Business problem

1
Business problem

• New process development

2
Business Relationship

• Customer is a hospital group with 209 accounts
  throughout the U.S.
• Company services diagnostic imaging and
  biomedical equipment for all accounts.
• New awareness to recent auditing events in the
  news, the customer has done its own internal
  audit.
• Errors found in billing from company.

3
Inaccurate inventory causing customer
dissatisfaction

• Customer side
• Billing incorrect
• Pricing not the same
• Shareholder responsibility
• To many variables

• Company side
• Integrity in question
• Poor process for inventory
• Potential loss of business
• Quality controls

4
Impact if situation not resolved.

• Loss of revenue for the company as well as future
  equipment sales.
• Companies integrity and reputation.
• Equipment will not get timely service.

5
Action Plan Short Term

• Re-inventory all of the 209 accounts.
• Use the existing local team to do the inventory.
• Emphasize the importance of getting the inventory
  correct.
• Resubmit the new inventory to the business center
  for pricing.

6
Results of re-inventory

• Still inaccurate. Different people, areas of the
  country, descriptions for the same equipment.
• Insufficient equipment information gathered.
• Customer wasnt involved in process.

7
Customer loosing faith

• Company embarrassed and makes concessions in good
  faith.
• Panic sets in.
• New process needed!!!

8
HPG DI Audit
DI Audit Y Flowdown The Path Forward
Audit 231 HCA Lifepoint Facilities
Hand Held Audit IT Tool
Process Definition Execution
Self Audit Control Plans

• Benchmarking CS
• Team formed
• Technology Plan Created

• Benchmarking CS
• Processes identified
• Team being formed

• Scope identified
• Resource discussions underway

GEMS A HS
Next Steps
Timeline
Finalize dedicated team and resources Assign
sub-teams to process definition Self
Audit Communicate project plan to HPG Drive,
drive, drive! (with quality, quality, quality)
5 Pilots complete re-done
231 sites complete
Pilot process defined
First Attempted DI Audit 99 Right (4 Sigma)
Now We Must Deliver True 6 Sigma Audit
9
Setting up the Inventory process

• Put together the best and only the best team.
• Utilize technology to improve the process
• Use the resources of the team to set up the
  process.
• Put the process in place.

10
Goals for the team

• Utilize existing technology to reduce inventory
  error.
• Put together the best process to reduce error.
• Analyze errors made in other attempt.
• Assign tasks to action items.
• Put together a timeline to track project.

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Whole new way of thinking
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PI Leader Tool KitSelf- Check List

• Note Pads
• Care Stickers
• Software- Project
• Extra Stylus
• Highlighters
• Sharpies/ Label Maker
• Flashlights
• Mirror
• Magnifying Glass
• Clip- Board
• Goof-Off (Citrus)

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Problem Solutions

• What is going to be inventoried?
• How is the inventory going to be taken?
• What resources are going to be needed?
• What are the training needs of the team?

• Learn what is covered under the contract.
• With the customer validating each pda entry.
• Primary engineers for the site and install dates.
• Equipment knowledge, PDA usage, Customer skills,
  and practice.

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MV Nuc Med Technology
ADAC Vertex,Solus
Picker Prism

• 135 Systems in IB
• Dedicated System
• Electronic Service Docs
• Training
• Board Repair
• Remote Connectivity

• 46 Systems in IB
• Electronic Service Docs
• Training
• Remote Connectivity

ADAC Forte
Siemens E-Cam

• 21 Systems in IB
• Dedicated System
• Electronic Service Docs
• Training
• Remote Connectivity

• 23 Systems in IB
• Dedicated System
• Electronic Service Docs
• Training
• Board repair

ADAC Genesys
Siemens Orbiter

• 132 Systems in IB
• Dedicated System
• Electronic Service Docs
• Training
• Board Repair
• Remote Connectivity

• 99 Systems in IB
• Dedicated System
• Electronic Service Docs
• Training
• Board Repair

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• Pre PI Preparation (at least day before)

• Take time to prepare proper documents as
  necessary to
• anticipate trouble areas
• item not on PDA, description wrong, cost
  center not loaded,
• b. Print out categorized list by modality, under
  contract, not
• under contract and in-warranty .
• c. Print out current PDA load list by modality
  to assist in looking
• up correct description.
• Talk with local GE team to anticipate any
  difficult/need to
• know situations we might walk into
• i. High speed access through BioMed (very
  helpful)
• ii. Place to keep PI materials and bags
• iii. New equipment installs or deinstalls

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2. Establish Positive Atmosphere from the Start

• Enlist the participation from hospital staff
  assisting with the PI.
• Assure them we are there to assist in their
  success and our partnership with them to achieve
  100 billing accuracy and asset management.
• Address upfront, any concerns they might have to
  keep us from slowing down once we have built
  momentum during the PI.
• Discuss plans such as lunch (or not) and any
  necessary breaks by either team.
• Discuss afternoon completion if getting close or
  waiting until next day. Better to come back and
  be accurate than push ahead and miss
  opportunities.

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3. Clarify and Instruct the HCA Team

• Ensure HCA team is clear on what and how we will
  be completing certain task throughout the PI.
• Walk all participants through launch package and
  try to answer all questions (as we will learn as
  we go) to assist HCA team in feeling comfortable
  with our task at hand.
• Show HCA participants the PDA and stickers we
  will be placing on their equipment and why.
• Explain the PDA and process to enter verifiers
  initials into PDA by graffiti or keyboard
  customer preference.
• If HCA ask to assist, allow them to participate
  in any way to streamline the process for all
  involved.
• Clarify departmental schedules and ease of
  access per that schedule.

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4. Begin PI

• Take time to teach participants PI process on
  first piece of equipment and answer all questions
  to help establish flow for the rest of the day.
• Take extra care and review first record before
  locking so all understand and potential
  explanation delays are avoided at PI close.
• Ensure process is adhered to from the beginning
• i. Locating the piece to be inventoried,
  collecting data, finding description, completing
  the CT slice/amp verification sheet, placing bar
  code sticker on (only CSI kind can be used),
  scanning bar code into PDA, recording serial
  number, verifying dates, cost center, placing
  yellow verification sticker on, obtaining
  verifiers initials and then saving and LOCKING
  the record.
• ii. Make sure customer understands that by
  locking the record, no changes can be made past
  that point.

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4. PI Process (cont)

• d. Locking the record is a safeguard to the
  customer that changes cannot be initiated post
  PI.
• If item cannot be found in PDA or the correct
  description cannot be verified per PDA load, then
  accomplish per appropriate add process.
• i. Paper add/exception process.
• ii. PDA new load process.

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5. Post PI

• Recap days activity and summarize
  accomplishments and identify additional efforts
  to complete PI if necessary.
• Educate participants on process to follow day
  end.
• i. PDA synchronization
• ii. Final reports download, etc.
• If necessary to complete PI next day, come to
  agreement with HCA participants on next day
  schedule and events.
• i. Meeting place.
• ii. Who will participate and expectations to
  complete.

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5. Post PI (cont)

• Final reporting.
• i. Explain reporting process to HCA
  participants.
• ii. Arrange proper meeting time and place to go
  over final report.
• iii. Verify final reports are formatted
  correctly per new process and allow PI team
  members opportunity to view for additional input
  and adjustments as deemed necessary for
  accuracy.
• iv. Make appropriate copies and prepare for
  distribution.

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6. Conclusion of PI

• a. With appropriate and complete documentation,
  meet with imaging director to explain conclusion
  of PI phase of process and present documents for
  signature.
• i. Ensure HCA participants understand that the
  ASM is to return to conclude billing changes
  and other issues identified during PI process.
• ii. Address any other concerns at this time and
  escalate if necessary to customer satisfaction.
• Obtain signatures and leave copies for HCA
  personnel.
• Keep copies for ourselves for reference.
• Mail originals back to PI admin support for back
  office phase of PI process.

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Outcome of the solution

• Very well. All of the team were giving the same
  presentations and documentation.
• All were identifying the equipment the same way
  and inventorying all the equipment meant to be
  covered under the contract.
• The customer signed off on the mutually agreed
  final inventory.

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Summary

• The customer and the company both agree on the
  inventory.
• The billing is consistent due to correct
  description and attention to detail.
• The inventory discovered severe contract
  non-compliance because of equipment found not
  under contract that should be.

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Lesson Learned

• As the customer changes
• So must the company

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LOCATION PACIFIC OCEAN
ACCOMODATIONS
REMOTE LOCATION
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LOCATION OF OUT PATIENT CLINIC
WE WILL ZOOM IN TO SEE THE EQUIPMENT
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WORK AFTER HOURS IF NEEDED.
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OTHER LOCATIONS
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Massages for after the inventory

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Necessary transportation
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Other modes
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Reduces rental and hotel costs

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Bar Graphs
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Dr. Seuss Presentation

• Customer mad.
• Company sad
• Inventory bad
• Company changes Organization Structure.
• Everyone glad.