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  • Problem: The time required to establish a medical aid station directly impacts the ability to save lives on the battlefield. Currently, the average lead time is 45 minutes. Every minute saved is lives saved.
  • Root Causes Discovered:
    • Wasted time searching for items
    • Disorganization in the staging area
    • Equipment not loaded effectively from the previous breakdown
    • Numerous variations in process and setup
    • Unclear roles and assignments
    • Inconsistent performance from one establishment to the next
  • Solution: Created standard work and an optimized process sequence along with cross-training and labeling.
  • Results: Aid station establishment lead time was reduced from 45 to 32 minutes—a 29% improvement—and breakdown lead time was reduced from 36 to 25 minutes—a 31% improvement—becoming arguably the most efficient aid station within the 2nd Stryker Brigade Combat Team (2SBCT) and possibly the entire Army.

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The Problem

A Battalion Aid Station (BAS) is designed to provide advanced trauma life support on the battlefield. The primary mission of the BAS is to collect the sick and wounded from the battlefield and stabilize their condition. It is structured to operate as far forward as the tactical situation permits. The BAS must also be able to move quickly to stay with troop movement.

For the past 6 months in Headquarters and Headquarters Company, 1st Battalion 41st Infantry Regiment, the establishment of the Battalion Aid Station, averaged 45 minutes. This was considered a good time but the entire medical platoon felt it could be improved.

First Lieutenant William A. Norman, Medical Services Corps says, “The faster we can establish our Aid Station, the faster we can receive and treat patients on the battlefield—ultimately leading to saving lives.”

William was chosen to lead this project. He decided the project would be perfect for the systematic improvement approach he was learning in his GLSS Green Belt Training & Certification.

When asked what was most helpful with the GLSS training, William noted, “I liked the work at your own pace. That was beneficial, being in the military and not knowing when I’d have access to my computer.”

The Root Causes

William conducted classes with the Medical platoon to work on the project and discuss the use of his GLSS training.

Reflecting on the engagement and support for the project, William says, “You’re surrounded by medical providers; each one wants to get better and more proficient because that correlates to saving lives on the battlefield. Everybody can get behind that.

The GLSS interactive training modules and the Bahama Bistro case study made it very easy to understand the content. It made all the concepts easier to communicate to the platoon. I could take the content and summarize it quickly because GLSS made it easy.

With the GLSS training William shared, the Medical Platoon worked diligently to lay out a Data Collection Plan in easy-to-understand deliverables. The ultimate goal was to define what was needed to measure aid station establishment time and identify improvement opportunities.

William recalls, “After a considerable amount of debate, we landed on measuring establishment as the amount of time it takes from the moment the medical platoon arrives on-ground to the moment that aid station is ready to receive patients.”

The data collection revealed the Baseline for aid station establishment time was a mean of 45 minutes and 14 seconds. However, with the process variation it could take as long as 55 minutes. This data was collected over 12 training cycle iterations at Fort Carson, CO.

Digging deeper into the data and the process, the team used the Fishbone Diagram, another valuable technique from the Green Belt Training, to explore the potential causes driving the establishment time.

Among the numerous factors involved, using logic, data, and process observations, the team discovered the root causes driving the establishment time:

  • Time locating equipment
  • Too many variations in aid station configuration
  • Unclear roles and assignments
  • Inconsistent reproducibility of the process

The team also conducted a Value-Added Flow Analysis of the process steps. The team was surprised to learn of a big opportunity to reduce one of the 8 Wastes—Wait Time—specifically, time waiting for:

  • Guidance from leadership on what needs to be placed next in the process
  • QA/QC of the aid station following the establishment

Another major “aha” was discovered during the analysis. There was significant confusion regarding which containers were needed at what time in the process.

The Solutions

Following the guidance and methods within the GLSS Training & Certification, the team identified improvement ideas and used the Solution Selection Matrix to determine the best solutions to implement. This included establishing Standard Work, which included:

  • Developing new process requirements from working with external organizations and sister platoons
  • Creating a refined aid station set-up
  • Optimizing the establishment process steps
  • Clarifying roles
  • Labeling of containers and determining the sequencing of unloading and loading
  • Takt Time analysis to determine ideal process task times and assignments
  • Cross-training for all medical platoon members on all aspects of setup

The Results

The aid station establishment average lead time was reduced from 45 minutes to 32 minutes—a 29% improvement. Subsequently, for the aid station breakdown procedure, removing all equipment, and preparing to move to another location, the average lead time was reduced from 36 minutes to 25 minutes—a 31% improvement. Establishment and breakdown times were both greatly reduced, allowing the aid station to receive and treat patients faster and more efficiently.

William states, “Decreasing establishment lead time by 29% and breakdown by 31% is an outstanding success. It is visible to the entire team that collaborated on this project. This transition helped us become the most efficient aid station within the 2SBCT and likely one of the most efficient aid stations in the entire Army.”

William continues, “The success of this project will undoubtedly lead to saving lives at the end of the day. With shorter lead times for the aid station, we can now receive and treat patients in a smaller amount of time which directly translates to being able to sustain America’s Army!”

An Action Review (AAR) of this project resulted in the identification of several additional improvement projects for the aid station, as well as other projects within the battalion to reduce lead time. GLSS Lean Six Sigma Training & Certification is a natural fit for the Army’s continual pursuit to “Be All You Can Be”!