Six Sigma

[Green Belt Project]

Continuous Quality Improvement

Purchasing Justification Process

Team: EMT-P Jason Ausman

D efine Sponsor: Chief Chris Hansen FTO Jim Bonham
Measure LT. Michael Hamel
Analyze Facilitators: DC Kim Dickerson EMT Robert Hofstetter
Improve Capt. Art Garcia EMT-P Angela Holbrook
Control
 Define

Problem Statement
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The current CQI process is inconsistent with

new product evaluation, justification,
implementation, and validation.
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Business Case
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 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
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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
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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.
 Define

Define Phase
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 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
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 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
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 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
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To develop a process that results in enhanced

patient care, demonstrates fiscal need and
provides for long term sustainability.

Result = risk avoidance

 Define

The Project Scope

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• 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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Previous Expenditures
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 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
 Define

Previous Expenditures
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 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
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 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
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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
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 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