chapter 6 book companion - american college of … 2e/hc ops 2 - cha… · chapter 6.ppt. templates...

1 Copyright 2012 Health Administration Press

CHAPTER 6

BOOK COMPANION

Much of the work of healthcare professionals is making decisions and solving problems In

todayrsquos rapidly changing world problems must be solved and good decisions must be made

quickly A structured approach can make this process more efficient and effective

Major topics covered in Chapter 6 include

bull the decision-making process with a focus on framing the problem or issue

bull mapping techniquesmdashmind mapping process mapping activity mapping and service

blueprinting

bull problem identification toolsmdashroot cause analysis failure mode and effects analysis and the

Theory of Constraints

bull analytical toolsmdashoptimization using linear programming and decision analysis and

bull force field analysis to address implementation issues

The tools and techniques outlined in Chapter 6 should provide a basis for tackling difficult

complicated problems After reading the chapter readers should be able to

bull frame questions and problems

bull analyze problems and solutions to the problems and

bull implement those solutions

An extensive set of resources is available in this section of the website and is intended to

be used by students instructors and healthcare professionals The author invites readersrsquo

comments recommended readings website suggestions and any other material that can be

added to this page for this or any other chapter Click here to send an email Please include

ldquoHealthcare Operations Management 2nd editionrdquo in the subject line


Downloadable Resources

PowerPoint Slides for Chapter 6

To access a PowerPoint presentation covering the key points of Chapter 6 click on the icon below to

openclose the attachments panel

HC Ops 2 slides - Chapter 6ppt

Templates

Fishbone Template

A cause-and-effect diagram is a graphic tool used to explore and display all the potential causes

of a problem The cause-and-effect diagram is sometimes called an Ishikawa diagram (after its

inventor professor Kaoru Ishikawa) or a fishbone diagram (because it resembles the skeleton of

a fish) The fishbone diagram is one of the seven basic quality tools To access a fishbone

diagram template click on the icon below to openclose the attachments panel

Ch 6 Fishbone Templatedoc

Failure Mode and Effects Analysis (FMEA) Template

FMEA was developed by the US military in the late 1940s Originally FMEA was used to assess

equipment failure More recently many service industries including the healthcare industry

have adopted it to evaluate process failure Hospitals accredited by The Joint Commission are

required to conduct at least one FMEA or similar proactive analysis annually Root cause

analysis is used to examine the underlying causes of an event or failure whereas FMEA is used

to identify the ways in which a process (or a piece of equipment) could fail and to eliminate or

reduce the severity of the potential failure A template for FMEA is available by clicking on the


icon below to openclose the attachments panel

Ch 6 FMEA TemplateXLT

Example Diagrams from the Text

Mind Mapping

Mind mapping is a structured brainstorming technique Brainstormed ideas are organized on a

ldquomaprdquo and the connections between ideas are made explicit An example (ex63pdf) is attached

to this PDF Click on the icon below to openclose the attachments panel

ex63pdf

Process Maps

A process map or flowchart is a graphical depiction showing inputs outputs and steps in the

process Standard flowchart symbols are shown in a PDF (ex66pdf) attached to this file Click

on the icon below to openclose the attachments panel

ex66pdf

A high-level process map of a clinicrsquos operation (ex64pdf) is attached to this PDF Click on the


ex64pdf


Also attached is the same map in more detail (ex65pdf)

ex65pdf

Cross-Functional (Swim Lane) Process Maps

The cross-functional process map or ldquoswim lanerdquo map is a specialized process map that follows

the flow of a process through the various departments of the organization The swim lanes

indicated by the dashed lines between departments show the work being completed by a

particular department or individual in the process Exhibit 67 (attached to this PDF) is an

example of the presurgery holding room for the Veterans Administration hospital

ex67pdf

Service Blueprinting

Service blueprinting is a special form of process mapping (as is value stream mapping see

Chapter 9) Service blueprinting begins with mapping the process from the customerrsquos point of

view Typically a service blueprint is used to identify points where the service might fail to

satisfy the customer and where the system could be redesigned or controls could be added to

reduce or eliminate the possibility of failure An example of a service blueprint (ex68pdf) is

attached to this PDF

ex68pdf


Mathematical (Linear) Programming

Optimization or mathematical programming is a technique used to determine the optimal

allocation of resources in relation to a desired goal For example the resources might be people

money or equipment Out of all possible resource distributions the objective is to find the one

that maximizes or minimizes some numerical quantity such as profit or cost Linear

programming techniques are available in the Microsoft Excel tool ldquoSolverrdquo An example that

uses solver to maximize diagnosis-related group reimbursement is attached to this PDF

Ch 6 DRG LP Examplexls

Decision Trees

Decision analysis is a process for examining and evaluating decisions in a structured manner A

decision tree is a graphical representation of the order of events in a decision process It is used

to evaluate the risks and rewards of choosing a particular course of action An example decision

tree is attached to this PDF

Ch 6 Decision Tree Examplexls

Websites of Interest

Webcasts and Podcasts (Audiocasts)

Root Cause AnalysismdashYou will need to register for this free webcast See also Root Cause

Analysis (RCA)mdashIs Data Collection Really Necessary from the Reliability Center Inc


Software

The authors recommend the following software tools to assist in implementing the tools

discussed in Chapter 6

Inspirationmdashmind mapping software A 30-day free trial version is available

FreeMindmdashfree mind mapping software

Microsoft Visiomdashprocess mapping software A 60-day free trial version is available

PrecisionTreemdashdecision tree software A 15-day free trial version is available

Tools

Many online tools and downloads are also available to execute the techniques discussed in

Chapter 6

Failure Modes and Effects Analysis (FMEA)

Failure Modes and Effects Analysis (FMEA) Toolmdashfrom the Institute for Healthcare

Improvement

Healthcare Failure Mode and Effect Analysis (HFMEAtrade)mdashfrom the Veterans Administration

National Center for Patient Safety

Root Cause Analysis

Cause-and-Effect Diagram (IHI Tool)

Decision-Making Techniquesmdasha list of decision-making tools and techniques

Force Field Analysis


Tutorials

The following tutorials will be of interest to those interested in learning how to use the tools and

techniques addressed in Chapter 6

Microsoft Visio

Microsoft Excel Solver

PrecisionTreemdashfrom Palisade

Linear Programming Graphic Tutorialmdasha Flash tutorial on linear programming

Decision Makingmdashan introduction to decision making with links to other resources

Mind Mapsmdasha brief introduction to mind mapping

Process MappingmdashAn Overviewmdashfrom NHS

Determine the Root Cause 5 Whysmdasha short tutorial

Failure Modes and Effects Analysis (FMEA)mdashan overview from American Society for Quality

Theory of Constraints (TOC)

Quality and Service Improvement Tools from NHS

Demonstrations

The following demonstrations clarify some principles and tools of operations management that

are difficult to understand

Theory of Constraints Demonstrationmdashan animated manufacturing-type demonstration of TOC

See TOC in Operations for a services-type demonstration

Goldrattrsquos Theory of Constraints Online Simulationmdashan interactive simulation (by Levinson

Productivity Systems PC) of the matchstick experiment from The Goal (by Goldratt and

Cox originally published in 1986) illustrating that a balanced line is never truly balanced

Goldrattrsquos Gamemdasha paper and pencil version of Goldrattrsquos matchstick experiment


People

A number of experts developed the tools covered in Chapter 6 including

Buzan Tony

Goldratt Eliyahu M Ishikawa Kaoru more on Ishikawa

Lewin Kurt

Organizations

The following organizations use the tools discussed in Chapter 6

Avraham Y Goldratt Institute

Institute for Healthcare Improvement (IHI)

The Joint Commission

Veterans Administration National Center for Patient Safety (VA NCPS)

Pittsburgh Regional Health Initiative (PRHI)

NHS Institute for Innovation and Improvement (UK National Health Service)

Case Studies

Case studies can be used to explore Chapter 6 topics in more depth

Failure Modes and Effects Analysis (FMEA) Computerized Prescriber Order EntrymdashStaff at

Fairview Southdale Hospital completed FMEA for the CPOE process

Researchers Use TreeAge Pro Healthcare to Evaluate the Cost-Effectiveness of Healthcare

Optionsmdasha study on decision trees


Additional References and Readings

Buzan T 1991 Use Both Sides of Your Brain New York Plume

Buzan T and B Buzan 1996 The Mind Map Book How to Use Radiant Thinking to Maximize

Your Brains Untapped Potential

Detsky A S G M Naglie M D Krahn D M Naimark and D A Redelmeier 1997 ldquoPrimer

on Medical Decision Analysis Part 1 Part 2 Part 3 Part 4 Part 5rdquo Medical Decision

Making 17 (2) 123ndash59

Goldratt E M and J Cox 2004 The Goal A Process of Ongoing Improvement Third Revised

Edition New York North River Press

Ishikawa K 1991 What Is Total Quality Control Trans D J Lu Englewood Cliffs NJ

Prentice-Hall

Kassean H K and Z B Jagoo 2005 ldquoManaging Change in the Nursing Handover from

Traditional to Bedside HandovermdashA Case Study from Mauritiusrdquo BMC Nursing 4 (1)

Lewin K 1951 Field Theory in Social Science Selected Theoretical Papers New York

Harper

Reid S 2000 ldquoFocusing on Ophthalmology Waiting Lists Using the Theory of Constraintsrsquo

Methodology to Increase Improve Services to Patientsrdquo ImpAct 6 (MarchApril)

Russo J E and P J H Schoemaker 1990 Decision Traps The Ten Barriers to Brilliant

Decision-Making and How to Overcome Them New York Simon amp Schuster Inc

Shostack G L 1984 ldquoDesigning Services That Deliverrdquo Harvard Business Review 62 (1) 133ndash

39

Wolstenholme E 1999 ldquoA Patient Flow Perspective of UK Health Services Exploring the Care

for New Intermediate Care Initiativesrdquo System Dynamics Review 15 (3) 253ndash71


Womack D and S Flowers 1999 ldquoImproving System Performance A Case Study in the

Application of the Theory of Constraintsrdquo Journal of Healthcare Management 44 (5) 397ndash

405

Wysocki B Jr 2004 ldquoTo Fix Health Care Hospitals Take Tips from Factory Floorrdquo The Wall

Street Journal April 9 Section A 1ndash5

Performance Improvement Tools Techniques and Programs146

FIGURE 62 Riverview

Clinic High-Level Process

Map

Physician examand consultation

Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room

Nurse doespreliminary

exam

Wait

FIGURE 63 Riverview

Clinic DetailedProcess Map

PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation

Insuranceinformation

No

Existing Infor-mation

Patienttype

Wait

4 Create a formal chart Once an initial flowchart has been generated thechart can be formally drawn using standard symbols for process map-ping (Figure 64) This can be done most efficiently using software suchas Microsoft Visio Note that when first developing a flowchart it ismore important to obtain an accurate picture of the process than toworry about using the correct symbols

5 Make corrections The formal flowchart should be checked for accuracyby all relevant personnel Often inaccuracies will be found in the flow-chart that need to be corrected in this step

6 Determine additional data needs Depending on the purpose of theflowchart data may need to be collected or more information mayneed to be added Often data on process performance are collected andadded to the flowchart


FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait




Chapter 6 Tools for Problem Solv ing and Decis ion Making 147

Measures of process performanceMeasures of process performance include throughput time cycle time and per-centage of value-added time (Chapter 9) Another important measure ofprocess subprocess task or resource performance is capacity utilizationCapacity is the maximum possible amount of output (goods or services) that aprocess or resource can produce or transform Capacity measures can be basedon outputs or on the availability of inputs For example if a hospital food serv-ice can provide at most 1000 meals in one day the food service has a capac-ity of 1000 mealsday If all magnetic resonance images (MRIs) take one hourto perform the MRI machine would have a capacity of 24 MRIsday Thechoice of appropriate capacity measure varies with the situation

Ideally demand and capacity are perfectly matched If demand isgreater than capacity some customers will not be served If capacity is greaterthan demand resources will be underutilized In reality perfectly matchingdemand and capacity can be difficult to accomplish because of fluctuations indemand In a manufacturing environment inventory can be used to compen-sate for demand fluctuations In a service environment this is not possibletherefore excess capacity or a flexible workforce is often required to meetdemand fluctuations Advanced-access scheduling (Chapters 9 and 12) is oneway for healthcare operations to more closely match capacity and demand

FIGURE 64 StandardFlowchartSymbols

An oval is used toshow inputsoutputs

to the process or startend of the process

Block arrowsare used to show

transports

Arrows show the direction of flow of the process

Feedbackloop

D shapes areused to show

delays

Atriangle

shows inventoryFor services

they can also indicate customer waiting

End

Adiamond

is used to show those points in the

process where a choice can be made or alternative

paths can be followed

Arectangleis used to

show a task oractivity

Chapter 6 Tools for Problem Solving and Decision Making


Tools for Problem Solving and Decision Making

Chapter 6


Decision-making framework

Framing

Basic process improvement

Root cause analysis

Failure mode and effects analysis (FMEA)

Decision trees

Optimization


Force field analysis

Copyright 2012 Health Administration Press

Decision-Making Framework

Framing

Identifying and framing the issue or problem

Gathering intelligence

Generating or determining possible courses of action and evaluating those alternatives

Coming to conclusions

Choosing and implementing the best solution or alternative

Learning from feedback

Reviewing and reflecting on the above steps and outcomes


Barriers to Good Decision Making


A Test of Your Problem-Solving Abilities


4

If a doctor gave you three pills and said to take one every half hour how long would they last

1

Can a man living in Milwaukee Wisconsin be buried west of the Mississippi

2

If you had only one match and entered a room where there was a lamp an oil heater and some kindling wood which would you light first

3

How many animals of each

species did Moses take along

on the ark

5

If you have two US coins totaling
55 cents and one of the coins is
not a nickel what are the two coins


Mind Mapping

Diagram created in Inspirationreg by Inspiration Softwarereg Inc



Process MappingFlowcharting

Graphical depiction of a process showing inputs outputs and steps in the process

Used to understand and optimize a process

Integral part of most improvement initiatives including Six Sigma Lean Balanced Scorecard root cause analysis failure mode and effects analysis and so forth


Process Mapping Steps

Assemble and train the team

Determine process boundaries and desired level of detail

Determine and order major process tasks

Draw a formal flowchart

Check the accuracy of the formal flowchart

Collect more data and information as needed


Flowchart Standard Symbols

Microsoft Visioreg screen shots reprinted with permission from Microsoft Corporation



Activity and Role Lane Mapping






Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis

Structured step-by-step techniques for problem solving

Aimed at determining and correcting the ultimate causes of a problem

What happened

Why did it happen

What can be done to prevent it from happening again


Five Whys Technique

Ask why the condition occurred

Ask why for each answer (five times is a good rule of thumb)


Cause-and-Effect Diagram


Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)




Old inner-city building

Lack of treatment rooms

Elevators broken

Wheelchairs

unavailable

Transport arrives late

Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)

Original appointment missed


Failure Mode and Effects Analysis


Steps in the Process

Failure Mode

Failure Causes

Failure Effects

Likelihood of

Occurrence (1ndash10)

Likelihood of

Detection (1ndash10)

Severity (1ndash10)

Risk Priority Number

(RPN)

Actions to Reduce

Occurrence of Failure

1

2

3

4

5

6

7

8

Total RPN (sum of all RPNs)



Failure mode What could go wrong

Failure causes Why would the failure happen

Failure effects What would be the consequences of failure

Likelihood of occurrence 1ndash10 10 = very likely to occur

Likelihood of detection 1ndash10 10 = very unlikely to detect

Severity 1ndash10 10 = most severe effect

Risk priority number Likelihood of occurrence times Likelihood of detection times Severity



The Goal (Goldratt and Cox 1986)

Every organization is subject to at least one constraint which limits it from moving toward its goal

Eliminating or alleviating the constraint can enable the organization to move closer to its goal


Theory of Constraints Five Steps

Identify the constraint (or bottleneck)

Exploit the constraint

Subordinate everything else to the constraint

Elevate the constraint

Repeat the process for the new constraint


Optimization

A technique used to determine the optimal allocation of limited resources given a desired goal

Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective

Maximize profit or revenue

Minimize cost



Optimization

Optimization models have three basic elements

An objective function which is the quantity that needs to be minimized or maximized

The controllable inputs or decision variables that affect the value of the objective function

Constraints that limit the values the decision variables can take on


Decision Trees

The tree diagram in this figure was drawn with the help of PrecisionTree a software product of Palisade Corp Ithaca NY wwwpalisadecom

Choose this path because expected costs of $104 million are less than $122 million




Decision Tree Risk Analysis




A technique for evaluating all the forces for (driving) and against (restraining) a proposed change

Used to decide whether a proposed change can be implemented successfully

Used to develop strategies that will enable successful implementation of a change




Plan

Change to bedside shift handover

Critical incidents on the increase

Staff knowledgeable in change management

Increase in discharge against medical advice

Complaints from patients and doctors increasing

Care given predominantly biomedical in orientation

Ritualism and tradition

Fear that this may lead to more work

Fear of increased accountability

Problems associated with late arrivals

Possible disclosure of confidential information

Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion

The tools and techniques outlined in this chapter are intended to help organizations along the path of continuous improvement The choice of tool and when to use that tool are dependent on the problem to be solved In many situations several tools from this and other chapters should be used to ensure that the best possible solution has been found


End of Chapter 6


OPERATIONS HEALTHCARE

MANAGEMENT $ amp amp ( $

D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity

A diamond is used to

show those point in the

process where a choice

can be made or

alternate paths can be

followed

Arrows show the

direction of flow of

the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts

An oval is used to show

inputsoutputs to the

process or startend of the

process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program


with mapping the process from the point of view of the customer The typi-cal purpose of a service blueprint is to identify points where the service mightfail to satisfy the customer and then redesign or add controls to the systemto reduce or eliminate the possibility of failure The service blueprint sepa-rates onstage actions (those visible to the customer) and backstage actionsand support processes (those not visible to the customer) A service blueprintspecifies the line of interaction where the customer and service providercome together and the line of visibility that is what the customer sees orexperiences the tangible evidence that influences perceptions of the qualityof service (Figure 65)

Problem Identification Tools

Root-Cause AnalysisRoot-cause analysis (RCA) is a generic term used to describe structuredstep-by-step techniques for problem solving It aims to determine and cor-rect the ultimate cause(s) of a problem not just the visible symptoms toensure that the problem does not happen again RCA consists of determin-ing what happened why it happened and what can be done to prevent itfrom happening again

The Joint Commission (2005b) requires all accredited organizationsto conduct an RCA of any sentinel event (an unexpected occurrence involv-ing death or serious physical or psychological injury or the risk thereof) andprovides some tools (Joint Commission 2005a) to help an organization con-duct that analysis These tools are not only useful for sentinel events and JointCommission requirements but they also provide a framework for any RCAA variety of commercial software is also available for RCAs

FIGURE 65 ServiceBlueprintCustomer

actionsLine of interaction

Customer givesprescription to

clerk

Customerreceivesmedicine

Pharmacistgives medicine

to clerk

Pharmacistfills

prescription

Clerkentersdata

Clerk gives prescription to

pharmacist

Clerkretrievesmedicine

Clerk givesmedicine to

customer

Onstageactions

Backstageactions

Line of visibility

Healthcare Operations Management142

Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

tubi

ngav

aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

Was

the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

Oth

er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

Syri

nges

retr

ieve

d fr

om

Pixi

s an

d ca

rt re

stoc

ked

OR NurseHolding Room NurseOR Nursing Assistant

Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

Pati

ents

is s

have

d by

O

R N

A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map

Cause-and-Effect Diagram Template

Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions

Decision Tree ExampleThis problem is solved using Pallisade PrecisionTree (decision tree software) A 10-day free trial version is available at wwwpalisadecomtrialsaspA tutorial for using Precision Tree can be found at wwwpalisadecomprecisiontree5tipsengsThe problem setup is shown on the Problem tab of this file

Problem

HMO vaccination decision
Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability
Risk Profile For HMO vaccination decision of Book6

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value
Cumulative Probability
Cumulative Probability For HMO vaccination decision of Book6

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability
Scatter Profile For HMO vaccination decision of Book6

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo


2 Determine the boundaries of the process (where does it start and end) andthe level of detail desired The level of detail desired or needed willdepend on the question or problem the team is addressing

3 Brainstorm the major process tasks and subtasks List them and arrangethem in order (Sticky notes are often helpful here)

FIGURE 61 Mind MapHigh AccountsReceivables

NOTE Diagram created in Inspiration by Inspiration Software Inc

Dataentryerror

Doctorcoding

Incorrectcoding

Incorrectinformation

Documentationproblems

Insufficientinformation

Electronicmedicalrecords

Slowbilling

Slowpayment

or nopayment

Claimdenied

Procedurenot medically

necessary

Complicatedsystem

Newcomputersystems

FundingMissingrevenue

Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions

DRG Linear Programming ExampleThe problem data and setup are shown on the worksheetTo solve the problem using Excel SolverOn the worksheet titled Problem Data and Setup choose Tools -gt Solver (If you do not see Solver in Tools you may need to go to Tools -gt Add-Ins and check the Solver Add-In box) Set target cell $I$9 Equal to Max By changing cells $B$13$E$13 Subject to the constraints $B$13gt=$B$11 $C$13gt=$C$11 $D$13gt=$D$11 $E$13gt=$E$11 $I$4lt=$G$4 $I$5lt=$G$5 $I$6lt=$G$6 $I$7lt=$G$7 The click on Solve

Problem Data and Setup

Answer Report 1

Sensitivity Report 1

Limits Report 1

FMEA Instructions

A typical FMEA consists of the following steps1 Identify the process to be analyzed Typically this is a main process for the organization2 Assemble and train the team Processes usually cross functional boundaries and therefore the analysis should be performed by a team of relevant personnel No one person or persons from a single functional area will have the knowledge needed to perform the analysis3 Develop a detailed process flowchart including all steps in the process 4 Identify each step (or function) in the process5 Identify potential failures (or failure modes) at each step in the process Note that there may be more than one potential failure at each step6 Determine the worst potential consequence (or effect) of each possible failure7 Identify the cause(s) (contributory factors) of each potential failure A root cause analysis can be helpful in this step Note that there may be more than one cause for each potential failure8 Identify any failure ldquocontrolsrdquo currently present A control reduces the likelihood of causes or failure occurring reduces the severity of an effect or enables the detection of the occurrence of a cause or failure before it leads to the adverse effect9 Rate the severity of each effect (on a scale of 1-10 with 10 being the most severe) This rating should reflect the impact of any controls that reduce the severity of the effect10 Rate the likelihood (occurrence score) of each cause occurring (on a scale of 1-10 with 10 being certain to occur) This rating should reflect the impact of any controls that reduce the likelihood of occurrence11 Rate the effectiveness of each control (on a scale of 1-10 with 1 being an error free detection system)12 Multiply the three ratings by one another to obtain the Risk Priority Number (RPN) for each cause or contributory factor13 Use the RPNs to prioritize problems for corrective action All causes which result in an effect with a severity of 10 should be high on the priority list regardless of RPN14 Develop an improvement plan to address the targeted causes (who when how assessed etc)

FEMA Worksheet

FEMA Example

FMEA PROJECT Patient Fall Reduction

FMEA goal 50 reduction of preventable patient falls in 2008

Project leader Abby Lin

Team members Kevin Smith Jessie Jones Brit Johnson

Date prepared October 13 2007

Results

Step(s) in the Process Potential Failure Mode Failure Cause(s) Failure Effect(s) Severity (1-10) Probability of Occurrence (1-10) Existing Control(s) Probability of Detection (1-10) Risk Priority Number (RPN) Recommended Actions Responsibility Target Date Outcome Measure Action Complete New Severity New Occurrence New Detection New RPN

Fall assessment upon admission Fall Anethesia Potential injury 10 1 1 10 Amublation assistance for the first 24 hours after admission 0

No asssesment Lack of complete patient history information Inaccurate fall risk assigned to patient 8 2 2 32 Chart audits to assure admission evalution 0

Incorrect fall assessment Fall Slip or trip due to wet floor trip hazards patient urgency Potential Injury 8 1 Patients assigned fall risk category 1 8 0

Patient not identified as having a high fall risk Incorrect use of assessment Lack of fall interventions 7 2 2 28 Training on fall assessment and prevention Monitor falls to insure that risks and preventions are identified 0

Medication issues Over-medication Patients are admitted in an agitated state requiring stronger medication Drowsiness leading to a fall 8 3 2 48 Medication training to make clinicians aware of sedative potential of medications Post alerts on patients with high medication Include fall risk in shift assessment 0

Medications increase ataxia andor drowsiness Medications have sedating and ataxic effects Potential Injury 9 8 2 144 Staff training on medication effectsInclude fall risk in shift assessment 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

Microsoft Excel 110 Limits Report

Worksheet [LP examplexls]Limits Report 1

Report Created 6272006 30702 PM

Target

Cell Name Value

$I$9 Margin Total $ 4345400

Adjustable Lower Target Upper Target

Cell Name Value Limit Result Limit Result

$B$13 Optimal Cases Respiratory 15 15 43454 15 43454

$C$13 Optimal Cases Coronary Surgery 12 10 38454 12 43454

$D$13 Optimal Cases BirthDelivery 20 20 43454 20 43454

$E$13 Optimal Cases AlcoholDrug Abuse 2908 10 42500 2908 43454

Microsoft Excel 110 Sensitivity Report

Worksheet [LP examplexls]Setup (2)


Adjustable Cells

Final Reduced

Cell Name Value Gradient

$B$13 Optimal Cases Respiratory 15 -6148

$C$13 Optimal Cases Coronary Surgery 12 0

$D$13 Optimal Cases BirthDelivery 20 -2094

$E$13 Optimal Cases AlcoholDrug Abuse 2908 0

Constraints

Final Lagrange

Cell Name Value Multiplier

$I$4 Diagnostic Services (hours) Total 29408 0

$I$5 ICU Bed Days Total 55 9648

$I$6 Routine Bed Days Total 40256 0

$I$7 Nursing Care (hours) Total 3800 1

Microsoft Excel 110 Answer Report



Target Cell (Max)

Cell Name Original Value Final Value

$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells


$B$13 Optimal Cases Respiratory 1 15


$D$13 Optimal Cases BirthDelivery 1 20


Constraints

Cell Name Cell Value Formula Status Slack

$I$4 Diagnostic Services (hours) Total 29408 $I$4lt=$G$4 Not Binding 3092

$I$5 ICU Bed Days Total 55 $I$5lt=$G$5 Binding 0

$I$6 Routine Bed Days Total 40256 $I$6lt=$G$6 Not Binding 1744

$I$7 Nursing Care (hours) Total 3800 $I$7lt=$G$7 Binding 0

$E$13 Optimal Cases AlcoholDrug Abuse 2908 $E$13gt=$E$11 Not Binding 1908

$D$13 Optimal Cases BirthDelivery 20 $D$13gt=$D$11 Binding 0

$C$13 Optimal Cases Coronary Surgery 12 $C$13gt=$C$11 Not Binding 2

$B$13 Optimal Cases Respiratory 15 $B$13gt=$B$11 Binding 0

DRG

Respiratory Coronary Surgery BirthDelivery AlcoholDrug Abuse Available Actual

Resources

Diagnostic Services (hours) 7 10 2 1 325 20

ICU Bed Days 1 25 05 0 55 4

Routine Bed Days 5 7 2 7 420 21

Nursing Care (hours) 50 88 27 50 3800 215

Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000

Minimum Cases 15 10 20 10

Optimal Cases 1 1 1 1

4 1 0

prob of Flu outbreak 07 -10 -1 10 -1 10 0 07




600 0

0 0

0 Flu

-7 0

400 0

0 0

Vaccination program 1

0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0

600 Vaccination Program 2

0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0

1 1 Program 3 2 No program

1 -7 1 -12 042

2 -8 028

3 0 03

DEFAULT SCALING HISTOGRAM OF PROFILE DATA

xMin -14 yMin 0 Midpoint 1 Program 2 No program

xMax 2 yMax 12 -14 0 0

Intervals 400 yUnit 02 -1396 0 0

-1392 0 0

RAW PROFILE DATA -1388 0 0

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2 -8 028 -1376 0 0

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-1 1 07

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-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0

Policy Suggestion for HMO vaccination decision of Book6

700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7

PrecisionTree Statistics Report

For HMO vaccination decision of Book6

Created on 172006 at 33050 PM

Vaccination program 1 1 Program 2 No program

STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0

Name HMO vaccination decision FILEVER 2

SheetRef 0 RETFUNC 0

GenInfo 01100Exponential 00-10-1

Def Link =

EXT REFS 0

Def Form

Highest 13

Kernel BName bformtype valformula pbformula distribution cumPayoffFunction link ENDNODEFORMULA VAL PB GenInfo IntRefs RefRefs NodeNames

0 HMO vaccination decision 0 0 0 200223000 0 Vaccination program 1

0 Program 0 DEFAULT -7 100245100 0 Flu

0 No program 0 DEFAULT 0 100267100 0 Flu

0 Flu outbreak 0 DEFAULT 0 07 4000200 0

0 No flu outbreak 0 DEFAULT DEFAULT 0 03 4000200 0

0 Flu outbreak 0 DEFAULT 0 07 200289300 0 Vaccination Program 2


0 Program 0 DEFAULT -7 10021213600 0 Costs

0 No program 0 DEFAULT 0 10021011600 0 Costs

0 C 0 DEFAULT DEFAULT -12 06 4000900 0

0 D 0 DEFAULT DEFAULT -8 04 4000900 0

0 A 0 DEFAULT DEFAULT -6 06 4000800 0

0 B 0 DEFAULT DEFAULT -4 04 4000800 0




Def Link =

EXT REFS 0

Def Form

Highest 13















Initial Vaccination Program No Initial Vaccination Program

X P X P

1 minus7 1 minus12 042

2 minus8 028

3 0 030

Role

Activity Clerk Nurse Porter Doctor

Take insurance information x

Move patient x x

Record vital signs x x

Take history x x

Examine patient x

Write pathology request x

Deliver pathology request x

Key Elements Barriers to Brilliant Decision Making

Framing the question Plunging inFrame blindnessLack of frame control

Gathering intelligence Overconfidence in your judgment Shortsighted shortcuts

Coming to conclusions Shooting from the hipGroup failure

Learningfailing to learn from feedback Fooling yourself about feedbackNot keeping trackFailing to audit your decision process


Downloadable Resources

PowerPoint Slides for Chapter 6

To access a PowerPoint presentation covering the key points of Chapter 6 click on the icon below to

openclose the attachments panel

HC Ops 2 slides - Chapter 6ppt

Templates

Fishbone Template

A cause-and-effect diagram is a graphic tool used to explore and display all the potential causes

of a problem The cause-and-effect diagram is sometimes called an Ishikawa diagram (after its

inventor professor Kaoru Ishikawa) or a fishbone diagram (because it resembles the skeleton of

a fish) The fishbone diagram is one of the seven basic quality tools To access a fishbone

diagram template click on the icon below to openclose the attachments panel

Ch 6 Fishbone Templatedoc

Failure Mode and Effects Analysis (FMEA) Template

FMEA was developed by the US military in the late 1940s Originally FMEA was used to assess

equipment failure More recently many service industries including the healthcare industry

have adopted it to evaluate process failure Hospitals accredited by The Joint Commission are

required to conduct at least one FMEA or similar proactive analysis annually Root cause

analysis is used to examine the underlying causes of an event or failure whereas FMEA is used

to identify the ways in which a process (or a piece of equipment) could fail and to eliminate or

reduce the severity of the potential failure A template for FMEA is available by clicking on the





Mind Mapping




ex63pdf

Process Maps




ex66pdf



ex64pdf



ex65pdf







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ex68pdf










Decision Trees











Software







Tools


Chapter 6



Improvement



Root Cause Analysis





Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

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can be made or


followed

Arrows show the


the process

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loop

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used to show

delays

Block arr

ows

are used to

show

transpo

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process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

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vaccination

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Flu

outbreak

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outbreak

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outbreak

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program

C

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Choose this

path because

expected

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Choose this

path because

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costs of $7

million are

less than

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Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

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-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

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-872 0 042

-868 0 042

-864 0 042

-86 0 042

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-852 0 042

-848 0 042

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-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

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-748 0 07

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-74 0 07

-736 0 07

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-728 0 07

-724 0 07

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-704 0 07

-7 1 07

-696 1 07

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-684 1 07

-68 1 07

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-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

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-452 1 07

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-44 1 07

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-424 1 07

-42 1 07

-416 1 07

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-4 1 07

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-384 1 07

-38 1 07

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-372 1 07

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-34 1 07

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-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x












Mind Mapping




ex63pdf

Process Maps




ex66pdf



ex64pdf



ex65pdf







ex67pdf








ex68pdf










Decision Trees











Software







Tools


Chapter 6



Improvement



Root Cause Analysis





Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

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aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

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the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

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er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

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nges

retr

ieve

d fr

om

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s an

d ca

rt re

stoc

ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

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ents

is s

have

d by

O

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efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

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-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

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-1064 0 042

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-102 0 042

-1016 0 042

-1012 0 042

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-10 0 042

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-984 0 042

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-94 0 042

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-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

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-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x










ex65pdf







ex67pdf








ex68pdf










Decision Trees











Software







Tools


Chapter 6



Improvement



Root Cause Analysis





Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

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show a

task or

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can be made or


followed

Arrows show the


the process

End

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used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

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Vaccination 4000

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Costs

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3000 -8-8

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HMO

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decision

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outbreak

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outbreak

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No

program

C

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A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



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Sw

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Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

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-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

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-1136 0 042

-1132 0 042

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-1112 0 042

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-11 0 042

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-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

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-94 0 042

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-92 0 042

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-904 0 042

-9 0 042

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-88 0 042

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-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x

















Decision Trees











Software







Tools


Chapter 6



Improvement



Root Cause Analysis





Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

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13

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13

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13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

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-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x









Software







Tools


Chapter 6



Improvement



Root Cause Analysis





Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

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process

70007

0-7

Flu

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Costs

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decision

Program

Flu

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No flu

outbreak

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outbreak

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Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

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program









clerk



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have

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to tr

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Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

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-1208 0 0

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-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

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-114 0 042

-1136 0 042

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-11 0 042

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-1064 0 042

-106 0 042

-1056 0 042

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-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

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-968 0 042

-964 0 042

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-6 1 07

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-584 1 07

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-5 1 07

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-42 1 07

-416 1 07

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-4 1 07

-396 1 07

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-384 1 07

-38 1 07

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-36 1 07

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-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x









Tutorials



Microsoft Visio











Demonstrations










People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

tubi

ngav

aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

Was

the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

Oth

er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

Syri

nges

retr

ieve

d fr

om

Pixi

s an

d ca

rt re

stoc

ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

Pati

ents

is s

have

d by

O

R N

A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

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-1336 0 0

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-126 0 0

-1256 0 0

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-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

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-86 0 042

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-852 0 042

-848 0 042

-844 0 042

-84 0 042

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-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

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-748 0 07

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-724 0 07

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-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

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-668 1 07

-664 1 07

-66 1 07

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-652 1 07

-648 1 07

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-64 1 07

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-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

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-472 1 07

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-46 1 07

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-452 1 07

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-44 1 07

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-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

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-404 1 07

-4 1 07

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-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x









People


Buzan Tony


Lewin Kurt

Organizations








Case Studies

















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

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riev

e IV

tubi

ng

from

SP

D c

art

Is IV

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onth

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rt

Clea

n to

p of

IV c

art

Was

the

cart

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ked

by

phar

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y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

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er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

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nges

retr

ieve

d fr

om

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s an

d ca

rt re

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ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

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ents

is s

have

d by

O

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A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x



















Prentice-Hall




Harper






39






405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

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Vaccination 4000

Vaccination

700

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Program 2

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program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

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pharmacist



customer

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me

and

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Exhi

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7

Sw

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Proc

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Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

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-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

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-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

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-1136 0 042

-1132 0 042

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-1112 0 042

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-11 0 042

-1096 0 042

-1092 0 042

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-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

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-948 0 042

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-94 0 042

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-92 0 042

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-9 0 042

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-828 0 042

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-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

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-652 1 07

-648 1 07

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-64 1 07

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-628 1 07

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-62 1 07

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-612 1 07

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-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

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-544 1 07

-54 1 07

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-532 1 07

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-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x











405




FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

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People13

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13

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13

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13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

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cause13

13

cause13

13

cause13

13

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13

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13

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cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x









FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait





FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

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d P

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ss M

ap o

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OR

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e N

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pat

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wai

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be re

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to tr

ansp

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Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x









FIGURE 62 Riverview


Map


Visitcomplete

Wait

Patientarrives

Patientcheck-in

Wait

Move toexamining

room


exam

Wait

FIGURE 63 Riverview


PatientCheck-in

HIPAAforms

HIPAAon file

No

YesSame

Wait

Move toexamining

room

Patientarrives

Line

ChangedNew

Medicalinformation


No


Patienttype

Wait











transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

tubi

ngav

aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

Was

the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

Oth

er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

Syri

nges

retr

ieve

d fr

om

Pixi

s an

d ca

rt re

stoc

ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

Pati

ents

is s

have

d by

O

R N

A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

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-1364 0 0

-136 0 0

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-1256 0 0

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-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

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-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

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-114 0 042

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-1112 0 042

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-11 0 042

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-108 0 042

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-106 0 042

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-104 0 042

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-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

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-996 0 042

-992 0 042

-988 0 042

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-9 0 042

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-868 0 042

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-86 0 042

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-84 0 042

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-788 0 07

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-764 0 07

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-6 1 07

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-584 1 07

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-4 1 07

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-3 1 07

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-292 1 07

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-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

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-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

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-132 1 07

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-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x















transports


Feedbackloop


delays

Atriangle



End

Adiamond









Chapter 6



Framing


Root cause analysis


Decision trees

Optimization





Framing













4


1


2


3



on the ark

5



Mind Mapping



























Customer

gives

prescription

to clerk

Clerk enters

data

Clerk gives

prescription

to

pharmacist

Pharmacist

fills

prescription

Clerk gives

medicine to

customer

Clerk

retrieves

medicine

Pharmacist

gives

medicine to

clerk

Customer

receives

medicine

Line of interaction

Line of visibility

Customer

Actions

Onstage

Actions

Backstage

Actions


Root Cause Analysis



What happened

Why did it happen



Five Whys Technique






Waiting Time

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Elevators broken

Wheelchairs

unavailable


Process takes

too long

Excessive paperwork

Unexpected patients

Wrong patients

Staff not available

Corridor

blocked

Sick

Late

Files unorganized

Bureaucracy

Incorrect referrals

Lack of technology

Poor scheduling

Poor maintenance

HIPAA regulations

Waiting Time

Methods

Machines

Man

Mother Nature

(Environment)






Failure Mode

Failure Causes

Failure Effects

Likelihood of


Likelihood of


Severity (1ndash10)


(RPN)

Actions to Reduce


1

2

3

4

5

6

7

8
























Optimization


Resources

People

Money

Equipment

Linear or nonlinear

Goal or objective


Minimize cost



Optimization






Decision Trees
















Plan












Total 19

4

4

3

5

5

Total 21

Driving Forces

Restraining Forces

4

5

3

3

4

Total 19

Total 21


Conclusion



End of Chapter 6




D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

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program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

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Det

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d P

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ss M

ap o

f Hol

ding

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m (

part

II)

OR

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to c

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to re

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noth

er s

lip a

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r tr

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ter o

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for

open

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rt

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ery

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ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

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er s

urge

ry p

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nts

are

shav

edp

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in th

e O

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have

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ts fo

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r the

pat

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wai

ts fo

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tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















X P X P


2 minus8 028

3 0 030

Role



Move patient x x


Take history x x

Examine patient x










D ) B M L ) + - ) amp

J $ - R O $

A

rectangle

is used to

show a

task or

activity




can be made or


followed

Arrows show the


the process

End

Feedback

loop

D shapes are

used to show

delays

Block arr

ows

are used to

show

transpo

rts




process

70007

0-7

Flu

-7-7

30003 6000

0-7 -6-13

Costs

-7-122

Vaccination 4000

Vaccination

700

Vaccination

Program 2

-4-11

program 1 0-104 6000

-7 -12-12

Costs

Flu -104

0-728 04000

3000 -8-8

00

HMO

vaccination

decision

Program

Flu

outbreak

No flu

outbreak

Flu

outbreak

No flu

outbreak

Program

No

program

C

D

A

B

Choose this

path because

expected

costs of $104

million are

Choose this

path because

expected

costs of $7

million are

less than

$728 million

No

program









clerk



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Pharmacistfills

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Clerkentersdata


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Onstageactions

Backstageactions

Line of visibility


Det

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bit 6

7

Sw

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Proc

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Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

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-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

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-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

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-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13























clerk



to clerk

Pharmacistfills

prescription

Clerkentersdata


pharmacist



customer

Onstageactions

Backstageactions

Line of visibility


Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

tubi

ngav

aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

Was

the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

Oth

er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

Syri

nges

retr

ieve

d fr

om

Pixi

s an

d ca

rt re

stoc

ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

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in th

e O

R

Pati

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is s

have

d by

O

R N

A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

-356 1 07

-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13
















Det

aile

d P

roce

ss M

ap o

f Hol

ding

Roo

m (

part

II)

OR

NA

retu

rns

to c

ontr

ol d

esk

to re

trie

ve a

noth

er s

lip a

nd p

atie

nt

Yes

No

Ret

riev

e IV

tubi

ng

from

SP

D c

art

Is IV

tubi

ngav

aila

ble

onth

e ca

rt

Clea

n to

p of

IV c

art

Was

the

cart

re

stoc

ked

by

phar

mac

y w

ith

salin

e an

d he

pari

n sy

ring

es

Mul

tipl

e IV

bag

sar

e op

ened

and

spik

ed w

ith

IVtu

bing

SPD

is c

alle

dto

rest

ock

Oth

er it

ems

in IV

car

t are

re

stoc

ked

by a

nest

hesi

a te

chni

cian

(see

item

und

er

anes

thes

ia h

eadi

ng in

ho

ldin

g ro

om)

Syri

nges

retr

ieve

d fr

om

Pixi

s an

d ca

rt re

stoc

ked


Yes

No

Yes

No

Is p

atie

nt

read

y fo

r tr

ansp

ort

Ass

ists

pa

tien

t on

to th

e lit

ter o

r w

heel

chai

r

Is th

e pa

tien

t sc

hedu

led

for

open

-hea

rt

surg

ery

OR

NA

ver

ifies

the

pati

entrsquo

s na

me

and

SSN

wit

h sl

ip

Oth

er s

urge

ry p

atie

nts

are

shav

edp

repp

ed

in th

e O

R

Pati

ents

is s

have

d by

O

R N

A b

efor

e tr

ansp

ort

Wai

ts fo

r pat

ient

Wha

t det

erm

ines

ho

w lo

ng th

e N

A

wai

ts fo

r the

pat

ient

OR

NA

wai

ts fo

r pa

tien

t to

be re

ady

to tr

ansp

ort

Exhi

bit 6

7

Sw

im L

ane

Proc

ess

Map


Policies13

Materials13

13

Procedures13

Methods13

13

People13

Manpower13

13

PlantTechnology13

Machines13

13

Problem or Effect13

13

Measurements13

13

Category13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Problem or Effect13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

cause13

13

Mother Nature13

13

Category13

13

13

treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

-1352 0 0

-1348 0 0

-1344 0 0

-134 0 0

-1336 0 0

-1332 0 0

-1328 0 0

-1324 0 0

-132 0 0

-1316 0 0

-1312 0 0

-1308 0 0

-1304 0 0

-13 0 0

-1296 0 0

-1292 0 0

-1288 0 0

-1284 0 0

-128 0 0

-1276 0 0

-1272 0 0

-1268 0 0

-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

-1232 0 0

-1228 0 0

-1224 0 0

-122 0 0

-1216 0 0

-1212 0 0

-1208 0 0

-1204 0 0

-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

-1176 0 042

-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

-1148 0 042

-1144 0 042

-114 0 042

-1136 0 042

-1132 0 042

-1128 0 042

-1124 0 042

-112 0 042

-1116 0 042

-1112 0 042

-1108 0 042

-1104 0 042

-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

-1076 0 042

-1072 0 042

-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

-944 0 042

-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

-804 0 042

-8 0 07

-796 0 07

-792 0 07

-788 0 07

-784 0 07

-78 0 07

-776 0 07

-772 0 07

-768 0 07

-764 0 07

-76 0 07

-756 0 07

-752 0 07

-748 0 07

-744 0 07

-74 0 07

-736 0 07

-732 0 07

-728 0 07

-724 0 07

-72 0 07

-716 0 07

-712 0 07

-708 0 07

-704 0 07

-7 1 07

-696 1 07

-692 1 07

-688 1 07

-684 1 07

-68 1 07

-676 1 07

-672 1 07

-668 1 07

-664 1 07

-66 1 07

-656 1 07

-652 1 07

-648 1 07

-644 1 07

-64 1 07

-636 1 07

-632 1 07

-628 1 07

-624 1 07

-62 1 07

-616 1 07

-612 1 07

-608 1 07

-604 1 07

-6 1 07

-596 1 07

-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

-564 1 07

-56 1 07

-556 1 07

-552 1 07

-548 1 07

-544 1 07

-54 1 07

-536 1 07

-532 1 07

-528 1 07

-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

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0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

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064 1 1

068 1 1

072 1 1

076 1 1

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084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

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124 1 1

128 1 1

132 1 1

136 1 1

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148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

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184 1 1

188 1 1

192 1 1

196 1 1

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xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

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-8 0 028

-75 0 0

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-6 0 0

-55 0 0

-5 0 0

-45 0 0

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-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13















treeCalc_6

treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

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400 0

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600 0

-12 0

0 Costs

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400 0

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0 Flu

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400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



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-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

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-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

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164 1 1

168 1 1

172 1 1

176 1 1

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184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

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-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13


















Def Link =

EXT REFS 0

Def Form

Highest 13















treeCalc_1

Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

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084 1 1

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096 1 1

1 1 1

104 1 1

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132 1 1

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2 -8 028 -11 0 0

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-8 0 028

-75 0 0

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-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0




Def Link =

EXT REFS 0

Def Form

Highest 13















Instructions


Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

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0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

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400 0

0 0


0

600 0

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004 1 1

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024 1 1

028 1 1

032 1 1

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048 1 1

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056 1 1

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084 1 1

088 1 1

092 1 1

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-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

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-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0

Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



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-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

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016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

700 0

0 0

0 Flu

-7 0

300 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

300 0

0 0

Statistics

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

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-122 0 0

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-1212 0 0

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-12 0 042

-1196 0 042

-1192 0 042

-1188 0 042

-1184 0 042

-118 0 042

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-1172 0 042

-1168 0 042

-1164 0 042

-116 0 042

-1156 0 042

-1152 0 042

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-1144 0 042

-114 0 042

-1136 0 042

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-1128 0 042

-1124 0 042

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-11 0 042

-1096 0 042

-1092 0 042

-1088 0 042

-1084 0 042

-108 0 042

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-1068 0 042

-1064 0 042

-106 0 042

-1056 0 042

-1052 0 042

-1048 0 042

-1044 0 042

-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

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-932 0 042

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-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

-864 0 042

-86 0 042

-856 0 042

-852 0 042

-848 0 042

-844 0 042

-84 0 042

-836 0 042

-832 0 042

-828 0 042

-824 0 042

-82 0 042

-816 0 042

-812 0 042

-808 0 042

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-664 1 07

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-62 1 07

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-592 1 07

-588 1 07

-584 1 07

-58 1 07

-576 1 07

-572 1 07

-568 1 07

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-56 1 07

-556 1 07

-552 1 07

-548 1 07

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-54 1 07

-536 1 07

-532 1 07

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-524 1 07

-52 1 07

-516 1 07

-512 1 07

-508 1 07

-504 1 07

-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

-464 1 07

-46 1 07

-456 1 07

-452 1 07

-448 1 07

-444 1 07

-44 1 07

-436 1 07

-432 1 07

-428 1 07

-424 1 07

-42 1 07

-416 1 07

-412 1 07

-408 1 07

-404 1 07

-4 1 07

-396 1 07

-392 1 07

-388 1 07

-384 1 07

-38 1 07

-376 1 07

-372 1 07

-368 1 07

-364 1 07

-36 1 07

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-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7





STATISTICS

Mean -7 -728

Minimum -7 -12

Maximum -7 0

Mode -7 -12

Std Dev 0 504

Skewness 0 05583270345

Kurtosis 0 16291297236

PROFILE

X P X P

1 -7 1 -12 042

2 -8 028

3 0 03

PolicySuggestion

Program
Flu outbreak
No flu outbreak

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

-1356 0 0

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-13 0 0

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-1292 0 0

-1288 0 0

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-1272 0 0

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-1264 0 0

-126 0 0

-1256 0 0

-1252 0 0

-1248 0 0

-1244 0 0

-124 0 0

-1236 0 0

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-1228 0 0

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-1216 0 0

-1212 0 0

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-1204 0 0

-12 0 042

-1196 0 042

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-1184 0 042

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-1168 0 042

-1164 0 042

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-114 0 042

-1136 0 042

-1132 0 042

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-104 0 042

-1036 0 042

-1032 0 042

-1028 0 042

-1024 0 042

-102 0 042

-1016 0 042

-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

-984 0 042

-98 0 042

-976 0 042

-972 0 042

-968 0 042

-964 0 042

-96 0 042

-956 0 042

-952 0 042

-948 0 042

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-94 0 042

-936 0 042

-932 0 042

-928 0 042

-924 0 042

-92 0 042

-916 0 042

-912 0 042

-908 0 042

-904 0 042

-9 0 042

-896 0 042

-892 0 042

-888 0 042

-884 0 042

-88 0 042

-876 0 042

-872 0 042

-868 0 042

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-852 0 042

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-832 0 042

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-824 0 042

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-812 0 042

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-792 0 07

-788 0 07

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-776 0 07

-772 0 07

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-76 0 07

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-588 1 07

-584 1 07

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-572 1 07

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-508 1 07

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-5 1 07

-496 1 07

-492 1 07

-488 1 07

-484 1 07

-48 1 07

-476 1 07

-472 1 07

-468 1 07

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-448 1 07

-444 1 07

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-412 1 07

-408 1 07

-404 1 07

-4 1 07

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-392 1 07

-388 1 07

-384 1 07

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-372 1 07

-368 1 07

-364 1 07

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-352 1 07

-348 1 07

-344 1 07

-34 1 07

-336 1 07

-332 1 07

-328 1 07

-324 1 07

-32 1 07

-316 1 07

-312 1 07

-308 1 07

-304 1 07

-3 1 07

-296 1 07

-292 1 07

-288 1 07

-284 1 07

-28 1 07

-276 1 07

-272 1 07

-268 1 07

-264 1 07

-26 1 07

-256 1 07

-252 1 07

-248 1 07

-244 1 07

-24 1 07

-236 1 07

-232 1 07

-228 1 07

-224 1 07

-22 1 07

-216 1 07

-212 1 07

-208 1 07

-204 1 07

-2 1 07

-196 1 07

-192 1 07

-188 1 07

-184 1 07

-18 1 07

-176 1 07

-172 1 07

-168 1 07

-164 1 07

-16 1 07

-156 1 07

-152 1 07

-148 1 07

-144 1 07

-14 1 07

-136 1 07

-132 1 07

-128 1 07

-124 1 07

-12 1 07

-116 1 07

-112 1 07

-108 1 07

-104 1 07

-1 1 07

-096 1 07

-092 1 07

-088 1 07

-084 1 07

-08 1 07

-076 1 07

-072 1 07

-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1



xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

-95 0 0

-9 0 0

-85 0 0

-8 0 028

-75 0 0

-7 1 0

-65 0 0

-6 0 0

-55 0 0

-5 0 0

-45 0 0

-4 0 0

-35 0 0

-3 0 0

-25 0 0

-2 0 0

-15 0 0

-1 0 0

-05 0 0

0 0 03

05 0 0

1 0 0

15 0 0

2 0 0


700 07

0 -7

Flu

-7 -7

300 03

0 -7


-7

RiskProfile

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





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-7 0

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0 Costs

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0 Flu

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0 0


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2 -8 028

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0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

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048 1 1

052 1 1

056 1 1

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072 1 1

076 1 1

08 1 1

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092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

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124 1 1

128 1 1

132 1 1

136 1 1

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144 1 1

148 1 1

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168 1 1

172 1 1

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188 1 1

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xMax 2 yMax 12 -14 0 0


-13 0 0



1 -7 1 -12 042 -115 0 0

2 -8 028 -11 0 0

3 0 03 -105 0 0

-10 0 0

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-9 0 0

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-75 0 0

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-15 0 0

-1 0 0

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0 0 03

05 0 0

1 0 0

15 0 0

2 0 0

RiskProfile

1 Program
2 No program
Value
Probability

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

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-1012 0 042

-1008 0 042

-1004 0 042

-10 0 042

-996 0 042

-992 0 042

-988 0 042

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-332 1 07

-328 1 07

-324 1 07

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-104 1 07

-1 1 07

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-092 1 07

-088 1 07

-084 1 07

-08 1 07

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-068 1 07

-064 1 07

-06 1 07

-056 1 07

-052 1 07

-048 1 07

-044 1 07

-04 1 07

-036 1 07

-032 1 07

-028 1 07

-024 1 07

-02 1 07

-016 1 07

-012 1 07

-008 1 07

-004 1 07

0 1 1

004 1 1

008 1 1

012 1 1

016 1 1

02 1 1

024 1 1

028 1 1

032 1 1

036 1 1

04 1 1

044 1 1

048 1 1

052 1 1

056 1 1

06 1 1

064 1 1

068 1 1

072 1 1

076 1 1

08 1 1

084 1 1

088 1 1

092 1 1

096 1 1

1 1 1

104 1 1

108 1 1

112 1 1

116 1 1

12 1 1

124 1 1

128 1 1

132 1 1

136 1 1

14 1 1

144 1 1

148 1 1

152 1 1

156 1 1

16 1 1

164 1 1

168 1 1

172 1 1

176 1 1

18 1 1

184 1 1

188 1 1

192 1 1

196 1 1

2 1 1

CumulativeProfile

Options

CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0


1 -7 1 -12 042

2 -8 028

3 0 03



xMax 2 yMax 12 -14 0 0


-1392 0 0



1 -7 1 -12 042 -138 0 0

2 -8 028 -1376 0 0

3 0 03 -1372 0 0

-1368 0 0

-1364 0 0

-136 0 0

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CumulativeProfile

1 Program
2 No program
Value

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

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0 Costs

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1 -7 1 -12 042

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3 0 03

ScatterProfile

Options

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





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0 0


1 -7 1 -12 042

2 -8 028

3 0 03

ScatterProfile

1 Program
2 No program
Value
Probability

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

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0

600 0

-6 0

0 Costs

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400 0

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0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

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0 0

400 0

0 0

New Problem

Program
No program
Flu outbreak
No flu outbreak
Flu outbreak
No flu outbreak
Program
No program
C
D
A
B

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








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0 0

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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0





600 0

0 0

0 Flu

-7 0

400 0

0 0


0

600 0

-6 0

0 Costs

-7 0

400 0

-4 0


0 0

600 0

-12 0

0 Costs

0 0

400 0

-8 0

0 Flu

0 0

400 0

0 0

sensInfo






Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

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0 0

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0 0

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0 0

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0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



4 1 0










Dataentryerror

Doctorcoding

Incorrectcoding





Slowbilling

Slowpayment

or nopayment

Claimdenied


necessary

Complicatedsystem

Newcomputersystems


Privateinsurance

Identifyand fix

systematicproblems

MedicareMedicaid

Noinsurance

Type ofinsurance

Highaccounts

receivable

Procedurenot

covered

JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text
JAS
Typewritten Text

Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



Instructions



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

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0 0

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0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000




Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints










DRG


Resources


ICU Bed Days 1 25 05 0 55 4



Margin $ 40000 $ 250000 $ 30000 $ 5000 $ 325000



Answer Report 1


Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

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Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange









Target Cell (Max)


$I$9 Margin Total $ 325000 $ 4345400

Adjustable Cells






Constraints











Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

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0 0

0 0

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0 0

0 0

0 0




Target

Cell Name Value











Adjustable Cells

Final Reduced






Constraints

Final Lagrange






Limits Report 1

FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

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0 0

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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

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Target

Cell Name Value








FMEA Instructions


FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

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0 0

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0 0

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FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FEMA Worksheet

FEMA Example






Results








0 0

0 0

0 0

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0 0

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0 0

0 0

0 0

0 0

0 0

0 0

0 0

FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

Results


0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

FEMA Example






Results








0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

Initial Vaccination Program	No Initial Vaccination Program

	X	P	X	P

1	minus7	1	minus12	042

2	minus8	028

3	0	030

Role

Activity	Clerk	Nurse	Porter	Doctor

Take insurance information	x

Move patient	x	x

Record vital signs	x	x

Take history	x	x

Examine patient	x

Write pathology request	x

Deliver pathology request	x

Key Elements		Barriers to Brilliant Decision Making

Framing the question		Plunging inFrame blindnessLack of frame control

Gathering intelligence		Overconfidence in your judgment Shortsighted shortcuts

Coming to conclusions		Shooting from the hipGroup failure

Learningfailing to learn from feedback		Fooling yourself about feedbackNot keeping trackFailing to audit your decision process



FMEA PROJECT Patient Fall Reduction

FMEA goal			50 reduction of preventable patient falls in 2008

Project leader			Abby Lin

Team members			Kevin Smith Jessie Jones Brit Johnson

Date prepared			October 13 2007

												Results

Step(s) in the Process		Potential Failure Mode		Failure Cause(s)		Failure Effect(s)		Severity (1-10)		Probability of Occurrence (1-10)	Existing Control(s)		Probability of Detection (1-10)		Risk Priority Number (RPN)		Recommended Actions	Responsibility	Target Date	Outcome Measure		Action Complete	New Severity	New Occurrence	New Detection	New RPN

Fall assessment upon admission		Fall		Anethesia		Potential injury		10		1		1		10		Amublation assistance for the first 24 hours after admission						0

	No asssesment		Lack of complete patient history information		Inaccurate fall risk assigned to patient		8		2		2		32		Chart audits to assure admission evalution						0

Incorrect fall assessment		Fall		Slip or trip due to wet floor trip hazards patient urgency		Potential Injury		8		1	Patients assigned fall risk category		1		8							0

	Patient not identified as having a high fall risk		Incorrect use of assessment		Lack of fall interventions		7		2		2		28		Training on fall assessment and prevention Monitor falls to insure that risks and preventions are identified						0

Medication issues		Over-medication		Patients are admitted in an agitated state requiring stronger medication		Drowsiness leading to a fall		8		3		2		48		Medication training to make clinicians aware of sedative potential of medications Post alerts on patients with high medication Include fall risk in shift assessment						0

	Medications increase ataxia andor drowsiness		Medications have sedating and ataxic effects		Potential Injury		9		8		2		144		Staff training on medication effectsInclude fall risk in shift assessment						0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0

								0									0



FMEA PROJECT

FMEA goal

Project leader

Team members

Date prepared

							Results

Step(s) in the Process	Potential Failure Mode	Failure Cause(s)	Failure Effect(s)	Severity (1-10)	Probability of Occurrence (1-10)	Existing Control(s)		Probability of Detection (1-10)	Risk Priority Number (RPN)	Recommended Actions	Responsibility	Target Date	Outcome Measure	Action Complete	New Severity	New Occurrence	New Detection	New RPN

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

				0						0

Microsoft Excel 110 Limits Report

Worksheet [LP examplexls]Limits Report 1

Report Created 6272006 30702 PM

		Target

	Cell		Name	Value

	$I$9		Margin Total	$ 4345400

		Adjustable			Lower	Target		Upper	Target

	Cell		Name	Value		Limit	Result		Limit	Result

	$B$13		Optimal Cases Respiratory	15		15	43454		15	43454

	$C$13		Optimal Cases Coronary Surgery	12		10	38454		12	43454

	$D$13		Optimal Cases BirthDelivery	20		20	43454		20	43454

	$E$13		Optimal Cases AlcoholDrug Abuse	2908		10	42500		2908	43454

Microsoft Excel 110 Sensitivity Report

Worksheet [LP examplexls]Setup (2)

Report Created 6272006 30702 PM

Adjustable Cells

		Final	Reduced

	Cell	Name	Value	Gradient

	$B$13	Optimal Cases Respiratory	15	-6148

	$C$13	Optimal Cases Coronary Surgery	12	0

	$D$13	Optimal Cases BirthDelivery	20	-2094

	$E$13	Optimal Cases AlcoholDrug Abuse	2908	0

Constraints

		Final	Lagrange

	Cell	Name	Value	Multiplier

	$I$4	Diagnostic Services (hours) Total	29408	0

	$I$5	ICU Bed Days Total	55	9648

	$I$6	Routine Bed Days Total	40256	0

	$I$7	Nursing Care (hours) Total	3800	1

	DRG

	Respiratory		Coronary Surgery		BirthDelivery		AlcoholDrug Abuse		Available		Actual

Resources

Diagnostic Services (hours)		7		10		2		1		325		20

ICU Bed Days		1		25		05		0		55		4

Routine Bed Days		5		7		2		7		420		21

Nursing Care (hours)		50		88		27		50		3800		215

Margin		$ 40000		$ 250000		$ 30000		$ 5000			$ 325000

Minimum Cases		15		10		20		10

Optimal Cases		1		1		1		1

4	1	0

prob of Flu outbreak	07	-10	-1	10	-1	10	0	07

prob of Flu outbreak	07	-10	-1	10	-1	10	0	07

prob of Flu outbreak	06	-10	-1	10	-1	10	0	06

prob of Flu outbreak	06	-10	-1	10	-1	10	0	06



	600		0

	0		0

0		Flu

-7		0

	400		0

	0		0

Vaccination program 1

0

			600		0

			-6		0

		0		Costs

		-7		0

			400		0

			-4		0

	600		Vaccination Program 2

	0		0

			600		0

			-12		0

		0		Costs

		0		0

			400		0

			-8		0

0		Flu

0		0

	400		0

	0		0

DEFAULT SCALING				HISTOGRAM OF PROFILE DATA

xMin	-14	yMin	0				Midpoint		1 Program		2 No program

xMax	2	yMax	12				-14		0		0

Intervals	400	yUnit	02				-1396		0		0

			-1392		0		0

RAW PROFILE DATA				-1388		0		0

	1	1 Program	3		2 No program			-1384		0		0

1	-7	1	-12		042			-138		0		0

2		-8	028			-1376		0		0

3		0	03			-1372		0		0

			-1368		0		0

			-1364		0		0

			-136		0		0

			-1356		0		0

			-1352		0		0

			-1348		0		0

			-1344		0		0

			-134		0		0

			-1336		0		0

			-1332		0		0

			-1328		0		0

			-1324		0		0

			-132		0		0

			-1316		0		0

			-1312		0		0

			-1308		0		0

			-1304		0		0

			-13		0		0

			-1296		0		0

			-1292		0		0

			-1288		0		0

			-1284		0		0

			-128		0		0

			-1276		0		0

			-1272		0		0

			-1268		0		0

			-1264		0		0

			-126		0		0

			-1256		0		0

			-1252		0		0

			-1248		0		0

			-1244		0		0

			-124		0		0

			-1236		0		0

			-1232		0		0

			-1228		0		0

			-1224		0		0

			-122		0		0

			-1216		0		0

			-1212		0		0

			-1208		0		0

			-1204		0		0

			-12		0		042

			-1196		0		042

			-1192		0		042

			-1188		0		042

			-1184		0		042

			-118		0		042

			-1176		0		042

			-1172		0		042

			-1168		0		042

			-1164		0		042

			-116		0		042

			-1156		0		042

			-1152		0		042

			-1148		0		042

			-1144		0		042

			-114		0		042

			-1136		0		042

			-1132		0		042

			-1128		0		042

			-1124		0		042

			-112		0		042

			-1116		0		042

			-1112		0		042

			-1108		0		042

			-1104		0		042

			-11		0		042

			-1096		0		042

			-1092		0		042

			-1088		0		042

			-1084		0		042

			-108		0		042

			-1076		0		042

			-1072		0		042

			-1068		0		042

			-1064		0		042

			-106		0		042

			-1056		0		042

			-1052		0		042

			-1048		0		042

			-1044		0		042

			-104		0		042

			-1036		0		042

			-1032		0		042

			-1028		0		042

			-1024		0		042

			-102		0		042

			-1016		0		042

			-1012		0		042

			-1008		0		042

			-1004		0		042

			-10		0		042

			-996		0		042

			-992		0		042

			-988		0		042

			-984		0		042

			-98		0		042

			-976		0		042

			-972		0		042

			-968		0		042

			-964		0		042

			-96		0		042

			-956		0		042

			-952		0		042

			-948		0		042

			-944		0		042

			-94		0		042

			-936		0		042

			-932		0		042

			-928		0		042

			-924		0		042

			-92		0		042

			-916		0		042

			-912		0		042

			-908		0		042

			-904		0		042

			-9		0		042

			-896		0		042

			-892		0		042

			-888		0		042

			-884		0		042

			-88		0		042

			-876		0		042

			-872		0		042

			-868		0		042

			-864		0		042

			-86		0		042

			-856		0		042

			-852		0		042

			-848		0		042

			-844		0		042

			-84		0		042

			-836		0		042

			-832		0		042

			-828		0		042

			-824		0		042

			-82		0		042

			-816		0		042

			-812		0		042

			-808		0		042

			-804		0		042

			-8		0		07

			-796		0		07

			-792		0		07

			-788		0		07

			-784		0		07

			-78		0		07

			-776		0		07

			-772		0		07

			-768		0		07

			-764		0		07

			-76		0		07

			-756		0		07

			-752		0		07

			-748		0		07

			-744		0		07

			-74		0		07

			-736		0		07

			-732		0		07

			-728		0		07

			-724		0		07

			-72		0		07

			-716		0		07

			-712		0		07

			-708		0		07

			-704		0		07

			-7		1		07

			-696		1		07

			-692		1		07

			-688		1		07

			-684		1		07

			-68		1		07

			-676		1		07

			-672		1		07

			-668		1		07

			-664		1		07

			-66		1		07

			-656		1		07

			-652		1		07

			-648		1		07

			-644		1		07

			-64		1		07

			-636		1		07

			-632		1		07

			-628		1		07

			-624		1		07

			-62		1		07

			-616		1		07

			-612		1		07

			-608		1		07

			-604		1		07

			-6		1		07

			-596		1		07

			-592		1		07

			-588		1		07

			-584		1		07

			-58		1		07

			-576		1		07

			-572		1		07

			-568		1		07

			-564		1		07

			-56		1		07

			-556		1		07

			-552		1		07

			-548		1		07

			-544		1		07

			-54		1		07

			-536		1		07

			-532		1		07

			-528		1		07

			-524		1		07

			-52		1		07

			-516		1		07

			-512		1		07

			-508		1		07

			-504		1		07

			-5		1		07

			-496		1		07

			-492		1		07

			-488		1		07

			-484		1		07

			-48		1		07

			-476		1		07

			-472		1		07

			-468		1		07

			-464		1		07

			-46		1		07

			-456		1		07

			-452		1		07

			-448		1		07

			-444		1		07

			-44		1		07

			-436		1		07

			-432		1		07

			-428		1		07

			-424		1		07

			-42		1		07

			-416		1		07

			-412		1		07

			-408		1		07

			-404		1		07

			-4		1		07

			-396		1		07

			-392		1		07

			-388		1		07

			-384		1		07

			-38		1		07

			-376		1		07

			-372		1		07

			-368		1		07

			-364		1		07

			-36		1		07

			-356		1		07

			-352		1		07

			-348		1		07

			-344		1		07

			-34		1		07

			-336		1		07

			-332		1		07

			-328		1		07

			-324		1		07

			-32		1		07

			-316		1		07

			-312		1		07

			-308		1		07

			-304		1		07

			-3		1		07

			-296		1		07

			-292		1		07

			-288		1		07

			-284		1		07

			-28		1		07

			-276		1		07

			-272		1		07

			-268		1		07

			-264		1		07

			-26		1		07

			-256		1		07

			-252		1		07

			-248		1		07

			-244		1		07

			-24		1		07

			-236		1		07

			-232		1		07

			-228		1		07

			-224		1		07

			-22		1		07

			-216		1		07

			-212		1		07

			-208		1		07

			-204		1		07

			-2		1		07

			-196		1		07

			-192		1		07

			-188		1		07

			-184		1		07

			-18		1		07

			-176		1		07

			-172		1		07

			-168		1		07

			-164		1		07

			-16		1		07

			-156		1		07

			-152		1		07

			-148		1		07

			-144		1		07

			-14		1		07

			-136		1		07

			-132		1		07

			-128		1		07

			-124		1		07

			-12		1		07

			-116		1		07

			-112		1		07

			-108		1		07

			-104		1		07

			-1		1		07

			-096		1		07

			-092		1		07

			-088		1		07

			-084		1		07

			-08		1		07

			-076		1		07

			-072		1		07

			-068		1		07

			-064		1		07

			-06		1		07

			-056		1		07

			-052		1		07

			-048		1		07

			-044		1		07

			-04		1		07

			-036		1		07

			-032		1		07

			-028		1		07

			-024		1		07

			-02		1		07

			-016		1		07

			-012		1		07

			-008		1		07

			-004		1		07

			0		1		1

			004		1		1

			008		1		1

			012		1		1

			016		1		1

			02		1		1

			024		1		1

			028		1		1

			032		1		1

			036		1		1

			04		1		1

			044		1		1

			048		1		1

			052		1		1

			056		1		1

			06		1		1

			064		1		1

			068		1		1

			072		1		1

			076		1		1

			08		1		1

			084		1		1

			088		1		1

			092		1		1

			096		1		1

			1		1		1

			104		1		1

			108		1		1

			112		1		1

			116		1		1

			12		1		1

			124		1		1

			128		1		1

			132		1		1

			136		1		1

			14		1		1

			144		1		1

			148		1		1

			152		1		1

			156		1		1

			16		1		1

			164		1		1

			168		1		1

			172		1		1

			176		1		1

			18		1		1

			184		1		1

			188		1		1

			192		1		1

			196		1		1

			2		1		1

Policy Suggestion for HMO vaccination decision of Book6

	700		07

	0		-7

	Flu

-7		-7

	300		03

	0		-7

Vaccination program 1

-7

PrecisionTree Statistics Report

For HMO vaccination decision of Book6

Created on 172006 at 33050 PM

Vaccination program 1	1 Program		2 No program

STATISTICS

Mean	-7		-728

Minimum	-7		-12

Maximum	-7		0

Mode	-7		-12

Std Dev	0		504

Skewness	0		05583270345

Kurtosis	0		16291297236

PROFILE

	X	P		X	P

1	-7	1		-12	042

2		-8		028

3		0		03

Name	HMO vaccination decision		FILEVER	2

SheetRef	0		RETFUNC	0

GenInfo	01100Exponential 00-10-1

Def Link	=

EXT REFS	0

Def Form

Highest	13

Kernel	BName	bformtype	valformula	pbformula	distribution		cumPayoffFunction		link		ENDNODEFORMULA		VAL		PB		GenInfo	IntRefs	RefRefs	NodeNames

0	HMO vaccination decision	0					0		0		200223000		0			Vaccination program 1

0	Program	0				DEFAULT		-7			100245100		0			Flu

0	No program	0				DEFAULT		0			100267100		0			Flu

0	Flu outbreak	0				DEFAULT		0		07		4000200		0

0	No flu outbreak	0			DEFAULT		DEFAULT		0		03		4000200		0

0	Flu outbreak	0				DEFAULT		0		07		200289300		0			Vaccination Program 2

0	No flu outbreak	0			DEFAULT		DEFAULT		0		03		4000300		0

0	Program	0				DEFAULT		-7			10021213600		0			Costs

0	No program	0				DEFAULT		0			10021011600		0			Costs

0	C	0			DEFAULT		DEFAULT		-12		06		4000900		0

0	D	0			DEFAULT		DEFAULT		-8		04		4000900		0

0	A	0			DEFAULT		DEFAULT		-6		06		4000800		0

0	B	0			DEFAULT		DEFAULT		-4		04		4000800		0

chapter 6 book companion - american college of … 2e/hc ops 2 - cha… · chapter 6.ppt. templates...

Documents

treeCalc_6

treeCalc_1

Instructions

Problem

Statistics

PolicySuggestion

RiskProfile

RiskProfile

CumulativeProfile

CumulativeProfile

ScatterProfile

ScatterProfile

New Problem

sensInfo

Instructions

Problem Data and Setup

Answer Report 1

Sensitivity Report 1

Limits Report 1

FMEA Instructions

FEMA Worksheet

FEMA Example

treeCalc_6

treeCalc_1

Instructions

Problem

Statistics

PolicySuggestion

RiskProfile

RiskProfile

CumulativeProfile

CumulativeProfile

ScatterProfile

ScatterProfile

New Problem

sensInfo

Instructions

Problem Data and Setup

Answer Report 1

Sensitivity Report 1

Limits Report 1

FMEA Instructions

FEMA Worksheet

FEMA Example

treeCalc_6

treeCalc_1

Instructions

Problem

Statistics

PolicySuggestion

RiskProfile

RiskProfile

CumulativeProfile

CumulativeProfile

ScatterProfile

ScatterProfile

New Problem

sensInfo

Instructions

Problem Data and Setup

Answer Report 1

Sensitivity Report 1

Limits Report 1

FMEA Instructions

FEMA Worksheet

FEMA Example

treeCalc_6

treeCalc_1

Instructions

Problem

Statistics

PolicySuggestion

RiskProfile

RiskProfile

CumulativeProfile

CumulativeProfile

ScatterProfile

ScatterProfile