November 2005. Winter is just around the corner here in Western Michigan. The leaves are literally raining off the trees. Just this morning at breakfast as I looked into the woods and I could see a steady stream of golden brown, red and yellow leaves heading towards the earth.
Last month I talked about keeping your quality improvement changes in place—using a manual that you develop of SOP’s, standard operating procedures. By the way, if you missed that issue, you can find it on my website, and several earlier ones too.
This month I want to address starting a quality improvement project. That is, how do you decide what project to work on? What issue or process is causing the most waste, is doing the most harm, is most affecting the bottom line? Maybe you are a leader at your site and you have an idea of what is generally causing problems. For instance, you may think that patients with catheters are getting a lot of infections. Perhaps, checking patients in at your site is taking too long and creating a bottleneck. Maybe patients are complaining about having to wait too long at check in at a doctor’s office. It could be that certain departments are running short of supplies too often. There are many other possibilities. The probability is that unless you are directly involved in the contentious process, you probably are not aware of what the exact problems are and are not aware of possible solutions.
This leads us to the conclusion that in order to discover the many problems facing every organization, especially in terms of wasted effort, time and money, there has to be in place a mechanism for the problems to surface to the leaders from the front lines of the organization. There has to be a way for the leaders to hear about the problems from those who are directly involved. For instance, does anyone in your organization know what ideas the cleaning staff has for making the organization better? When I say that there has to be a way for the ideas to surface, I don’t mean that the only ones with a voice should be nursing staff and other professionals. Rather, as in the Baldrige Improvement Plans, the entire staff is involved in quality improvement.
I know of a few hospitals where the leadership—president, CFO, COO, etc.—go out several mornings every week to talk to staff at all levels and patients to see how things could be better and to get some positive feedback about what things are going well. Perhaps at your site you want to start something like this. As time goes by and as suggestions are implemented, staff will feel safer about making suggestions.
Leadership needs to make sure that staff feel safe about making suggestions, no matter what the method of suggesting changes is used. Perhaps you might want to use an anonymous survey for collecting initial suggestions. After some of the suggestions are acted upon, the staff will feel like the leaders really want good ideas and will feel safer making them known. Perhaps you might want to use a consultant in Lean Healthcare (many of these ideas I suggest come directly from Lean Healthcare) to teach the staff the principles and processes of Lean Healthcare and other tools as may seem fit. This approach will help a large organization start making many positive changes quickly, rather than using the idea of slowly spreading the means of change throughout an organization, as some prefer.
Whatever your initial process of getting the ideas percolating up in the organization, after some ideas for quality improvement recommended by the rank and file are successfully implemented and after the improvements and savings are made known in the organization, it is time to create ways to get more ideas. Perhaps you want to have regular meetings with a designated leader and representatives from several staffing areas that will bring up ideas. That means that the rest of the staff must feel comfortable about making suggestions to these team members. If your site has few employees, then perhaps it would be best to have regular staff meetings with all employees where the agenda always includes time for quality improvement ideas and for updates on ongoing projects. Whatever method you decide works best for your site, be sure that an atmosphere safety and security exists for all the staff. This may mean going so far as to guarantee that no staff will lose there position as improvements create more time to get things done.
So, once you have a steady flow of quality improvement ideas being generated by all in the organization, which ones should you act upon? Next month, I’ll address that issue. This issue I decided to concentrate on the Define step of Six Sigma’s DMAIC (define, measure, act, improve, control). Next, I will discuss the measure segment. Sometime in the future I’ll cover team dynamics too.
Have a great Thanksgiving!
Are You Missing Your Best Quality Improvement Ideas?
Are Air Purifiers the Solution to Improving Indoor Air Quality?
Possibly due to the increased pollutants in the air we breathe, greater numbers of people are suffering from environmental sensitivities. Second hand smoke, dust, pollens, and molds cause millions of people to seek allergy relief products. Although we can't always control our outdoor or work environments, we can take steps to control the air quality of our homes. Furnace filters and vacuum cleaners can help indoor air pollution, but many people turn to air purifiers to make the air in their homes easier to breathe.
Types of Air Purifiers
There are many different types of air purifiers, each designed to address a specific type of problem:
Dust Removal: Unless you keep your home spic and span and run your heating and air conditioning system 24 hours a day, seven days a week, you most likely have a build up of dust. Many people are allergic to dust, and turn to HEPA machines to filter out dust. HEPA machines usually only take care of the dust in the room where they're located, so they're not a good solution to keeping your whole house dust-free. Instead, it's best to keep your HVAC running 24/7 and invest in good furnace filters. There are several types of furnace filters, such as washable electrostatic furnace filters, that will filter out over 90 percent of dust particles over one micron in size.
Mold Removal: If you have a problem with surface mold, it's best to consult with a professional contractor. But many people seek allergy relief products due to allergic reactions to airborne mold. Air purifiers that remove airborne mold usually raise ozone levels (like the Airfree and Air Oasis lines of products), and in the process kill odors, chemical particulates and bacteria.
Second Hand Smoke Removal: Smoke not only negatively impacts health and air quality, but it also seeps into fabrics and hard surfaces. Liquid air purifiers (such as the Air Oasis Xtreme) are the best and most effective way to remove second hand smoke.
Virus Protection: Many people buy HEPA machines that are purported to kill viruses using UV lamps. Unfortunately, small UV lamps just don't work; you need a lamp that will create at least 24,000 microwatts of UVGI.
Total Solution?
Are there any air purifiers that are complete and total allergy relief products? Unfortunately, no. To comprehensively address indoor air quality issues, you need to implement a number of approaches. First, because carpeting collects dust and releases gas, your home should have hardwood floors. Second, you should run your HVAC system 24 hours a day, seven days a week, and use a washable electrostatic furnace filter. An ozone generator air purifier near the return air duct will help tremendously. Third, you should have an induct air sanitizer to cleanse viruses, molds, and bacteria. Fourth, you should vacuum and clean your floors with a Hyla vacuum water filtration, wet cleaning, and air purification system. Fifth, you should use air purifiers in your home's bedrooms (such as Airfree or Austin Air purifiers). Sixth, you should spray surfaces with TiO2 PCO liquid, which will address gasses, viruses, and molds.
Even considering today's air quality, respiratory illnesses aren't inevitable. By improving your home air quality through cleaning and air purifiers, you are certain to breathe easier.