Initial Report As part of the Define and Measure phases of the DMAIC model, you will evaluate the processes involved in emergency care and create an Initial Report for the Shelbyville Medical Center.

Initial Report

As part
of the Define and Measure phases of the DMAIC model, you will evaluate the
processes involved in emergency care and create an Initial Report for the
Shelbyville Medical Center.

The Initial Report is the
first task of the assessment. As part of the Initial Report, you will evaluate
the following:

• the
  tools that support defining a problem for improvement
• the
  processes involved in emergency care
• the
  elements of a successful project charter

Follow these three steps
to help you complete the Initial Report:

Discover: Review
the importance of customer feedback and the tools that are used in the Define
and Measure phases of DMAIC.

Engage: Study
the processes involved in emergency care and examine a report from a
Shelbyville Medical Center’s CQI team that will add insight to the
inefficiencies in the emergency care process.

Review: Apply
what you have learned to complete Task 1 of the Quality Improvement in
Healthcare assessment. For more detailed requirements, visit the Assessment area
on the Course of Study landing page.

Essential Materials

Use the
following resources to complete the Initial Report.

Improving Patient Flow and Reducing Emergency Department
Crowding: A Guide for Hospitals provides
step-by-step instructions for planning and implementing patient flow
improvement strategies.

Basics Healthcare Performance Improvement: A Lean Six Sigma
Approach prepares healthcare administrators to meet the challenges
of a changing marketplace through the Lean Six Sigma method of quality
improvement.

“Project Charter Toolkit” provides templates, samples,
and a guide supported with videos, to help you create an effective project
charter.

The Voice of the Customer Report from the
continuous quality improvement (CQI) team at the organization compares
patients’ experiences at the Shelbyville Medical Center to the national
average.

Task 1: Initial Report Template

The
DMAIC model of Six Sigma is one example of a framework for effective quality
improvement. Before implementing a quality improvement initiative, leaders
should first understand the value of quality improvement. The next step is to
become familiar with and analyze how the DMAIC model can be used in healthcare
organizations. The following articles, case studies, and videos illustrate the
strategies and tools that lead to a structured approach to quality improvement
implementation.

What is the
value of quality improvement and the DMAIC model in healthcare?

How does
customer feedback affect healthcare?

What tools
are used in the Define and Measure phases?

Now
that you have reviewed and explored the tools supporting the Define and Measure
phases of DMAIC, you can begin application to the Shelbyville Medical Center
case study.

What Are the Processes Involved in Emergency Care?

Because
Six Sigma focuses on processes, healthcare leaders need a well-developed
understanding of the operational relationships among and across departments,
employees, and resources that comprise a system for care. Delivering emergency
care involves an especially complex process. Systems must respond efficiently
to deliver care in an environment where rapid response is crucial to patient
well-being. Developing a process flowchart is an effective way to represent a
complex system and identify areas for improvement.

Processes in an emergency department,
click to open activity

In
response to the patient satisfaction survey results, the CQI team conducted
interviews with stakeholders and staff members from various departments to
identify possible sources of waste or inefficiency. The team summarized their
findings by the department.

Select
each link to see more.

The triage staff observed
that response time for patients in life-threatening situations is comparable to
benchmarks, but patients triaged at a less urgent level are often kept waiting
for several hours. The triage staff members’ consensus is that the process for
patient triage is well formed. The continued influx of patients creates a
bottleneck in the overall arrival to treatment time. In addition to determining
patient priority, triage staff have been assigned multiple other tasks and are
faced with numerous distractions and interruptions.

The nursing staff expressed
similar concerns regarding overall emergency department patient volume. The
nurses observed that patients frequently complain about wait times before being
seen by a physician. The nursing staff also expressed frustration about ease of
access to the equipment and supplies needed to treat patients. A general sense
from the nursing staff is that physicians tend to be abrupt with patients and
staff, which may be limiting open dialogue.

Resident Physicians

Resident physicians reported
feeling constantly rushed. Their primary complaint is difficulty in efficiently
communicating to the attending physician. The process of direct handoff of
patient information has eroded to passive communication within the patient’s
medical record, decreasing the quality and reliability of the communication.

Attending physicians reported
feeling constantly rushed. They are frustrated about poor communication from
resident physicians and believe this is a factor in delayed patient care.
Attending physicians reported that they are often required to perform repeat
patient assessments due to inadequate information provided by the residents.

References