WGU D469 FUN1 Task 1: DMAIC Model – Expert Guide + Worked Example | Fielder Medical Center

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The Assignment

Introduction

Improving, optimizing, and stabilizing business processes is critical in today’s business environment, which requires data-driven decision-making competencies.

In this task, you will assume the role of a process owner tasked with improving shoulder replacement surgical processes at a medical center. You will use a Six Sigma approach to improve patient care, reduce waiting time, and reduce costs. Using the case study provided, you will apply principles of the DMAIC model to create a value stream map.

Scenario

Use the information in the attached “Case Study: Shoulder Replacement at Fielder Medical Center” supporting document to complete your submission.

Create a Value Stream Map

A. Create a multimedia presentation (e.g., PowerPoint, Keynote) (suggested length 10–15 slides)for key stakeholders in which you apply the DMAIC model to create a value stream map by doing the following:

Define and Measure Phase

1.  Using the attached case study, apply the Define and Measure phases of the DMAIC model by doing the following:
2.  Develop the project charter by doing the following:
3.   Explain the project scope and problem.
4.  Identify the time frame, boundaries, and stakeholders.
5.  Identify threecritical characteristics for customer satisfaction.
6.  Identify oneof each: output, input, and process variable.
7.  Qualitatively describe threedefects in the current system.
8.  Describe quantitative measurements of eachof the three defects from part A1d.
9.  Evaluate the process capability for eachof the three defects from part A1d.

Analyze Phase

2.  Using the attached case study, apply the Analyze phase of the DMAIC model by doing the following:
3.  Describe the root causes for eachof the three defects from part A1d by using a cause-effect table.
4.  Assign a value analysis process to eachof the root causes from part A2a based on a determination of whether they are value added (VA) or non-value added (NVA).
5.  Justify your answer to part A2b.

Improve Phase

3.  Using the attached case study, apply the Improve phase of the DMAIC model by doing the following:
4.  Explain oneproposed solution to eachof the defects from part A1d, for a total of three solutions.
5.  Describe how onesolution from part A3a will be implemented by doing the following:
6.    Describe the expected outcome of the proposed solution.
7.   Describe onetask to be performed.

iii.  Describe the documentation process for the proposed solution by referencing the current baseline.

Control Phase

4.  Using the case study, apply the Control phase of the DMAIC model by doing the following:
5.  Create a control plan by doing the following:
6.  Describe what stakeholders will monitor in the implementation of the proposed solution from part A3a.
7.  Explain the purpose of a statistical process control (SPC) chart within the control process.
8.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
9.  Demonstrate professional communication in the content and presentation of your submission.

B. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

C. Demonstrate professional communication in the content and presentation of your submission.

Case Study: Shoulder Replacement at Fielder Medical Center

Case Study Shoulder Replacement at Fielder Medical Center

What Is WGU D469 and Why Does FUN1 Task 1 Matter?

WGU D469 — Quality, Continuous Improvement, and Lean Six Sigma — is a performance-task-heavy MBA course that tests your ability to apply process improvement frameworks in realistic healthcare and operations contexts. FUN1 Task 1 is a single high-stakes deliverable: a 10–15 slide multimedia presentation in which you apply every phase of the DMAIC model to a provided case study.

The course competency is 3232.3.2: Applies Quality Management Strategies. WGU evaluators assess your submission against a detailed rubric, which means generic DMAIC theory will not earn you a passing grade — you must demonstrate applied analysis tied directly to the Fielder Medical Center scenario.

Unlike WGU’s objective assessments (OAs), FUN1 cannot be retaken the same day. A thoughtful, rubric-mapped submission the first time is the only efficient path forward.

Understanding the Fielder Medical Center Case Study

Fielder Medical Center is a 1,000-bed hospital attempting to optimize its shoulder replacement surgical process using a Six Sigma approach. The project team’s mandate is explicit: do not change how surgeons perform the procedure — eliminate the administrative and logistical waste surrounding it.

Shoulder replacement is a high-volume, high-cost procedure. Approximately 70,000 shoulder replacement procedures are performed in the United States annually, at an average cost of $25,000 per surgery, representing an aggregate annual expenditure of approximately $1.75 billion (Jazayeri & Singh, 2023). Patients currently report a negative view of Fielder’s quality of care, and the center is experiencing patient overflow, outdated technology, and a length of stay (LOS) averaging six days — more than double the NIH-reported median of two to four days for shoulder arthroplasty (Dunn et al., 2015).

The Three Core Process Defects You Must Identify

Correctly identifying and consistently applying these three defects across all DMAIC phases is the single most important structural decision in your entire presentation:

Tip for your presentation: Assign each defect a label (D1, D2, D3) on your first mention and use it consistently across every slide. WGU evaluators cross-reference rubric items; inconsistency is a common cause of revision requests.

What Is the DMAIC Model and How Does It Apply to Healthcare?

DMAIC — Define, Measure, Analyze, Improve, Control — is the core problem-solving methodology of Six Sigma and the structured framework around which your entire D469 FUN1 submission is organized. It is a data-driven cycle designed to reduce process variation and eliminate defects (ASQ, 2023).

In healthcare, DMAIC has demonstrated measurable impact. A landmark study applying DMAIC to knee replacement surgery achieved a statistically significant reduction in patient LOS by systematically mapping waste in pre- and post-operative processes — directly analogous to the Fielder scenario (Improta et al., 2017). Six Sigma’s performance standard targets no more than 3.4 defects per million opportunities, a benchmark that requires rigorous measurement and root-cause analysis before any improvement is attempted.

How to Complete the Define and Measure Phase (Rubric A1)

The Define and Measure phase establishes the project charter, identifies what the customer values, and quantifies the magnitude of each defect. Every element in rubric items A1a through A1f must trace directly back to the Fielder case data.

A1a — Project Charter

Project Scope and Problem Statement (A1a-i):

The scope of this project encompasses the end-to-end shoulder replacement surgery process at Fielder Medical Center, from initial patient intake through post-surgical discharge. The project excludes the surgical procedure itself, as the team identified that uncontrollable intraoperative variables are outside the scope of administrative improvement.

Problem Statement: Fielder Medical Center’s shoulder replacement surgical process generates excessive patient wait times, is supported by an unstable healthcare information system, and lacks a standardized discharge protocol — resulting in an average length of stay of six days, 2.5 times the NIH median benchmark of two to four days (Dunn et al., 2015) and contributing to patient dissatisfaction.

Timeframe, Boundaries, and Stakeholders (A1a-ii):

A1b — Three Critical-to-Quality (CTQ) Characteristics

Critical-to-quality characteristics are measurable attributes that directly reflect what patients and stakeholders define as value. The Voice of the Customer (VOC) for this project, derived from patient dissatisfaction reports and staff feedback, yields three CTQs:

• CTQ 1 — Reduced Length of Stay: Patients require a predictable, evidence-based LOS of ≤2.5 days, consistent with national benchmarks for shoulder arthroplasty (Dunn et al., 2015).
• CTQ 2 — Timely Bed Assignment: Patients should be assigned a bed within 30 minutes of arrival, eliminating the current 3-hour hallway wait that drives dissatisfaction.
• CTQ 3 — Reliable Health Information System Uptime: Clinical and administrative staff require a health information system with ≥99.9% operational uptime to support accurate data collection, real-time bed tracking, and safe patient handoffs (Ngafeeson, 2014).

A1c — Output, Input, and Process Variables

A1d — Three Defects in the Current System (Qualitative)

1. Defect 1 — Intake Overflow: The centralized intake design routes all patients through a single receiving area before bed assignment. Complex administrative procedures and inter-staff communication failures cause patients to wait three or more hours in hallways, producing significant patient distress and care delays.
2. Defect 2 — Unstable HIS: The existing healthcare tracking system is technologically obsolete, requiring an average of five forced reboots per day. Data entry errors, inconsistent multi-user access, and extended training timelines for new staff degrade the accuracy and timeliness of patient data, impairing clinical decision-making (Ngafeeson, 2014).
3. Defect 3 — Extended Pre-Surgery Assessment and Unstructured Discharge: Patients undergo a two-to-three-day in-hospital risk assessment prior to surgery, consuming bed capacity before any surgical value is added. Post-surgical discharge lacks a standardized protocol, producing a disconnect between care staff and patients — a deficiency nationally associated with a 70% 30-day rehospitalization rate and $17.4 billion in avoidable costs (Kassin et al., 2012).

A1e — Quantitative Measurements of Each Defect

A1f — Process Capability Evaluation for Each Defect

Process capability quantifies how well a process performs relative to its specification limits. The indices Cp and Cpk measure process spread and centering, respectively. A Cpk ≥ 1.33 is the minimum acceptable threshold; Six Sigma targets Cpk ≥ 2.0 (i.e., 3.4 DPMO).

How to Complete the Analyze Phase (Rubric A2)

The Analyze phase identifies the root causes that drive each defect and classifies process activities as value-added (VA) or non-value-added (NVA). A cause-effect (fishbone) analysis is the primary tool required by rubric item A2a.

A2a — Cause-Effect Table for Root Causes

A2b — Value Analysis: VA vs. NVA Classification with Justification

Value analysis determines whether each root cause activity directly contributes to patient care (value-added) or represents waste that should be eliminated or reduced (non-value-added). Lean Six Sigma defines value as any activity for which the customer would willingly pay (ASQ, 2023).

How to Complete the Improve Phase (Rubric A3)

The Improve phase proposes evidence-based solutions for each defect and details the implementation plan for one selected solution. Solutions must directly address the root causes identified in the Analyze phase — not introduce unrelated interventions.

A3a — Proposed Solutions (One Per Defect)

• Solution for D1 — Implement Decentralized/Hybrid Intake with Digital Pre-Registration: Transition from the single centralized receiving area to a unit-level intake model with digital pre-registration, consistent with the hybrid approach described by the National Association of Healthcare Access Management. Patients complete administrative data collection online prior to admission, enabling direct bed assignment upon arrival and eliminating the 3-hour hallway wait.
• Solution for D2 — Replace Legacy HIS with Epic EHR Platform: Migrate from the current unstable legacy system to the Epic Electronic Health Record platform, which is widely adopted by high-volume academic medical centers including Johns Hopkins, Cedars-Sinai, and Mayo Clinic. Epic offers real-time backup, 24/7 support, system redundancy, and full interoperability with modern healthcare data standards (NIH, 2023).
• Solution for D3 — Pre-Hospitalization Service + Standardized Discharge Protocol: Launch a pre-hospitalization service that moves all pre-surgical risk assessment activities (diagnostic testing, laboratory work, patient risk scoring) out of the inpatient setting and into an outpatient pre-admission clinic. Simultaneously implement a standardized discharge protocol to reduce 30-day rehospitalization risk (Kassin et al., 2012).

A3b — Implementation Plan for the Pre-Hospitalization Service (Solution for D3)

Why this solution? The pre-hospitalization service has the highest direct impact on the primary CTQ metric (LOS reduction from 6.0 days to ≤2.5 days) and is specifically identified in the case study as the team’s executed intervention.

A3b-i — Expected Outcome:

Implementing the pre-hospitalization service is projected to reduce average LOS from 6.0 days to 2.5 days or fewer, aligning Fielder Medical Center with the NIH median benchmark of two to four days for shoulder arthroplasty (Dunn et al., 2015). By shifting the 2–3 day pre-surgical risk assessment to an outpatient setting, the first in-hospital experience for patients becomes the surgical procedure itself. This eliminates the largest single source of non-value-added bed-days, reduces per-case cost, and improves patient satisfaction scores by replacing hallway waiting with a structured pre-admission visit.

A3b-ii — One Task to Be Performed:

Establish a Pre-Hospitalization Assessment Clinic staffed by orthopedic nurses, an anesthesiologist, and an administrative coordinator. The clinic will conduct comprehensive pre-surgical risk assessments — including complete physical examination, diagnostic imaging review, laboratory testing, and patient risk scoring using validated instruments (Bartelstein et al., 2022) — within a scheduled 4-hour outpatient visit occurring 3–7 days before the planned surgery date. Patients will be cleared for surgery, pre-registered in the HIS, and assigned a post-surgical bed before the day of surgery.

A3b-iii — Documentation Process (Referencing Current Baseline):

The documentation process will use the existing BTIS (Bed Tracking and Information System) — already deployed at Fielder but currently underutilized — as the primary platform for logging pre-hospitalization assessment completion status. The current baseline is a paper-based and manual HIS process requiring 2–3 days of in-hospital documentation. The new protocol establishes a digital pre-admission checklist within the BTIS, which flags a patient as ‘cleared and pre-registered’ before admission. This flag triggers automatic bed assignment on the day of surgery, eliminating the intake bottleneck (D1) as a co-benefit. Variance from the checklist (e.g., incomplete lab results) triggers an automated alert to the orthopedic care coordinator, who contacts the patient to resolve the gap before the surgery date.

How to Complete the Control Phase (Rubric A4)

The Control phase ensures that improvements are sustained over time through structured monitoring, stakeholder accountability, and statistical process control. Without a robust control plan, even well-implemented solutions regress to baseline — a failure mode well-documented in healthcare quality improvement literature.

A4a — Control Plan

What stakeholders will monitor: The control plan assigns monitoring responsibilities across three stakeholder groups for the pre-hospitalization service solution:

A4b — Purpose of a Statistical Process Control (SPC) Chart

A Statistical Process Control (SPC) chart is a real-time graphical tool that plots process performance data over time against statistically derived control limits, enabling teams to distinguish between common-cause variation (inherent to the process) and special-cause variation (indicating a process shift requiring investigation).

In the context of the Fielder LOS improvement, an X-bar control chart would plot the mean LOS for each weekly cohort of shoulder replacement patients. The upper control limit (UCL) and lower control limit (LCL) are set at three standard deviations from the process mean established post-implementation. Any data point outside these limits, or any non-random run pattern (e.g., seven consecutive points above the centerline), signals a special cause requiring immediate root-cause review.

SPC charts serve a critical function in healthcare quality management: they prevent over-reaction to normal variation (which wastes resources) and under-reaction to true process deterioration (which harms patients). For D469 purposes, this distinction between common cause and special cause is what separates a monitoring system from a reactive firefighting culture — the core cultural shift Six Sigma is designed to produce.

What Is a Value Stream Map and How Should It Appear in Your Presentation?

A Value Stream Map (VSM) is a visual representation of every step in a process from customer need to customer fulfillment, annotating each step with time, quality, and resource data to make waste visible (Rother & Shook, 1998, as cited in Improta et al., 2017).

In your D469 FUN1 presentation, the VSM does not need to be a professional-grade industrial engineering diagram. It must functionally illustrate two states: the current-state value stream (showing where NVA time accumulates) and the future-state value stream (showing the improved flow after your proposed solutions).

Current-State VSM for Fielder Medical Center — Key Elements

• Patient Arrives → Centralized Intake (Wait: 180+ min NVA) → Administrative Data Collection (NVA) → Bed Assignment
• Bed Assignment → In-Hospital Pre-Surgery Risk Assessment (2–3 days NVA)
• Risk Assessment Complete → Surgery Preparation → Shoulder Replacement Procedure (VA)
• Post-Surgery Recovery → Unstructured Discharge Planning (variable NVA) → Discharge
• Total NVA Time: 2–3 days pre-surgical + 3+ hour intake wait + variable discharge delay → 6-day average LOS

Future-State VSM — Post-Improvement

• Patient Arrives → Direct Bed Assignment (≤30 min; BTIS pre-cleared)
• Surgery Day → Shoulder Replacement Procedure (VA)
• Post-Surgery Recovery → Standardized Discharge Protocol → Discharge
• Total NVA Time Eliminated: Pre-hospital assessment completed as outpatient; no intake wait; structured discharge → Target LOS ≤2.5 days

WGU D469 FUN1 Task 1 Example

WGU_D469_FUN1_Task1_DMAIC_Example  (Click to Download)

References

American Society for Quality. (2023). Six Sigma. https://asq.org/quality-resources/six-sigma

Bartelstein, M. K., Forsberg, J. A., Lavery, J. A., Yakoub, M. A., Akhnoukh, S., Boland, P. J., Fabbri, N., & Healey, J. H. (2022). Quantitative preoperative patient assessments are related to survival and procedure outcome for osseous metastases. Journal of Bone Oncology, 34, 100433. https://doi.org/10.1016/j.jbo.2022.100433

Dunn, J. C., Lanzi, J., Kusnezov, N., Bader, J., Waterman, B. R., & Belmont, P. J. (2015). Predictors of length of stay after elective total shoulder arthroplasty in the United States. Journal of Shoulder and Elbow Surgery, 24(5), 754–759. https://doi.org/10.1016/j.jse.2014.11.042

Improta, G., Balato, G., Romano, M., Ponsiglione, A. M., Raiola, E., Russo, M. A., Cuccaro, P., Santillo, L. C., & Cesarelli, M. (2017). Improving performances of the knee replacement surgery process by applying DMAIC principles. Journal of Evaluation in Clinical Practice, 23(6), 1401–1407. https://doi.org/10.1111/jep.12810

Jazayeri, R. (2023, February 12). Optimizing total shoulder replacement surgery recovery. Xcelerated Recovery. https://xrscience.org/blogs/education/optimizing-total-shoulder-replacement-surgery-recovery

Kassin, M. T., Owen, R. M., Perez, S. D., Leeds, I., Cox, J. C., Schnier, K., Sadiraj, V., & Sweeney, J. F. (2012). Risk factors for 30-day hospital readmission among general surgery patients. Journal of the American College of Surgeons, 215(3), 322–330. https://doi.org/10.1016/j.jamcollsurg.2012.05.024

Ngafeeson, M. (2014). Healthcare information systems: Opportunities and challenges. In Book sections/chapters (Paper 14). Northern Michigan University. http://commons.nmu.edu/facwork_bookchapters/14

Panahi Tosanloo, M., Adham, D., Ahmadi, B., Rahimi Foroshani, A., & Pourreza, A. (2019). Causes of conflict between clinical and administrative staff in hospitals. Journal of Education and Health Promotion, 8, 210. https://doi.org/10.4103/jehp.jehp_358_19

Frequently Asked Questions

What are the three defects in the WGU D469 Fielder Medical Center case study?

The three defects are: (1) centralized patient intake causing 3+ hour wait times due to administrative bottlenecks and single-point access design; (2) an unstable legacy healthcare information system requiring five daily reboots that disrupts data flow and staff communication; and (3) unstructured pre-surgical risk assessment conducted over 2–3 inpatient days combined with the absence of a standardized discharge protocol, collectively driving an average LOS of six days.

How do I write the project charter for WGU D469 FUN1 Task 1?

Your project charter must include: (a) a problem statement specifying the process scope (shoulder replacement at Fielder, excluding the surgical procedure itself), (b) the timeframe and boundaries (what is in/out of scope), and (c) the project stakeholders. The key phrase to include in your problem statement is that the goal is to eliminate waste associated with shoulder surgeries, not to change how surgeons perform the procedure — this language is drawn directly from the case study and signals close reading to your evaluator.

What is the difference between VA and NVA in DMAIC Analyze phase?

Value-added (VA) activities are those a customer would pay for — in healthcare, this means direct patient care that advances their treatment. Non-value-added (NVA) activities consume time and resources without contributing to outcomes. In the Fielder case, the shoulder replacement surgery is VA; the 3-hour intake wait, the daily HIS reboots, and the 2–3 day in-hospital pre-surgical assessment are all NVA and should be targeted for elimination.

How do I explain process capability in my D469 presentation?

Process capability measures how well a process output fits within specification limits. For D469, explain that Cpk < 1.0 means the process is not capable of meeting its target, and describe the gap between current performance and the specification. For example: the current LOS of 6.0 days against a target of ≤2.5 days produces a Cpk well below zero, meaning virtually all patients experience care that exceeds the acceptable LOS threshold.

What should the Control phase include for the D469 DMAIC presentation?

The Control phase requires two things: (1) a control plan identifying which stakeholders will monitor which metrics (e.g., the QI team tracks weekly LOS; intake coordinators log wait times daily), and (2) an explanation of how SPC charts work — specifically, that they distinguish common-cause variation from special-cause variation, enabling data-driven intervention decisions rather than reactive firefighting.

How long should my WGU D469 FUN1 Task 1 presentation be?

WGU specifies 10–15 slides. A 14–15 slide deck allows you to dedicate one slide to each rubric item without crowding content. Slide economy matters — each slide should open with a declarative statement that directly answers its rubric requirement, followed by supporting data, tables, or visuals. Avoid slides that only contain bullet text; evaluators respond better to structured tables and labeled diagrams.

Can I use the same three defects for all DMAIC phases?

Yes — and you must. Maintaining consistent defect labels (D1, D2, D3) across Define, Measure, Analyze, Improve, and Control is critical. WGU evaluators explicitly check that your root causes, solutions, and control measures map back to the defects you identified in the Define phase. Introducing new defects in later phases or failing to address an earlier defect in your solutions will trigger a revision request.

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