february 25 – 27, 2013 executive sponsor – dr. judy shlay process owner – sarah rodgers lean...
TRANSCRIPT
FEBRUARY 25 – 27, 2013Executive sponsor – Dr. Judy Shlay
Process Owner – Sarah RodgersLean Lead – Kathy Root
Participants – Lori Ramirez, Dean McEwen, Alexis Juarez, Ashley Oliver, Marianne
Aguirre-Colon, Andrew Yale, Heather Weir, Melissa Edel, Kathie Chichester, Kristi
Yamaski
Inefficient use of resources – financial and staff
Improving/creating standard work Adhere to federal and state laws Adjusting inventory
• Standard practice• Easy process• Immunizations and apply to other
programs/agencies• Root cause• Minimize errors and safety• Decrease financial errors• Reduce staff burden• Patient satisfaction and wait times
•Clerk writing too much important info on routing slips•Lot # list not being used•Lot # list•Vaxtrax pulling incorrect lot #•Using the wrong lot #•Multi user friendly files•Order too often•Par levels•Too few people knowing the process•Missing QA of correct lot # being used•Routing slip does not have standard documentation•Self pay defaults to VFC eligible in Vaxtrax
• Nurse is faxing and copying• Handwriting• Wrong person is ordering• Nurse asking for payment and printing
records• Nurse/clerk charting
• Data entry into Vaxtrax• Confirmation fax• Streamline process• Determine lot # before bringing patient
into clinic room
• Multi inventory books• Visual assessment of vaccine needed• Rebalancing of inventory• Delay in billing/chart review
Fixing lot #’s VFC vaccine processing report Sending email twice to billing person if
denied claim Too many forms Using lot # form routing slip
Paperwork for patient Paperwork for inventory Un-useful Vaxtrax reports Billing reports QA every visit
Do quickly Prioritize
Do it soon Analyze Later
Level of effort each action requires
Impa
ct to
cus
tom
er
Low High
Low
H
igh
Forms & Stickers: Created new labels for the routing sheet to cover the lot #’s Developed new consent forms Wrote standard billing procedures
Fridge & Opening/Closing Procedures: Reorganized immunization refrigerator Developed Start/End of Shift Checklist Improved Inventory Lot Number list – Alphabetized, color-coded
by VFC/317/Private Ordering process
Par levels Standardized ordering process Improved ordering form for private vaccines Updated ordering procedures and process Updated binders
1) FinancialIncrease donations baseline is January’s donation amount goal – 10% increase by April
2) OrderingRetro report of # of times orderingPrivate order per monthTime study of old vs. new ordering systemBaseline done nowGoal - undetermined
3) Quality assurance – lot/site/program/wrong potBaseline – 30%Goal – less than 5%
4) Employee satisfaction – survey changes after 45 and 90 days
WHAT BY WHOM BY WHEN
Ordering
Use new ordering sheet Lori 1-Apr
Finish standard ordering process Lori/Dean 1-Apr
E-borrowing form Dean/Sarah 30-Jun
Patient Visit-Clerk
Standards for opening and closing Alexis/Ashley 8-Mar
Track donations Ashley 30-Mar
Standard for check out process Alexis/Sarah 1-Apr
Determine patient flow Kathy/Sarah 31-May
Assess vax trax self pay insurance Sarah/Andrew send email 30-Dec
Patient Visit-RN
Finalize Consents-Translate/Legal Sarah 8-Mar
Training sticker/create script Lori 18-Mar
Standard work/documentation/peer audits Marianne March 18/ April 31
Data Analysis
Complete the spread sheet Dean 29-Mar
Improve reporting Dean 30-Apr
Denial vaccine reconciliation process Dean/Sarah 30-Jun
Quality
Visual management board Sarah/Marianne/Kathy 18-Mar
Add QA process for checking lot/develop QA/audit tool Ashley/Heather 15-Apr
Employee satisfaction Heather/Judy April 19/ June 28