QI Leaders Academy Kaizen Program: Referral to Care

This QI initiative was identified as a component of the strategic plan that had not yet been addressed. The QI project was chosen as the Kaizen QI initiative, which was implemented with training and guidance by the Public Health Accreditation Board (PHAB) QI Leaders Academy. Before the event, the process owner and QI project lead created and distributed the pre-event survey to gather baseline data on customer and staff knowledge and satisfaction with the current internal referral process. These data were compared with the results from another survey distributed after the process launch. In addition, the gathering practical knowledge tool was used to assess QI team understanding of the current process and to identify the current state. This information was used to provide the team with baseline data to review during the first day of the week-long Kaizen event, which took place from August 10 through August 14, 2015. The team also completed a 5-Whys analysis to determine root causes, brainstorm solutions to the root causes, and prioritize solutions using a solution matrix, which focused on control and impact. A new state process map was then created and tested with those who would be most affected by the process changes: front desk, community health, and clinical staff. The improvements made during the project will result in a 20% increase in referral and service knowledge by staff. In addition, if the QI team creates a clear process workflow, procedures, and simplified access points to the many programs, staff will be able to effectively use the new process, and there will be a 20% increase in satisfaction with the process. Last, if the QI team creates an easily tracked form with e-mail notification capabilities, they will then be able to measure the number of interdepartmental referrals and number of closed-loop referrals, as well as establish baseline data for the process. Thus, a referral form and process were created to make referrals through a secure electronic site, and a comprehensive DCHS services directory (deskbook) with program descriptions, eligibility requirements, and links to the referral form was created. Using these tools, the team accomplished a standardized and easy way to learn about programs and submit internal referrals. The process directly affects all staff members who provide services or schedule clients or community members for programs and/or services. The process also influences clients and community members who are in contact with DCHS.

A pre-test/post-test survey will be distributed to determine staff knowledge, use, and satisfaction, with a desired improvement of 20%. The first survey was distributed on August 1, 2015, by the QI specialist. The staff survey was redistributed 2 months after the site launch in February 2016. The referral site will also be used to determine the baseline number of interdepartmental referrals and closed-loop referrals. These data will pulled from the site into a Microsoft Excel spreadsheet and will be reviewed monthly for the first 3 months (November, December, and January) and tracked quarterly thereafter.