erPrograms and Courses

Classroom Training

w 5-day Advanced Emergency Department Operations Management Program

5-day program teaches basic and advanced concepts that will allow both workers and administrators of Emergency Departments to more effectively manage their work environment.  Concepts include Lean, Theory of Constraints, Flow, and Variation.  Includes 3-stage Emergency Department simulation to help apply critical concepts learned.  Also gives participants a flow-based detailed overview of the latest, cutting edge practices in Emergency Medicine Operations in a simple, walk-through approach.  Featuring and including the Advanced Emergency Department Management Tool, an invaluable tool to help with everyday Emergency Department Operations Management.


w 2-day Emergency Department Lean Management Course *
2-day course covering basic Lean concepts and how to implement them in an Emergency Department setting.  Includes 2-stage Emergency Department simulation (Stages 1 and 2 from above) to help apply critical concepts learned.  Featuring and including the Advanced Emergency Department Management Tool, an invaluable tool to help with everyday Emergency Department Operations Management.  


w 2-day Emergency Department Managing Lean Flow Course *
A 2-day course covering basic flow concepts and how to implement them in an Emergency Department setting.  Includes 2-stage Emergency Department simulation to help apply critical concepts learned.  Featuring and including the Advanced Emergency Department Management Tool, an invaluable tool to help with everyday Emergency Department Operations Management.  



* 2-day courses can be scheduled by an organization and held at their location with a class size ranging from 15 to 35 students.  Please contact us for more information.
 

Resources at No Charge:

  • New Releases:  New, hot topics in Lean Healthcare Management practices.  
  • Classics:  A new, fresh look at topics that have stood the test of time.  
  • Quick Reference:  Beneficial tools that help you analyze and achieve your business goals.  
  • Learning Library:  Comprehensive resources to enhance your learning and improvement experience.  

erOn Site Consulting Services

On Site Consulting Services Include:

  • Post-education supervision geared towards execution and implementation.  
  • ED and hospital-wide flow analysis and operations assessment.  
  • Custom education to help instill the same values throughout your organization.  

Brian Livingston, MD
Dr. Livingston is a practicing emergency physician and medical director at Swedish Medical Center’s First Hill campus in Seattle, Washington.  He is board certified in emergency medicine and a fellow in the American College of Emergency Physicians.  He is currently completing a Master of Business Administration (MBA) at the University of Washington’s Foster School of Business.

As medical director he has lead his department’s effort to eliminate ambulance diversion, from a high of over 1,000 hours in 2008 to 0 hours since April of 2009.  Additionally, he has spearheaded efforts to decrease the overall length of stay of ED patients, achieving a 20% time reduction since 2008.  He is also focused on patient satisfaction, helping his department achieve a 25 percentile increase in Press Ganey rankings.

Steven Offerman, MD
Dr. Offerman is a practicing emergency physician and chief of emergency medicine at South Sacramento Medical Center in Sacramento, California.  He is board certified in emergency medicine and medical toxicology along with being certified as an advanced cardiac life support instructor, advanced pediatric life support provider plus advanced trauma life support and pediatric advanced life support.  He is a member of American Academy of Clinical Toxicology, American Academy of Emergency Medicine, Fellow American College of Medical Toxicology and Fellow American College of Emergency Medicine.

His current research focuses on head trauma with pre-injury anticoagulant use, acetaminophen poisoning associated with hospital length of stay, adolescent patients with alcohol intoxication and the use of delayed telephone informed consent.  He has published seven book chapters, a book review, 21 peer reviewed articles plus given 18 presentations and 26 lectures relating to toxicology and emergency medicine.


Phil Drew
Phil Drew is a lean sensei with the Southwest Washington Medical Center in Vancouver, Washington.  He is a certified lean six sigma black belt and a certified project management professional (PMP).  He received his Master of Science degree in chemistry from Sam Houston State University and his Master of Business Administration (MBA) degree from Washington State University.  He has been an adjunct professor at Clark College and Washington State University in chemistry, mathematics, operations management and statistics since 2001.  He has 21 years of continuous improvement experience in chemical manufacturing, information technology and health care industries.  His recently completed projects include the implementation of a fast track segment in the emergency department and the systematic redesign of the emergency department triage process.  The former reduced the length of stay for some patients by 42% and the latter improved the patient flow for acute patients.


Dana Webb, RN
Dana Webb is the director of care management and continuous improvement at Southwest Washington Medical Center in Vancouver, Washington.  She is a registered nurse in Washington and Oregon and has recently served as the interim director of emergency services and the interim director of medical staff services.  She is a certified lean six sigma green belt, has three years experience as a critical care float nurse, five years experience as an emergency room nurse and 18 years experience as a hospital director / manager.  She received both her Bachelor of Science degree in health care administration and her Master of Business Administration (MBA) degree from Concordia University.

Her recently completed projects include the implementation of a clinical documentation program and the systematic redesign of emergency department processes.  The former increased Medicare reimbursement by $4.5 million the first year and the latter reduced the average daily ambulance divert hours by 78%.

erX32 Healthcare Lean Healthcare Tool Summary

A quick summary of the tools currently offered by X32 Healthcare is listed below.  The time requirements include the time from start of the process to the end of analysis.  They include time for data collection, data review and verification, plus data evaluation and recommendation generation.  They do not include time for improvement project identification or implementation.


Name Description Actions
EDucate Model

The Emergency Department Utilization and Capacity Analysis Tool in Excel.  Allows user to analyze their current state with respect to demand for critical resources including docs, nurses, and beds.  Provides critical insights into the approrpiate alignment of resources, areas for improvement.  The tool also gives a financial snapshot of current losses and potential gains based on operational performance. Identification of existing inefficiencies and opportunities for improvement within the current ED.
Shift Optimizer

Provide shift duration and start time recommendations to meet staffing profile. Based on demand and productivities from the Educate Model. Applicable to doctor and nurse shifts.
Geographic Market Analyzer

Evaluation and analysis of market share for rational market territories. Identification of opportunities in primary and surrounding areas to increase market share.
Hospital Flow Simulator


Computer-based simulation of hospital flow including ED admits, OR admits, and direct admits. Helps identify bottlenecks on inpatient flow which result in ED holds. Enables what-if analysis on LOS reductions or increased capacity.
ED Simulator

Computer-based simulation of ED operations.  Uses a simplified treatment model (Triage-MD-RN-Diagnostic-MD-RN-D/C). Can effectively illustrate time-of-day bottlenecks due to productivity or staffing issues.