GRANVILLE-VANCE DISTRICT
HEALTH DEPARTMENT
Where the “WIC” Things Are
WE HAVE SOLUTIONS!!!
THE QUALITY IMPROVEMENT TEAM
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
3
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
SUMMIT…
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 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.
70
60
50
40
30
20
10
0
APPOINTMENT LEAD TIME
63
WIC Chart Retrieval
Before/After Process Change
Minutes
43
1200
1100
1000
BEFORE
AFTER
800
600
400
361
200
0
BEFORE
AFTER
KEY IMPROVEMENTS
Telephone with a
new second line with
rollover and a
bilingual message
New Sign In Process
Charts pulled daily
and put in portable
box
Filing Cabinets
Old Height & Weight Room shared with
Clinic Nurses
Old Sign In Process
New Height & Weight Room
next to WIC
The New Signal Process
WHAT WE LEARNED
OUR “AHA” MOMENTS
• 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 CHALLENGES
• 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
• 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!
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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 YOU
SO THIS IS WHERE WE LIVE
AND ARE EVOLVING!!!!