using triz innovation tools

8/7/2019 Using TRIZ Innovation Tools

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Uig TRIZ Iti TlIn a RapId ImpRovemenT WoRkshop

Case sTUdy


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At a GlanceIndustryHealthcareFull-Service Community Hospital

DepartmentEmergency Department

Business IssueOrder-to-collect time neededto be reduced and a new process putin place.

Approximately 30% o the delay in

SA lab tests was due to order-to-collect time.

Methodology Applied

RIZ Innovation ools

Business ImpactnImproved order-to-collect t ime

by 66%

Background

A Rapid Improvement Workshop (RIW) was conducted to address coordination o patientcare in the Emergency Department o a community hospital. Te RIW was the result o a

ProcessVSA that had ocused on reduction o turn-around-time (A) or SA lab tests.

During the ProcessVSA, a value analysis o the process revealed that 30% o the delay

in A was due to the order-to-collect time, or rom physician entry o the order to

collection o the specimen. A lack o coordinated access to the patient by ancillary

services (lab, radiology, respiratory, etc.) was identied by root cause analysis to be a

key contributor to delayed SA lab orders. About 25% o the time, the phlebotomist

would respond to the ED to collect the specimen only to discover that the patient was

not in the bed. Te phlebotomist would then seek out the nurse caring or the patient

to determine where he had been taken and when he was likely to return. I the patient

had been taken, or example, to Radiology or a C, the phlebotomist would then go on

to collect other specimens, oen on other hospital units. Upon return later to collectthe specimen, the phlebotomist might nd that an EKG was being perormed or a

respiratory treatment being given, causing urther delay.

Investigating the ProblemTe goal o the Patient Care Coordination RIW was to reduce order-to-collect time by

coordinating access to the patient. It was immediately apparent to the team that a new process

was required. It was agreed that it was the inherent role o the ED nurse to coordinate ED patient

care. Te order in which specimens were collected, diagnostic studies conducted, and emergent

treatments administered should be determined by the needs o the each patient, the tests and

treatments ordered, and nursing logic. Some radiological studies take only a ew minutes to

complete while others take 20 minutes or longer. A specimen takes just moments to collect,

but common laboratory studies require an average o 28 minutes o processing. I care was

Figure 1. Related section o the proc ess map.

PatientAvailable?

Yes

No

Yes

Wait for

patient To PIRegistration

Go back toLab

Collectanother ER

patient

Verify ID?Collect

Specimen


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ConclusionRIZ tools allowed the team to see beyond the problem and the presumptive solution (x

the soware) to the ideal solution. A simple, manual interim solution made an immediate

impact on the process and, ultimately, produced the model and specications necessary to

make appropriate changes to the soware. By clearly communicating the needs o the sta

to the soware developers aer piloting the solution, the ED whiteboard soware unctionsin a way that supports patient care and works very eectively or the ED clinical sta.

Figure 3. Ideal Final Result


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About the Author

Vickie Kamataris, Senior Business ConsultantVickie Kamataris is a senior business consultant or NOVACES.

A registered nurse with more than twenty years o clinical

experience, Vickie earned her BSN rom Southwestern College

where she graduated Valedictorian in 1988. She has achieved

multiple specialty certications including CPHQ and is a Lean Six

Sigma Master Black Belt. As t he NOVACES Master Black Belt or

Navy Medicine, National Capital Region, Vickie provides Lean Six Sigma expertise and

leadership to develop and guide Lean Six Sigma deployment strategies, lead complex,

enterprise-level projects and events, and mentor Master Black Belt candidates at the

Bureau o Medicine and Surgery, National Naval Medical Center, and Naval Health

Clinics. In her role as Quality Leader or General Electric Corporate Healthcare and

Medical Programs, Vickie developed and deployed a balanced scorecard across GEs

network o more than 240 clinics in 36 nations. She led multi-disciplinary, cross-unctional global teams to improve mean perormance related to cost/productivity,

compliance, and medical quality indicators rom 54% to 96% and led key global

initiatives including implementation o an electronic health record, emergency medical

response, travel medicine, health promotion and wellness, medical surveillance

assurance, disability case management, and development o clinical protocol. She has

extensive experience as an educator, serving as hospital education coordinator and

adjunct aculty in the Biology department at Cowley County Community College

and has mentored and certied physician and nurse Green Belts and Black Belts. She

has presented at national and international venues and authored journal articles and

papers on a range o quality-related topics including Lean, Six Sigma, and balanced

scorecard. Vickie has more than 30 years o experience leading clinical, business, and

military teams and has received multiple academic and proessional awards. She servedas a noncommissioned ofcer in the US Air Force. Vickie is a member o Sigma Teta

au International, National Association or Healthcare Quality, the American Society or

Quality and the International Society o Six Sigma Proessionals.


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Notes


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New OrleaNs, la

red BaNk, NJ

TOll free: 877.577.6888

www.NOvaces.cOm 2009 NOvaces, llc. a ight

About UsNOVACES is a leading provider o continuous process improvement (CPI) consulting and

training services to the public and private sectors. By leveraging over two decades o applied

research experience, the company is capable o delivering todays most eective methods

or generating breakthroughs in operational capabilities and nancial perormance.

Employing its SystemCPI methodology, NOVACES provides clients with an integrated

ramework o Lean, Six Sigma and Constraints Management to deploy and manage a

process improvement program, resulting in aster and better return on investment.

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