Crouse program trains EMS providers in Lean Six Sigma

SYRACUSE  —  Crouse Hospital is using a new training program to try to straighten the road for ambulances and emergency medical service (EMS) providers.

The program teaches Lean Six Sigma strategies. It is an attempt to boost medical-care quality and improve interactions between hospitals and EMS organizations.

Lean strategies zero in on eliminating waste, while Six Sigma techniques center on removing the causes of errors and limiting variability in business processes. The techniques were developed by manufacturers and are often still associated with that industry.

However, they can be applied to health care, according to Dr. Michael Jorolemon, the Crouse program’s lead organizer and senior quality officer for emergency services at the hospital. Crouse has used Lean Six Sigma for several years, but this is the first time it is bringing in EMS providers to work on the techniques, he says.

“This has not been done any place that we’ve been able to find,” he says. “I sit on the Quality Improvement Committee at the National Association of EMS Physicians. Nobody there had ever heard of anything like this before.”

The course includes instruction and application. Participants are broken into groups that examine specific issues, such as EMS offload delays and turnaround operations — how an EMS crew prepares for its next call.

“It’s providing a structured way to attack problems,” Jorolemon says. “In health care and EMS, often we like to jump to solutions. But having a very structured, proven methodology allows for the generation of some new ideas.”

Jorolemon predicts the course will lead to increased efficiency and cost savings for the hospital and participating EMS organizations. But, he doesn’t have firm savings projections yet, as class participants have not finished their projects.

“There will be decreasing wait times to free up staff to get back into service sooner,” Jorolemon says. “So that means maybe a second crew doesn’t need to be activated, saving costs. Or more importantly, they are available sooner to take care of the next patient.”

Jorolemon started organizing the course about a year ago, after hearing a suggestion at a Crouse listening session with EMS providers.

Faculty members from the Rochester Institute of Technology’s Center for Quality & Applied Statistics teach the training sessions, which are held at Crouse’s Marley Education Center at 765 Irving Ave. in Syracuse. The course started at the beginning of April and is being held weekly through the end of June.

A total of 21 EMS providers make up the class, and they represent 15 different organizations from Cayuga, Cortland, Madison, and Onondaga counties. Providers come from professional and volunteer agencies. They consist of a mix of positions, including paramedics, training officers, directors of operations, general managers, and technicians.

“You get the frontline workers who actually work the process and the administrative and operational management members who can see how to make it happen,” Jorolemon says. “You don’t have somebody coming up with an idea and not understanding what’s needed to make it happen. And vice versa, you’re not having someone from up high making a decision and not really understanding how it impacts the frontline staff.”

In July, participants will issue reports on their group projects. Those reports are slated for Crouse’s EMS listening session, which brings together between 125 and 150 EMS providers, Jorolemon says.

He hopes the groups’ findings will spread beyond participating organizations. For example, he wants to roll results into the protocols that govern EMS procedures throughout Central New York. 

Participants will be certified at Lean Six Sigma’s Green Belt level once the course is complete, Jorolemon says.

“It gives the tools needed to be the project manager and help not only these projects, but future projects,” he says. “And that’s our hope: that this will continue within their agencies.”

A grant from the State University of New York Community College Workforce Development Training Grant Program is funding the Crouse classes. The grant is for just over $40,000, with in-kind and cash matches from employers totaling almost $12,000, according to Bruce Hamm, assistant director of workforce development at Onondaga Community College.

Crouse is picking up any additional costs, such as parking, breakfast, and lunch expenses, Jorolemon says. He hopes to run another version of the class next year, but has not yet solidified plans to do so.

Participant response

Rural/Metro Medical Services of Central New York is sending four employees to Crouse’s Lean Six Sigma classes. They are working on a project evaluating the readiness of ambulance groups.

That includes looking at everything from the vehicle check-out process to what providers do between calls, says Troy Hogue, Rural/Metro Syracuse area manager and one of the Rural/Metro employees at the class.

“Are there more efficient, smarter ways to do things?” he says. “Are there ways for other people to do these things for the crew so they show up set, prepared, and ready to hit the road?”

The weekly classes typically include instruction sessions followed by group breakouts, according to Hogue. The breakout sessions allow participants to apply skills right away, he adds.

“We’ve been through some similar, more traditional quality improvement [at Rural/Metro],” he says. “Some of the techniques are things that we’ve used before, and there are some new techniques.”

Rural/Metro Medical Services of Central New York, headquartered at 488 W. Onondaga St. in Syracuse, employs more than 300 people. It serves a six-county area in Central New York. 

Crouse Hospital is a private, not-for-profit hospital licensed for 506 acute-care beds and 57 bassinets. It serves more than 23,000 inpatients, 66,000 emergency-services patients, and more than 250,000 outpatients per year from 15 counties in Central New York and Northern New York. The hospital is located at 736 Irving Ave. in Syracuse and employs 2,700 people.