Improving the Timeliness of Client Service Records

A Gemba was conducted, and the root causes were validated. When staff in the Dental program were asked the standard for CSR timeliness, they were unsure. When they looked for the timeliness standard, they referred to the AR policy, which applied to billable CSRs. It was discovered that staff treated billable CSRs differently than they treated nonbillable CSRs because they were unaware that the Central Office monitored timeliness of all CSRs, whether billable or not. Several countermeasures were developed with the team: timeliness standards applicable to all CSRs were clarified in writing, CSR timeliness was added to the training checklist for new hires, the timeliness measure was added to the staff Specific, Measurable, Achievable, Relevant, Time-bound (SMART) performance expectation, communication was sent to all staff to clarify standards for CSRs, and results were continuously reported. A pilot was conducted for the third quarter of the calendar year, and the percentage of CSRs filed on time was monitored to determine countermeasure effectiveness. The team reconvened with the Dental program after the pilot to obtain feedback and document lessons learned.

The team monitored the number of late CSRs for all programs, paying close attention to the program piloting countermeasures. Data were stratified to analyze how a reduction in late CSRs in each program would affect the overall aim. The team set a target to reduce the number of late CSRs within the Dental program, which showed the greatest opportunity for improvement. The project team compared before and after Pareto charts for the number of late CSRs by program to display the reduction in late CSRs with the Dental program (see attached before and after Pareto charts). Improvement in the Dental program affected the percentage of CSRs filed on time for the organization as a whole (see attached 2016 line graph).