Tiffany has worked in the emergency department (ED) of a

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Tiffany has worked in the emergency department (ED) of a regional medical centre for the past year. The average length of stay is more than 4 hours, the number of patients who leave without being seen has climbed to 180/month, and patient satisfaction scores have fallen to 80%. A Six Sigma team, including ED nurses, ancillary department staff, and physicians, has been established to identify opportunities to decrease average length of stay and the number of patients who leave without being seen. Tiffany, a new member of her department’s practice council, has been asked to participate in the Six Sigma team. The team will apply the six steps of the quality improvement (QI) process (in Box 21-2 of the text) to determine an approach to reduce excessive wait times and improve patient satisfaction. The practice council completed the first two steps of the process (identifying needs most important to the consumer of health care service and assembling a multidisciplinary team to review identified consumer needs and services) before Tiffany was asked to join.
Questions
1. Identify the next (third) step in the QI process and an approach that the Six Sigma team might take.
2. The Six Sigma team then moves to the fourth step and identifies the following outcomes of quality indicators: to
decrease average length of stay to less than 180 minutes, to reduce the number of patients who leave without being seen to less than 1% of the monthly volume, and to raise patient satisfaction scores to 97%. What is the next (fifth) step of the QI process? Identify an effective approach that the team might take.
3. Describe the sixth step in the QI process, which is the evaluation of the plan implementation. Speculate on how communication rounds affected wait times, reduced the number of patients who left before being seen, and improved patient satisfaction.

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