GRANVILLE-VANCE DISTRICT GRANVILLE-VANCE DISTRICT

HEALTH DEPARTMENT HEALTH DEPARTMENT

Where the “WIC” Things AreWE HAVE SOLUTIONS!!!

THE QUALITY IMPROVEMENT THE QUALITY IMPROVEMENT TEAMTEAM

CORE TEAM MEMBERS:

DEBORAH GRIFFIN, RN, CARE MANAGEMENT

CASEY CHAMPION, REHS - ENV. HEALTH

LOU ANN ELAM, RN - CLINIC NURSE

BILLIE JAMES, MANAGEMENT SUPPORT

LAUREN FAULKNER, WIC NUTRITIONIST

SHASHEENA ATKINS- HEALTH EDUCATOR

HEALTH DIRECTOR – LISA M. HARRISON

AD HOC MEMBERS –

MESINA REDDISH, WIC SUPERVISOR

WENDY MILON, WIC STAFF

SPECIAL ADVISOR - JAMES GOOCH, DRPH

WHAT WE NEEDED TO CONQUER

• LONG WAITING TIME FOR WIC CLIENTS

• PERIODS OF “DOWNTIME” FOR WIC STAFF

• IMPROVING CONFIDENTIALITY FOR WIC AND CLINIC CLIENTS

• INADEQUATE PHONE SYSTEM IN WIC OFFICE

• LACK OF ACCOUNTABILITY FOR HANDLING OF PHONE MESSAGES

• FLAWED FLOW PATTERN TO THE VISIT…EXCESSIVE WALKING BETWEEN CLINICS

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OUR AIM…OUR AIM…

TO IMPROVE THE OVERALL WIC EXPERIENCE FOR THE WIC CLIENT

AND WIC STAFF. THIS WILL BE ACCOMPLISHED BY

INCREASING THE EFFICIENCY OF THE VISIT AND ENHANCING STAFF

PRODUCTIVITY. WE WANT TO ELEVATE THE CLIENT

AND STAFF SATISFACTION WITH THE MANNER IN WHICH SERVICES ARE

OFFERED.

OUR GOALS

• DECREASE OVERALL LEAD TIME FOR WIC ASSESSMENT

• DECREASE OVERALL CYCLE TIME FOR WIC MEASUREMENTS

• DECREASE THE NUMBER OF STEPS STAFF TAKE TO RETRIEVE CHARTS.

• INCREASE RATE OF RETURN CALLS BY WIC STAFF

• IMPROVE WIC CLIENT SIGN-IN PROCESS

• IMPROVE CLIENT SATISFACTION WITH THE WIC VISIT

• IMPROVE STAFF SATISFACTION 5

OUR JOURNEY TO THE OUR JOURNEY TO THE SUMMITSUMMIT……

KAIZEN EVENT RESULTS

OUR FOCUS:

IDENTIFYING A SPACE IN AN ALREADY SMALL HEALTH DEPARTMENT TO CREATE A SPACE FOR WIC TO DO THE HEIGHT AND WEIGHT ASSESSMENTS.

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KAIZEN EVENT RESULTS

OUR ACCOMPLISHMENTS:IDENTIFIED A SPACE FOR WIC TO MOVE THE ASSESSMENT

EQUIPMENT BUT HAD TO WORK OUT DETAILS. INTRODUCED A NEW “FLOW” PATTERN FOR CLIENTS TO SIGN IN

THAT DECREASED STEPS FOR THE CLIENT. ADJUSTMENTS MADE TO THE WIC PHONE LINE UNTIL FUNDS

CAN BE APPROPRIATED TO UPDATE PHONE SYSTEM, A BILINGUAL MESSAGE ADDED.

COLLABORATED WITH MANAGEMENT SUPPORT IN DEVELOPING A PLAN THAT ALL CHARTS PULLED FOR WIC ARE ACCOUNTED FOR AT THE END OF EACH DAY.

PROJECT MEASURESPROJECT MEASURES DECREASED LEAD TIME FOR APPOINTMENTS IMPROVED PROCESS FOR OBTAINING CHARTS THAT IMPROVED EFFICIENCY OF WIC

STAFF. IMPROVED STEPS FOR CHART RETRIEVAL AND RETURN RATE.

BEFORE AFTER

KEY IMPROVEMENTSKEY IMPROVEMENTSTelephone with a new second line with rollover and a bilingual message

Filing Cabinets

Charts pulled daily and put in portable box

New Sign In Process

Old Sign In Process

Old Height & Weight Room shared with Clinic Nurses

New Height & Weight Room next to WIC The New Signal

Process

WHAT WE LEARNED OUR “AHA” MOMENTS OUR CHALLENGES

• THE WILLINGNESS OF OTHER EMPLOYEES TO ADAPT TO CHANGES BROUGHT ABOUT BY OUR PROJECT.

• WIC HAS A SMALL SPACE TO ACCOMMODATE A LOT OF PEOPLE.

• QI AND ACCREDITATION PROCESSES COMPLIMENT EACH OTHER.

• OUR PDSA’S OVERLAPPED AND REQUIRED GOOD COMMUNICATION TO ENSURE OUTCOMES.

• TEAM DYNAMIC BROUGHT MUCH EXPERIENCE, UNDERSTANDING AND APPRECIATION.

• H.D. STAFF ASKING WHAT WE WERE DOING NEXT!

• TIME, TIME, TIME

• ROLLING WITH RESISTANCE

• COMMUNICATION- MAKING SURE THE MESSAGE IS DELIVERED.

• CULTIVATING THE QI CULTURE AND INTERSPERSING IT THROUGHOUT THE HD WITH SUCCESS

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GRANVILLE VANCE DISTRICT HEALTH DEPARTMENT

RETURN ON INVESTMENT (ROI)TANGIBLES AND INTANGIBLES

OVERALL IMPROVEMENT OF WIC VISIT

• CYCLE TIME IMPROVED

• LEAD TIME IMPROVED BY 30.7% AS A RESULT

• IMPROVED FLOW OF WIC CLINIC

• INCREASED CONFIDENTIALITY TO WIC CLIENTS

POTENTIAL TO ADD TO WIC CLIENT-BASE

•INCREASED CAPACITY TO GROW WIC PROGRAM

•NO ADDITIONAL COST TO WIC PROGRAM TO INCREASE CAPACITY

•POTENTIAL QI PROJECT TO IDENTIFY MARKETING STRATEGIES TO REACH POTENTIAL CLIENTS

IMPROVED PRODUCTIVITY

• TIME SAVING PRACTICES ENHANCE STAFF PRODUCTIVITY

• IMPROVED COMMUNICATION THAT WILL FOSTER CQI IN WIC IN THE FUTURE.

• COLLABORATION WITH OTHER HEALTH DEPARTMENT UNITS

ROI CALCULATIONS• REALLOCATION OF STAFF TIME:

• 20 MINUTE OF REALLOCATED STAFF TIME DUE TO DECREASED WIC PATIENT LEAD TIME

• 20 MINUTE (LEAD TIME SAVED) X 2,486 (TOTAL CASELOAD X 2 ASSESSMENTS/YEAR = 49, 720 MINUTES

• 49, 720 MINUTES / 60 MINUTES = 829 HOURS

• 829 HOURS X $26.66 (2 PA STAFF SALARIES PER HOUR) = $22,101.14

• 96 DAYS (1/2 STAFFED IN WIC) = 96 X 7.5 (HRS PER DAY) =720 HOURS

• 720 HOURS (1 FULL STAFF) X $13.33 (1 PA HOURLY SALARY) = $9, 597.60

• $22,101.14 (2 PA SALARIES) - $9,597.60 (1PA SALARY) = $12,503.54 (TOTAL SAVINGS)

THANK YOUSO THIS IS WHERE WE LIVE AND ARE EVOLVING!!!!