improving access to child health clinics in nanaimo

It’s important you get your baby immunized on schedule!

…and then I told her the next appointment was two months from now!

Nurse Conversation Admin Staff Conversation

Background

• Public Health promotes timely immunization of infants and toddlers

• Unofficial (provincial) standard is two weeks to next appointment

• Access has grown to over 50 days in several health units at Island Health

• Credibility of Public Health is at risk• Most importantly infants and toddlers are at

risk

Aim of Project

Access to the 3rd next <2 year old Child Health Clinic appointments will be improved from 57 days to 14 days at the Nanaimo Health Unit, and the satellite office of Princess Royal Family Centre by March 31, 2015.

Team MembersName Role/Responsibilities

Brett Hodson Overall Project Management Leadership and Coordination

Marie Duperreault Site and Change Management Leadership

Tricia Fothergill Site change design and leadership

Erin Kenning Site change design and leadership

Lynn Mason Administrative data gathering and change leadership

Helen Von Bucholz Project Support

Sandra Guerrier HR Business Partner

Changes Tested• Survey of Clients to determine acceptability of

time to access appointments (14 days to 28 days), and drop in clinics

• Determine real time appointment demand• Reduced ‘drop in’ clinic availability to once a

week from twice a week• Eliminated fee for service activities• Added 34 of total 49 appointments per week

needed to meet demand

Results so Far

Results so Far

Elimination of Thursday Drop In

Elimination of Thursday Drop In

Start of Measles outbreak concerns

"Reduced Service Week"

Comparison of Grant and Princess Royal Service Delivery Sites

Date

Lessons Learned• Half of clients who accessed drop-ins prefer

booked appointments• Pre-intervention study and assessment revealed

overall lack of capacity• Adding capacity improves short term outcomes,

however holiday period and unanticipated events may confound intervention

• Staff report mixed feelings about improved time/task management capability

Next Steps: Future Focus

• Continue to collect data to:– Monitor time to access appointments– Collect additional data on real time

appointment demands to determine need to add capacity to reach full 49 total appointments as per original plan

– Develop sustainability for this specific work at the local office

– Plan to disseminate findings

Contact Information

Brett Hodson, ManagerPublic Health ServicesBrett.Hodson@viha.ca@hodson4qph