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Special Thanks…Debra Isaac, Customer Service Supervisor – Vital
Luis CarrilloMary CouteeEsmeralda GonzalezCathy GrantLoretha JimmersonWillie “Tweety” McClintokJuanita VelasquezHelen Smith
Larissa EstesJulia Gee
Naomi MaciasCelina Garza Ridge
Varsha Vakil
Public Health Department Accreditation Measurement of performance against nationally
recognized, evidence-based standards
Improve and protect the health of the public by advancing the quality and performance of public health departments
Benefits Systematic approach to public health Ensures quality services are provided to residents Enhances visibility and validates commitment to residents Means to obtain additional funding Provides an opportunity to identify areas of performance
improvement
Why Quality Improvement?Foundation of public health
accreditationAccountability
Results of investment in public healthDeclining – do more with lessFuture funding requirement
Getting better all the time Improving performance Improving health outcomes Improving customer satisfaction
Definition of Quality Improvement In Public Health
“Quality improvement in public health is the use of a deliberate and defined improvement process, such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health.
It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.”
Defining Quality Improvement in Public Health; Journal of Public Health Management & Practice: January/February 2010 - Volume 16 - Issue 1 - p 5–7, Riley, William J. PhD; Moran, John W. PhD, MBA, CQIA, CQM, CMC; Corso, Liza C. MPA; Beitsch, Leslie M. MD, JD; Bialek, Ronald MPP; Cofsky, Abbey -
Continuous Improvement
Act
DoCheck/Study
Plan The continuous improvement phase of a process is how youmake a change in direction.The change usually is because the process output is deterioratingor customer needs have changed
What Is Quality?Today the most progressive view of quality is
that it is defined entirely by the customer or end user and is based upon that person's evaluation of his or her entire customer experience.
The customer experience is the aggregate of all the Touch Pointsouch Points that customers have with the organization’s product and services, and is by definition a combination of these. (RFT)
“Quality is not an act. It is a habit”Aristotle 384BC-322BC, Greek philosopher and scientist, student of Plato and
teacher of Alexander the Great
Vital Statistics Lobby
AIM StatementAn opportunity exists to improve the Vital
Statistics Customer Flow beginning with
customer receipt of ticket number from
information window and ending with being
called by a cashier to complete financial
transaction. This effort should reduce wait
time by 15 minutes for the customer.
AIM StatementThis process is important to work on now because
wait times are experienced between the info desk
and cashier and to provide good, efficient customer
service
The baseline measurement is defined as the
following metric: Average wait time per cashier
window of 28 minutes by cashier by day
MethodologyObserved the customer waiting areaMultiple one-on-one discussions with
supervisor and deputy registrar Observed cashiers during several time points
during the work weekSummary analysis of operational reports
Begins with: Customer receiving ticket # from info desk
Ends with: Customer call to cashier window
Process/Activities: • Customer waiting for cashier call (in lobby)•Cashier call
Outputs: • Check documents• Begin database search• Send to Print•Complete transaction
Customers: •General public (Residents of Texas state)
Measures: Average Customer wait timeCashier feedbackCustomer feedback
Inputs: • # of Customers• # of Cashiers•Supervisor triggers/alerts• Previously completed application (at home, office etc)•Availability of all needed documents
Suppliers: • Texas State database• Network
Call # Assigned
NY
Cashier Call
Complete SearchFinancial Transaction
Sent to Printer
Obtain Correct Information
Customer Wait TimeAvg.: 28 min
Is application information correct?
Pick up Certificate at window #10
Print Window CallCustomer Wait Time, includes SOD certificates Avg.: 7 min
Customer enters Vital Statistics Lobby
Info Desk
NY
Complete correct section
Leave if cannot
complete form or
missing docs
Is a correct application section complete and required documentation available?
Customer Wait Time: UnknownFlow Chart
Fishbone – Cause and Effect
Wait time of 28 minutes for vital statistic customers
SituationHDHHS Vital Statistics currently experiencing average customer wait time of 28minutes. Among the reasons for these difficulties is few cashier windows open to serve customers.
AssumptionsVital Statistics will work collaboratively
to implement the project
External factorsStaff feels alienated, incentives not good
enough to motivate and organizational bureaucracies.
And Cashier Feedback. Increase in customer satisfaction to access HDHHS Vital Statistics resources.
Goal: Build avenues to instruct supervisor/s on available resources that can be implemented to reduce customer wait time and assist them to adopt multiple trigger modules to use the available resources. Avenues created are flexible to accommodate all barriers.
Houston Department of Health and Human Services (HDDHS) aims to reduce Vital Statistics customer wait time.
Customers waiting in lobby with 4 Cashier Windows Open Pilot program - Friday 06/08/12 at 2 pm
Cashier Feedback (N = 6)
Q. Did you like the Star TRaK Pilot Program? A. Yes = 5 No = 0
Cashier Comments:“Were able to assist customers faster, continue with more windows open.” “Compliments from customers really made me feel good.”“One [extra] window does make a difference.”“Need to keep more windows open.”“Enjoyed all windows being open, made everything flow smoothly and faster.”“Need more bilingual staff.”
Update on improvement effortsUpdate Cashier Standard Operating Procedures
(SOP)Brought on board temporary staff for Vital
StatisticsStreamlining tasks Workload analysis, resultsPerformance expectations – improved Bureau &
staff functionality New vacation/ sick time policyStaffing levels to improve efficiency &
effectiveness
Next Steps Employee SurveyContinue to monitor & Plan Do Check ActCustomer Survey
Lessons LearnedBlack box / Ripple effectCashiers
Great customer service skillsEfficient and FASTExcellent troubleshooting
Control what you can control… Customer Cashier
???
Lessons learned from Vital Open to change, constructive criticismGoal improved customer servicesListen to othersSuggestions are a way to improve
Improvements ≠ failure it is an opportunity to make it even better