1. Quality Improvement for Local Health Departments Presented by the NYS Department of Health In collaboration with the NYS Association of County Health Officials Funded by a grant from the Robert Wood Johnson Foundation With the support of the Public Health Informatics Institute

2. 2 Process Mapping

3. Why do quality improvement? Quality Improvement is a valuable tool in public Health because: The Public Health System is complex and involves multiple interlocking processes (e.g., food borne illness outbreak). We often have to react quickly to a situation and put “quick fixes” in place. Many of the “quick fixes” remain after the emergency but may not be the most effective and efficient. An organization is only as effective as its processes. 3

4. Benefits of Process Mapping Helps the team to develop a complete, shared understanding of a “process” to clarify responsibilities and ownership Helps to focus on how the client/patient views the process Helps the team to understand what is actually happening and not what individuals thought was happening Opportunity for staff to express their ideas and show how they contribute to the organization 4

5. What is a Process? 5 A process is a series of interrelated activities performed to meet an organizational objective

6. Example of an LHD Process 6

7. Questions to Ask in Selecting an Improvement Opportunity First: What do you do a lot? Where and when have things gone wrong? Where are complaints from clients and staff coming from? Make a list of possible opportunities, then ask: Is it a priority? Is the team committed to change, especially key stakeholders? Is it possible to make any identified changes? 7

8. Examples of Processes Improved in Real Projects Intake Inventory control Purchasing Billing (Certified Home Health Agencies, Clinic Immunization) Contractual (across multiple agencies, subcontracting) 8

9. Opportunity Statement Format 9 Improve/increase/decrease the _________________ of the _________________

10. Opportunity Statement Examples Decrease the number of insurance denials, including Medicaid, for medical services provided. Increase the number of clients seen in a POD in a 3 hour period. Decrease the time it takes to call in all staff in an emergency situation. 10

11. Exercise 1: Opportunity Statement Select an idea from your list Develop your idea and write out an opportunity statement Pause the module and take 5 minutes to write an opportunity statement. 11

12. Opportunity Statement Tips It must be measurable. It can be a two part statement. It is OK to refine to better describe your opportunity. Make sure that it explains the project to others, including leadership. Be careful not to jump ahead to the solution. 12

13. Process Improvement 13 Organize the Improvement Team

14. The Role of Leadership Invite team members and charter the team With specific deliverables Within a specified timeframe Endorsing the role of the facilitator Make it clear to the organization that they are committed to the project and expect other members of the organization to support the initiative 14

15. Organize the Improvement Team WHO? People who know how a process should work as well as … People who understand how a process really works 15

16. Organize the Improvement Team HOW MANY? Ideally 7 +/- 2 (5 to 9 people) If there are more who need to be involved, consider A CORE team that attends all of the meetings Plus an EXTENDED team that attends periodic update meetings where they can make comments 16

17. Summary Select the process or opportunity Develop the opportunity statement Organize the improvement team Have leadership endorse the team and the process 17