“Women in Charge” Increasing our WIC Participants and WIC Caseload

NAME OF HEALTH DEPARTMENT: MTW District Health Department

PROJECT TITLE: “Women in Charge” Increasing our WIC Participants and WIC Caseload

L. Loretta Hodges
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Project Overview

Project Aim:
We aim to increase the number of active WIC participants enrolled in the program within the Martin Tyrrell Washington District Health Departments.  The WIC program includes pregnant, post-partum, and breastfeeding Women, infants, and children up to five years of age.  We will accomplish this by September 1, 2011.  This is important because the agreement addendum requires that we have a 97% or higher caseload.  Falling below this amount could affect our caseload total and funding for our program. We will achieve this by using QI methods we learned in the public health QI course to increase our caseload.


  • Increase the number of women participating in our program from 82% to 97%
  • Increase number of WIC referrals from other community agencies from X to X
  • Decrease the average no show rate to the WIC clinic from 50% to 25%

Project timeframe:
January 2011 to September 30, 2011

How was the need for the project determined?
MTW WIC program had continuously been decreasing in both participation and caseload and wanted to    find a way to increase our numbers and prevent cuts in funding for our program.

Does this quality improvement project link to accreditation?
The project does affect our state funding and therefore we may have cuts which can affect employees by either cutting positions or money to our program for other needs.

Areas for Improvement and Change Ideas Implemented

Improvement 1
Obtaining correct address and telephone numbers of clients to contact them for their appointment times and reminder letters.

  • Developed and gave a survey to clients to determine why participants were not keeping their appointments. We started out doing one week in each county and then did 2 weeks and  found out that transportation was the number one reason for not keeping their appointments so we made sure that they were given a time when they could come in and encouraged them to call us if they needed to change appointments or come in as a walk-in appointment if they needed to.

Improvement 2
We wanted to see who was referring our clients to the WIC program and did a survey for 2 weeks in each county and found that family and friends were the number one referrals for our program. The local doctors in the area were the next highest referrals and DSS was the third on our list.  We decided to give gift baskets to our local doctors ‘offices and DSS to thank them for our referrals and also to hopefully increase our referrals from both of them. We have increased our referrals from both but we are still continuing to communicate with both of them to increase our referral numbers. The WIC program also sent cards very similar to our survey forms as decreased caseload is a state wide problem to see who was referring clients to the WIC Program.  We are continuing to use the state WIC program cards and send them to the state on a monthly basis.

Improvement 3
We provided food demos in all three of our counties to help our clients use the WIC foods to see that they could be both tasty and nutritious.  The clients enjoyed tasting the foods and learning new recipes.  We made fruit smoothies, bean and cheese tortillas, peanut butter French toast and spinach dip and homemade pita chips. We will continue to provide the food demos to show our clients healthy ways to use their WIC foods.

Improvement 4
We wanted to reach more of our clients so decided to provide a billboard in our service area.  We called other WIC offices that had billboards to get ideas for the billboard and who to contact. We sent information to the billboard company and they sent us a sample billboard.  We had 4 versions of the billboard before we decided on the final one.  We ask our clients to look at the samples to help us decide on the final one.  We have had many comments by  our clients, our health department staff and visitors.


Overall Improvements

  • Developed reminder letters for our clients for their appointments.
  • Provided ways for clients to use their WIC foods that were tasty and nutritious.
  • Improved communication in each county with DSS and local doctors’ offices which provide referrals.
  • Coordinated with the state WIC program to provide outreach efforts in each county.
  • Provided advertisement for the WIC program with the billboard and signs to each WIC office.
  • Organized each WIC office to better serve our clients.
  • Gave our WIC staff a chance to work together as a group which is difficult since we have 3 counties.

Lessons Learned:

  • Phone calls did not work as a way to contact our clients even though we tried to get a new number every time they came to WIC. 
  • It was difficult to get the staff together as a group so we would meet once a month in person but we had much greater success with our phone conference calls.  This gave us an opportunity to meet without having to travel and waste time.
  • Have an open mind to change which can in the long run make improvements.

A program of:

Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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