Intensive Care Lab Assessing Process Capability Example 6.5 Cp = Cp = Upper specification - Lower specification 30 - 20 6(1.35) 6 = 1.23 Process Capability Ratio Does not meet 4 (1.33 Cp) target Before Process Modification Upper specification = 30.0 minutes Lower specification = 20.0 minutes Average service = 26.2 minutes  = 1.35 minutes Cpk = 0.94 Cp = 1.23 After Process Modification Upper specification = 30.0 minutes Lower specification = 20.0 minutes Average service = 26.1 minutes  = 1.2 minutes Cpk = 1.08 Cp = 1.39 © 2007 Pearson Education
View full slide show




Reading List 1. 2. 3. 4. 5. 6. 7. 8. 9 10 11. 12 13 Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M;Early Goal-Directed Therapy Collaborative Group. Nugyen HB, Rivers EP, Havstad S, Knoblich B, Ressler JA, Muzzin AM, Tomlanovich MC:Critical care in the emergency department:Aphysiologic assissment and outcome evaluation.Acad Emerg Med. 2000 Dec;7(12):1354-61. Shoemaker WC, Wo CC, Yu S, Farjam F, Thangathurai D:Invasive and noinvasive haemodynamic monitoring of acutely ill sepsis and septic shock patients in the emergency department. Eur J Emerg Med. 2000 Sep;7(3):169-75. Truog RD, Cist AF, Brackett SE, Burns JP, Curley MA, Danis M, DeVita MA, Rosenbaum SH, Rothenberg DM, Sprung CL, Webb SA, Wlody GS, Hurford WE. Recommendations for end-of-life in the intensive care unit:The Ethics Committee of the Society of Critical Care Medicine. Crit Care Med. 2001 Dec;29(12):2332-48. Sprung CL, Geber D, Eidelman LA, Baras M, Pizov R, Nimrod A, Oppenheim A, Epstein L, Cotev S. Evaluation of triage decisions for intensive care admission.Crit Care Med. 1999 June;27(6):1073-9. Metcalfe MA, Sloggett A, McPherson K. Mortality among appropriately referred patients refused admission to intensive care units. Lancet. 1997 July 5;350(9070):7-11. Morales IJ, Peters SG, Afessa B. Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit. Crit Care Med. 2003 Marcgl31(3)L858-63, Diringer MN, Edwards DF. Admission to a neurologic/neurosurgical intensive care unit is associated with reduced mortality rate after intracerebral hemorrhage. Crit Care Med. 2001 Mar;29(3):635-40. Afessa B. Triage of patients with acute gastroinestional bleeding for intensive care unit admission based on risk factors for poor outcome. J Clin Gastroenterol. 2000 Apr;30(3):281-5. .Morales IJ, Peters SG, Afessa B. Hospital mortality rate and length of stay in patients admitted a night to the intensive car unit. Crit Care Med. 2003 Mar;31(3):858-63. Rosenberg AL, Hofer TP, Strachan C, Watts CM, Hayward RA. Accepting critically ill transfer patients:adverse effect on a referral cneter’s outcome and benchmark measures. Ann Intern Med. 2003 June3;138(11):882-90. Higgins TL, McGee WT, Steingrub JS, Rapoport J, Lemeshow S, Teres. Early indicators of prolonged intensive care unit stay:impact of illness severity, physician staffing, and pre-intensive care unit length of stay. Crit Care Med. 2003 Jan;31(1):45-51. Rocker G, Cook D, Sjokvist P, Weaver B, Finfer S, McDonald E, Marsh J, Kirby A, Levy M, Dodek P, Heyland D, Guyatt G; Level of Care Study Investigators;Canadian Critical Care Trials Group. Crit Care Med. 2004 May;32(5):114954. Nasraway SA, Button GJ, Rand WM, Hudson-Jinks T, Gustafson M. Surviors of catastrophic illness:outcome after direct transfer from intensive care to extended care facilities. Crit Care Med. 2000Jan;28(1):19-25.
View full slide show




Intensive Care Lab Assessing Process Capability Example 6.5 Cpk = Minimum of Cpk = Cpk = Upper specification = 30 minutes Lower specification = 20 minutes Average service = 26.2 minutes  = 1.35 minutes x= – Lower specification Minimum of 3 26.2 – 20.0 3(1.35) Minimum of © 2007 Pearson Education , 1.53, 0.94 Upper specification – x= 3 , 30.0 – 26.2 3(1.35) = 0.94 Process Capability Index
View full slide show




24 Functions are not Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods are are are are are are are are are are are are are are are are are are are are are are are are not not not not not not not not not not not not not not not not not not not not not not not not Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods are are are are are are are are are are are are are are are are are are are are are are are are not not not not not not not not not not not not not not not not not not not not not not not not Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods F are are are are are are are are are are are are are are are are are are are are are are are are not not not not not not not not not not not not not not not not not not not not not not not not Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods Methods are are are are are are are are are are are are are are are are are are are are are are are are not not not not not not not not not not not not not not not not not not not not not not not not Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions Functions
View full slide show




Intensive Care Lab Example 6.5 The intensive care unit lab process has an average turnaround time of 26.2 minutes and a standard deviation of 1.35 minutes. The nominal value for this service is 25 minutes with an upper specification limit of 30 minutes and a lower specification limit of 20 minutes. The administrator of the lab wants to have four-sigma performance for her lab. Is the lab process capable of this level of performance? Upper specification = 30 minutes Lower specification = 20 minutes Average service = 26.2 minutes  = 1.35 minutes © 2007 Pearson Education
View full slide show




Process Capability Index, Cpk Process Capability Index, Cpk, is an index that measures the potential for a process to generate defective outputs relative to either upper or lower specifications. Cpk = Minimum of x= – Lower specification 3 , Upper specification – x= 3 We take the minimum of the two ratios because it gives the worst-case situation. © 2007 Pearson Education
View full slide show




Sulfate Reduction Norman Landfill Cozzarelli temp oC pH USGS Reston, VA (avail) Well MLSNPD -6 MLS38-6 DO Ca2+ (ppm) (mg/L) chemet. field lab 0.04 166.00 0.11 514.00 Mg2+ (mg/L) field 16.6 ND field 7.01 6.78 Si Fe 2+ Mn2+ Sr2+ Ba2+ SiO2 (mg/L) (mg/L) (mg/L) (mg/L) (mg/L) (mg/L) lab 8.70 16.80 lab 0.13 19.30 lab 1.94 0.90 lab 1.06 9.87 lab 0.14 7.12 lab 52.60 232.00 lab 18.60 35.90 Na+ (mg/L) lab 91.80 606.00 NO3(mg/L) IC lab 0.05 3.48 K+ (mg/L) lab 2.50 14.40 NH4+ Cl(mg/L) IC lab 181.0 1026.6 SO4 2(mg/L) IC lab 113.60 0.10 Br- Alk (HCO3) mg/L lab 626 2,642 - (mg/L) IC lab 0.79 7.54 DOC (ppm) (mg/L) Chemet. field lab 2.1 2.9 15.0 158.7 Barium concentration appears insignificant unless barium is lost to cation exchange or mineral precipitation.
View full slide show