traumas and broken bones in the middle through high school age group. Your emergency room is a general trauma ED staffed by ED generalists, but there is a clinic within two miles that has a host of orthopedic and neurology surgeons and neurologists. Problem: Waiting times for bringing in the specialties to the ED averages 2-4 hours as most of them are in surgery within the hospital, but not available. You have had four deaths in 3 months from not being able to address compound fractures or head traumas fast enough for these teenagers. You average five (5) neuro-ortho cases per day during the week with most of these from 11a-7p each weekday. You also average 10 neuro-ortho cases from Friday at 5p to Saturday midnight each week. Your job is to prevent deaths and come up with a plan that can address the needs of this community within your ED. Address the following using Six Sigma, Lean thinking, educational needs, and community outreach. Address the following: What do you believe the initial problem is? Who are the customers (stakeholders) and what do they need? (minimum of 5) How would each customer (stakeholder) describe being satisfied in the end? What are the current processes being used (you may need to make some of this up)? Be complete. Identify the process from an event to a full or limited but permanent recovery. What is some of the identified waste seen in this process? (Imagined waste). Are the processes currently planned or unplanned? Who are the personnel involved currently in each step? Give time estimates for the steps? (may need to create some) What would be new goals for being timelier? What are the educational needs for the various stakeholders? Is there duplication or redundancy adding to the waste? What measures would need to be made to evaluate improvements? Are the measurements reliable measures? What is needed to sustain these improvements? What new agreements would need to be made to sustain these improvements? What are the rewards identified for all the stakeholders in this process?
