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A Fair Display of Innovation and Initiative

30 March 2023

From Douglas Stutz

When Hospital Corpsman 3rd Class Julia Muro was given the opportunity to use the Continuous Process Improvement Fair to demonstrate how to mitigate a staffing shortage concern, that is exactly what she did.In an unorthodox way, those efforts worked so well she ended up not needing to actually attend the fair.Along with HM3 Eric Huerta and
When Hospital Corpsman 3rd Class Julia Muro was given the opportunity to use the Continuous Process Improvement Fair to demonstrate how to mitigate a staffing shortage concern, that is exactly what she did.

In an unorthodox way, those efforts worked so well she ended up not needing to actually attend the fair.

Along with HM3 Eric Huerta and Hospitalman Hunter Jeffers, Muro represented Directorate Surgical Services Anesthesia department with the submission, “Planning for Manning.”

“With decreased manning, this is a real purposeful, great idea,” said Lt. Jason Balazs, certified registered nurse anesthetist who provided project lead oversight and presented the project for the corpsmen.

“Planning for Manning” was one of 12 submissions at the fair, designed to showcase innovations and initiatives in providing safe, high-quality patient care.

“Working on this year’s CPI project was a great opportunity to put my developing leadership skills to the test. Being given a chance to teach is always something I [have] looked forward to,” explained Muro.

According to Lt. Cmdr. Shingmei Chang, Process Improvement Sciences lead, the Process Improvement Fair concept is based upon the Defense Health Agency Ready Reliable Care principle, which is focused on reducing unwarranted variation across the system, eliminating waste, and lowering costs.

Staff are then tasked to solve problems by leveraging improvement science - which emphasizes innovation - to enhance, refine and support existing procedures, methods and standards in their military treatment facility.

Their collection results are then displayed and explained to appraising judges, curious co-workers and interested staff members in a convivial fair setting.

“It is wonderful to see staff from various departments taking part in improving their processes and sharing their work and results at this event,” said Chang. “All of their efforts are showing positive impacts on patient safety, quality of care, and readiness. Continuous Process Improvement is an integral component for the hospital as a high reliability organization.”

Muro and her team’s project was centered on the notion that with no hospital corpsmen expected to be assigned to the Anesthesia Department there was a need to augment the current shrinking manning level.

“Anesthesia is the best department in the hospital for someone to cross train in. Most corpsmen do not develop their hands on skills until they are deployed. Luckily I get to practice them every day,” said Muro.

They devised a plan to cross train other corpsmen with surgical technologist specialty skills to help with the daily workflow in the Main Operating Room.

“I had to delegate and be patient as my corpsman were learning. I am so thankful to have had this privilege,” Muro said.

The plan to train the others became acute when one of the two assigned anesthesia technicians transferred which limited the ability to provide assistance to the anesthesia provider. Anesthesia and Main OR department heads collaborated to come up with a viable, workable plan to ensure that day-to-day anesthesia needs would be met.

Two surgical techs were selected to train for a month with their anesthesia tech counterpart and complete the necessary professional qualification standards. With those corpsmen already assigned in the Main OR, they gained added proficiency such as knowing the technique of intravenous placement which would help prevent any future roadblocks in providing patient care.

Along with Planning for Manning, also presented was Increasing OR First Case On-Time Starts from the Main Operating Room team with Directorate Surgical Services; Improving DMHRSi [Defense Medical Human Resource System – Internet] Completion at NMRTC Bremerton; Pharmacy Revolution from Directorate of Clinical Support Services; Increase Weight Loss Pre-Op To Improve Post-Op Outcomes in Bariatric Patients, from Director of Administration’s Nutrition Management; Multidisciplinary Weight Loss Clinic from Director of Medical Services Family Medicine team; Improving Efficiency With Technology from Directorate of Branch Clinic’s Navy Medicine Readiness Training Unit Everett; Directorate for Surgical Services Ophthalmology department on fixing equipment problems; Endoscopy Clinic on Time Outs Matter – tailer to your department; Endoscopy Clinic with Narcotic Reversal Agent box; NMRTU Everett with Vaccine Receipt Process Standardization and Directorate for Administration Patient Administration with Suitability Screening.

“With the help from our Lean Six Sigma Master Black Belt, Mr. Bradford Jense, we’ll be sharing their projects online for all Defense Health Agency to see. That will serve a few purposes. First, their successful effort can be seen by other military treatment facilities who may be facing similar issues and may benefit from the same process improvement methods. Second, their projects serve as a documentation of their work, which is a necessary step in obtaining the Lean Six Sigma Green Belt certification. Lastly, their projects will be considered in next year’s Naval Medical Forces Pacific CPI competition,” stated Chang.

Lean Six Sigma is a team-based concept rooting in seeking performance and process improvement by eliminating resource waste, redundancy and deficiencies.

Process improvement can also enhance time-management, as Muro can readily attest.

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