PPT Assignment: Lean Management
SCENARIO- Hypothetical
The facility had three safety events involving a patient receiving blood transfusions of the wrong blood type. All three patients died. Two patients received their transfusions on a medicine unit and the other patient received his transfusion on a surgical unit. After a root cause analysis, it was found that transfusion orders for each patient were meant for other patients. Additionally, it was found that in two of the cases there were blood specimen labeling errors.
In the six months before the deaths of these three patients, the facility had received ten patient safety event reports (JPSR) related to blood labeling errors, but all were caught before a patient was harmed. When staff were interviewed about the event, many reported that communication between clinical staff has always been an issue. Several of the physicians interviewed stated that it is not uncommon for the Laboratory to make errors because nothing is ever done to correct them. The Medical Center Director has met with the staff members. They all report feeling really bad that this happened. They believe in the care they provide and only want to do a good job.
MUST INCLUDE - NEED Graphs and visual aid
• Identify an interdisciplinary team-based improvement project based on the root cause analyses of the safety events. During the pitch, identify why you selected the project and which safety issues are addressed.
• Include a draft of the problem statement you plan to share with the Medical Center Director, which also discusses two (2) associated high reliability principles.
• Discuss how will you manage and lead these projects through to completion.
• Identify the improvement methodology you plan to use to address and track the safety failures.
• Is there any data that you need? Discuss which databases you plan to pull it from.
• Identify any tools and/or resources you will you need to implement your plans and manage the activities of your team. Include how you plan to train the teams to carry out the improvements.
• Discuss how will you ensure sustainability once the project deliverable are deployed and implemented.
• Explain how you would use change management to prepare the Care or Service Line to accept, implement, and sustain the improved processes.
• Discuss how you plan to incorporate dashboards and graphical reports into your tracking and sustainability plan.
• Finally, discuss how you plan to close out the project. Include how you will confirm that all project requirements have been met and how your project benefits the experience of the veterans at MEDVAMC.
Format your assignment according to the give formatting requirements:
• The answer must be using Times New Roman font (size 12), double spaced, typed, with one-inch margins on all sides.
• The response also includes a cover page containing the student's name, the title of the assignment, the course title, and the date. The cover page is not included in the required page length.
• Also include a reference page. The references and Citations should follow APA format. The reference page is not included in the required page length.