NNPHI Kaizen Program: Tazewell County Health Department Food Inspection Process

Within the food inspection process, there were six large steps, and within the Kaizen event, staff were going to take any and/or all steps into account to attain the 33% target in administrative time. The Kaizen process was the QI method used, and within that process, many tools were used: 1. Confirm Kaizen Kaizen event selection criteria were used to ensure that Kaizen would be the best QI method for the project. Once staff decided to use Kaizen, they completed steps 1–8 of the PrISM document (see uploaded documents) and the goal statement template. 2. Prepare for Kaizen In preparing for the Kaizen event, it is important to complete the stakeholder analysis. This job aid helped to ensure the best communication method with the many different people involved in the event. Once staff completed the analysis, they developed a communication strategy that helped circumvent some of the issues that arose during this step. The event preparation checklist was useful in ensuring that no detail was missed. Staff used the value stream map to break down the steps of the process into measurable pieces, which helped to track some baseline data. Using the gathering knowledge job aid was helpful when team members walked through the process before the actual event week. Using this form helped to ensure that knowledge was not lost. At this step in the process, staff completed steps 9–11a of the PrISM document (see upload). 3. Perform Kaizen During the Kaizen event, many methods and tools were used. A newspaper was developed daily to ensure that the team knew what work needed to be completed, and once the day was complete, the newspapers served a secondary purpose of letting everyone else in TCHD know about progress. In helping to identify areas of waste, staff used the forms of waste wall chart and the subprocess maps of the current process that were developed from the value stream map. The prioritizing issues 2x2 matrix helped to focus on the issues that would show the highest impact on the problem, and the cause-and-effect analysis (5-Whys) helped break down those issues even more. In helping to identify possible solutions, staff used the prioritizing solutions 2x2 matrix so they could focus on the solutions that had the highest impact on eliminating the identified issues/problems. Once the matrix was completed, staff developed improvement hypotheses and actually performed some tests using the test plan template and action items worksheets on the hypotheses. Then staff created the subprocess map of the future process and reviewed the process for possible areas of failure. The "parking lot" wall chart was invaluable in collecting possible issues or solutions throughout this event so that staff could stay on task with the process and have team members' thoughts captured and addressed at the appropriate time. Training the food inspectors who were not on the Kaizen team was accomplished using the goal statement template, and training occurred during the week of the Kaizen event. The continual improvement system (CIS) wall chart and measure definition sheets were started to ensure that the process owner could institutionalize the process. 4. Institutionalize Kaizen Since the completion of the event, the process owner has met at least once a month to update the CIS. For now, this entails discussion of the progress for action items but will include progression toward the goals using the data collected during the monthly time studies to ensure upward movement and catch any possible downturns.

Measures and Targets Beneficiary: staff What measured: administrative time How measured: the time it takes to complete a food inspection minus the inspection itself Target: 33% reduction in administrative time by the end of the Kaizen project Beneficiary: TCHD administration What measured: materials saved How measured: amount of materials for each food inspection Target: 50% reduction in material use by the end of the Kaizen project Data and Information Collection 1. The food inspectors and supervisor will track time within each step of the process in January and February 2014 to acquire baseline data. 2. The EH staff will track supplies used within each step in March 2014 for baseline data. 3. The QI team leader and members of the Kaizen team will gather practical knowledge of the process from December 2013 to February 2014.