“Quality Raiders” Lowering Family Planning Visit Times

NAME OF HEALTH DEPARTMENT: Richmond_County Health Department

PROJECT TITLE: “Quality Raiders” Lowering Family Planning Visit Times

Cheryl Speight, RN
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Project Overview

Project Aim:
Richmond County aims to reduce the amount of time that new/annual family planning clients are in the health dept by 50%.  We will accomplish this by December 31, 2011.  This is important because we want to increase client satisfaction, decrease cost to the agency, and improve staff productivity therefore increasing the number of clients seen per day.  We will achieve this by monitoring the clinic, conducting time and motion studies, completing observational walks, examining data collected and implementing changes where we can.

Project timeframe:
April 2010 to December 2011

How was the need for the project determined?
The need for this project came about through several different means.  The main idea was started when the client satisfaction surveys were reviewed and a chief complaint was wait time. Time studies were then conducted and it was noted that the average time a new or annual family planning client was in the health dept was 2.6 hrs. We also noted that several stops were made along the way with wait times. We felt this could be improved and provide a better and more efficient service to our clients.  This would in turn allow us to see more clients, increase our revenue, and ease frustration to the staff.

Does this quality improvement project link to accreditation?
Accreditation was not in the fore front of our thoughts at the beginning of this project but we are now in the process of reaccreditation.  There are links to these two projects but we feel the QI project goes into more detail than accreditation requires.

Areas for Improvement and Change Ideas Implemented

Improvement 1
Revised the assessment form used for family planning clients. With the old forms, some things were duplicated and some things were not required.

  • We obtained forms from other health depts. And used parts of them to create our own. We also got our family planning nurse consultant involved in the process.

Improvement 2
Reduce confusion in the fast track clinic on what information is needed to obtain a refill for birth control pills.

  • We created a new form to be used for this clinic only so anyone working in that clinic will know exactly what is required for this type of visit

Improvement 3
Reduce the different “stops” a client makes in the registration process.

  • We introduced a one stop for registration and financial to reduce one stop the client has to make. Instead of going to 2 different offices, the client stops in one office for both therefore cutting down on wait times between stops.

Improvement 4
Make the registration area more accessible to staff from clinic area.

  • Because our lobby and registration area has been remodeled through the years, there was no quick assess for the nurses and registration area to walk between the 2 areas. A door was placed in a convenient area for both to cut down on walking a great distance to get from point A to point B.


Overall Improvements

  • The nurse work-up is quicker with the forms now used.  The duplication was removed that was also on the self history form
  • Fewer stops for the client also means reduced wait times between these stops.
  • Overall “cleaning out” and standardizing clinic rooms makes for better organization and quicker service for the clients. Also reduces frustration for the nursing staff.
  • Better accessibility to other department reduces walk time.

Lessons Learned:

  • Any time forms are changed, such as consent forms or history forms, get your nurse consultant involved.  We did this for the history form and questioning labs that were required but did not for the consent forms.  We put a lot of effort into creating new consent forms and found out in the end we could not use them. 
  • Keep other staff involved in the process and continue communication throughout.   This is a process that involves them in the end so they need to be included throughout.
  • Staff may be resentful in the beginning because of the changes you are making.  This is where communication throughout the process can help.  Also encourage their input into the changes so they feel a part of the decision making process.

Programs supported by:

BlueCross BlueShield of NC FoundatoinThe Duke Endowment

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