1. Rich Zimmerman Illinois Department of Public Health, Springfield IL
Utilizing a “Time Study” with Viral Hepatitis Integration Projects to Streamline Clinic Flow
Rich Zimmerman
Illinois Department of Public Health, Springfield IL

2. Time Study
Goal: examine length of pre and post hepatitis integration visits and identify impact of expanded hepatitis prevention services had on waiting and interaction time periods
Staff/client interaction periods combined into three types of services
Registration
Medical
Education/counseling

3. Background: Illinois VHIP Project
2000 Accomplishments Funded Five Pilot Sites to:
Provide hepatitis B vaccination services to STD clinic clients and others identified through community-based outreach initiatives
Establish an improved system to collect behavioral risk data, history of hepatitis and hepatitis vaccination
Establish seroprevalence rates among clients aged 18 and older
Establish opportunities and identify barriers to hepatitis B vaccination
2001 Initiatives Funded Seven Pilot Sites to:
Provide hepatitis A and B vaccination services to clients with a history of IDU-related and/or MSM risk behavior(s)
Establish an improved system for collecting data on vaccination return rates
Perform hepatitis B and C testing on clients with IDU-related risk only.
Establish a database that links information from the risk assessment survey with data from the lab and vaccination return data

4. So Much To Do . . . So Little Time!
We need to:
Educate clients about hepatitis
Coordinate services with other Health Department programs (CD, IMM)
Motivate clients to return for 2nd and 3rd doses
Perform reminder/recall
We have to:
Send in risk assessment surveys (RAS) on every client
Submit an extra specimen on IDUs
Complete a spreadsheet entry on clients vaccinated
Provide other clinic services

5. Where can we save time and add services?
Service Flow Chart for Four VHIP Pilot Clinics Participating in “Time Study”

6. VHIP Time Study Data Collection
Data Elements Collected
PRE - VHIP projects collected time-specific service data for 1 week in early 2001 prior to new VHIP Service Roll-out to IDUs and MSMs
VHIP projects and IDPH reviewed clinic protocols, procedures and process to identify areas where services could be improved.
VHIP Project staff wanted to improve services
POST - VHIP projects collected data for 1 week in mid-April or early May 2001
VHIP Timestudy Date: _______
Client # ___________
Enter times below:
Clinic arrival: ____________
RAS returned: ____________
LAB __________ to _________
EXAM: ________ to _________
Counseling ______ to _______
RX ________ Other _________
Vaccination: ______ to _____
Client Dismissed __________

7. Adjusted Average Time Spent Providing Generalized STD Services by Four IL VHIP Pilots
Included Registration & RAS Completion
Included Lab, Exam, Vaccination, Treatment
Included Education, Pre
& Post Test Counseling

8. Clinics were able to reduce overall client visit time by:
Integrating hepatitis prevention with other STD messages
Streamlining clinic flow to reduce waiting times
Focusing on service first during clinic
Increasing staff at two clinics to provide clinic and recall services
Utilizing both interactive and waiting periods to deliver STD and hepatitis services by using written materials, posters, and videos to enhance prevention messages

9. Average Total Time Spent Accessing Services: Pre and Post Integration of Services to Targeted Populations
Winnebago
Macon
Lake
DuPage

10. QUESTIONS
Richard Zimmerman Illinois Department of Public Health STD Section 525 West Jefferson Street, Ground Floor Springfield, IL Phone:  Fax: