Read the attached case study and analyze it from the Certified Quality Engineer's $($CQE$)$perspective$.$ Examine the background information, show the factors that were considered, and describe the overall view of the case.

I would like to also see your own personal views of the case.

Quality Hospitals

The Institute of Medicine's $"$To Err Is Human" report of

$2000$ estimated that nearly $100,000$ deaths each year in the

United States are caused by medical errors. Many hospitals

are working to change that by employing certified quality

engineers $($CQEs$)$ to apply quality tools and techniques to a

wide variety of issues. This case describes one of those hos$-$

pitals. In $2007,$ this hospital saw $350,000$ patients, many

of whom visited multiple times, for an overall total of $1\mathrm{.}8$

million patient encounters. Though this hospital has an ex$-$

cellent reputation for patient care, leadership has identified

a need to make improvements. The certified quality engi$-$

neers study a variety of areas including the physical layout

of the hospital, its treatment rooms, and operating rooms.

They assess operational efficiency and effectiveness. They

study patient throughput and infection rates.

One problem that the CQEs have had to overcome is

that health$-$care professionals, especially physicians, may

not be very receptive to implementing changes proposed

by someone outside the medical field. Some doctors and

staff members don't like the idea of an outsider taking a

look at what they are doing. The CQEs have discovered

that if a docter gets excited about an improvement, then

the staff will follow.

A recent area of study is the surgery center. Whenever

a patient is scheduled for a surgical procedure, pretests are

scheduled. These may include a physical, blood testing,

x$-$rays, cat scans, or other lab tests. This paperwork and

test results goes into the patient's file $($a paper file, not an

electronic file$).$ Nationwide, hospitals and doctor's offices

do not usually use electronic files, despite significant evi$-$

dence that efficiencies could be obtained by using them.

This is because of a concern for patient privacy, informa$-$

tion sharing between government and insurance compa$-$

nies, and other issues.

All this paperwork needs to be at the surgery center at

least $48$ hours in advance of the surgery. This provides the

time needed for the anesthesiologist and other key partici$-$

pants in the surgery to review the file and make sure that

the right information is available. Without this informa$-$

tion, the surgery may place the patient at risk. When the

information is not available, the surgery is usually canceled.

The CQEs studied the number of canceled surgeries.

They determined that incorrect, incomplete, or late paper$-$

work accounted for $45$ percent of the reasons why surger$-$

ies were canceled. Canceling surgeries is very expensive.

Surgeons are paid for four hours of their time, anesthesi$-$

ologists and surgical technicians bill their time, charges are

incurred for sterilized equipment that did not get used, tests

are rescheduled and redone, an appointment coordinator

must reschedule the surgery, and so on$.$ Don't forget, there

is also the patient who prepared mentally and physically

for the surgery and now must go through the entire process

again. The costs can run into the thousands of dollars for each cancellation.