Scenario:

Basin General Hospital's emergency department (E.D.) has eight beds. The E.D. sees approximately 870 cases each month (i.e., every 30 days) and operates 24 hours a day, 7 days a week. Patients arrive from the outside the E.D., from home presumably, and after going through the E.D. are either discharged home or are admitted to the hospital. The patient load is unpredictable day to day and unbalanced hour to hour. Staff availability is measured, but nothing is really done with the information. Most important to the E.D. is Patient Lead Time (the end-to-end time for a patient in the E.D.). The end-product of the E.D.'s emergency team is a well-patient.

For this scenario please submit:

a. Assume our improvement goal is a 50% reduction in patient Lead Time. Report the patient Lead Time in minutes and the % Value Add Time for this emergency department.

b. A Value Stream Map (the "blueprint" for improvement) of the scenario described.

c. A Load Balance Diagram with a statement summarizing the interpretation of the diagram.

d. A list of the wastes (TRIMWOOD) and their locations identified from the value stream map, load balance diagram and scenario provided.

e. Recommend 3 wastes (TRIMWOOD) to reduce in the E.D.: Submit three PDSA Test-of-Change forms, one for each waste you recommend to eliminate (note: actions may be taken to eliminate the same type of waste in multiple locations in a single Test-of-Change).

f. Which operation do you think might benefit from a Spaghetti Diagram and why?

g. Submit a plan to "5s" one of the areas in the E.D. Briefly describe what and how you would sort, store, shine, standardize and sustain that area.

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