Project Team: DeKalb County Death Filings Timeline: Begin 3/17/2014; end 3/21/2014; performance outcome assessment: 4 weeks _ SOLVE _ What is the need (e.g. outcome) or gap that caused this project to be considered in the first place? The current process to gather data, validate and input death certificates in the Office of Vital Records (Office) requires significant human resources. These staff are being drawn from other duties, which affects resource leveling within the Office and negatively impacts the Office’s overall performance. The inability to file registrations in a timely manner results in delay of time-to-certificate for the public, and data to support public health surveillance activities. This also negatively impacts the revenue flow and increases expenses for personnel services due to the provision of additional staff resources. b. Who is establishing the need? The DeKalb County Board of Health has recognized that this is a business need, with the Office of Vital Records as an integral contributor to the overall process. c. How is the need being measured and is it possible for this project to make an impact on that measure? Number of FTEs required to process death certificates d. What data or analysis was used to establish that this project will make a key impact? The current amount of time to produce accurate filings, the number of filings each week, the one staff resource, and the number of weekly man-hours required to achieve the accurate weekly filings, which is currently 30% greater than 40 man-hours. e. What scope (e.g. geographic, organization, customer) are you expected to impact? Walk-in, long form certificates f. What conditions are being placed on this project? One FTE max to be used for process
Process step: Certificate processing Waste: Stopping (interruptions due to phone calls to death clerk) Incoming Phone tree and website not effective in providing information to customers due to length, accuracy and clarity of key information. Routing of calls not consistent with organization policy, not designed to reduce interruptions to death clerk. Organization policies do not exist to establish service level agreement, priority setting, and process coverage. Policy statements Within kaizen event Process step: verify/edit Waste(s): Not needed. Birth data verification, Waste: Things Gone Wrong, Movement. Verification of individual data fields State standard not clear as to requirement for verification and leads to inconsistency and confusion in application No inspection standards for content of individual data fields exist; organization policy for whether DeKalb or Funeral director is responsible does not exist Review state policy; Standardized work Standardized work; visual job aids for Dekalb and Funeral Directors; redesign process to require correct and complete data as part of receipt Within kaizen event Within kaizen event Process step: certificate processing Waste: Not needed Redundant tracking logs DeKalb process steps: Verification and inspection (final manager inspection) Multiple logs believed required to ensure traceability; work process not standardized nor examined for how reliable traceability is achieved Team member roles and responsibilities not clear/established as to who does what, the individual’s accountability for self-inspection; work process not evaluated for how defects can be eliminated without inspection Stop manual log; Process redesign, standardized work and use of document scanning system to electronically track Process redesign, standardized work; visual job aids Within kaizen event Process step: certificate processing Waste: Stopping (interruptions; team members at death clerks desk) Lack of role clarity, no process for identifying overloads(help) and addressing Process redesign so death clerk initiates request for help; standardized work; visual job aids Within kaizen event Process Waste: Stopping Death clerk physical location Redesign process to have Within kaizen
step: certificate processing (interruptions) and Movement (office organization) promotes interruptions by funeral directors supervisor provide intake part of process; move death clerk to location away from receiving window event (Summary of potential means to achieve goal) Issue Improvement Expected Results Incoming defects IF…we redesign the request form, provide clarity and feedback to the Funeral directors as to frequently missed or corrected items AND we standardize our acceptance criteria for review of data… THEN…incoming defect rates will drop and interruptions to the death clerk and will be reduced. Consistency of process IF… we redesign our process to utilize the supervisor for intake, standardize and clarify roles and responsibilities and have the death clerk only receive “help” when it is requested… THEN…labor required to process will be reduced and the consistency of the process output will be improved Travel motion IF… we move offices and equipment to match the work process... THEN…travel for performing process steps, interruptions from other team members and labor required will be reduced Redundant operations IF…we introduce scanning hardware, software and a process for its use during initial receipt of documents… THEN…redundant logs and processes can be eliminated and labor reduced without sacrificing traceability Getting customers correctly routed for answers IF…we redesign the phone messaging prompts and redesign the routing/rollover system so that it is shorter, clearer to customers and provides needed information… THEN…customers will get their information faster with less transfers and there will be less interruptions to non-involved team members _ TRY _ (How will you test the potential solutions?) Update the project schedule For trial and learning) Tests How When Who Successful if… Future state work process run though Take sample request form and data and run through new process by role and using job aids March 28 Susan and Team Process successfully achieves final deliverable; no more than 3 required changes identified Phone tree (message) Have 3 customers (birth and death) listen to new messaging, and attempt to access needed information March 28 B. James, H. Gary All customers respond favorably on 5 point scale that improvement over prior messaging made.