QI tools used to identify possible solutions were as follows:
• Brainstorming allowed all team members to participate and develop solutions. Brainstorming also allowed other team members to build on each others' solutions while staying focused on the aim statement.
• A solution-and-effect diagram identified areas of solutions with subcategories that would help the team achieve the aim statement.
• The impact difficulty matrix was used by considering the solutions identified in the solution-and-effect diagram. The solutions were organized by level of difficulty and ease of solution. This helped the team identify solutions that were quick, easy fixes and those that may require more work or time but would also affect the aim statement.
• The nominal group technique with multi-user voting allowed the team to quickly come to a consensus on the importance of solutions while allowing all staff to have a voice. This helped build a level of commitment among the team members and encourage the quieter staff to have a voice.
• The Gantt chart is a simple, accessible tool for all staff that showed which tasks could be done over the life of the project and who is responsible.
• The roles and responsibilities diagram was developed as part of the Gantt chart and posted, so all staff were aware of their role during the entire course of the project.
The following solutions were chosen:
1. Define staff roles and responsibilities.
2. Provide on-site access to data entry through employee Surfaces and multi-user hot spots.
3. Beef up staffing at large outreach clinics. Bring in outside service section help, if needed.
4. Establish responsibility and ownership.
5. Have a competent team approach.
All team members were encouraged to use and follow the QI tools developed before making any changes to the process before the first check-in meeting. Following the tools created would distinguish whether any problems occurring were due to the actual process or tool developed or because of personal choices to not complete an assigned task.
This project will affect the following customers:
• Internal: AIDEP staff who assist in the flu vaccine program, public health nurses, the health promotion manager, and the senior health nurse
• External: Medical providers in Iowa (all medical providers, pharmacies), patients who receive these immunizations, Iowa Department of Public Health's Immunization Grant, and Iowa's IRIS
Methods of evaluation:
Data were provided by the Iowa Department of Public Health's IRIS before, during, and after completing this project.
Data entry measured for this project included all patients who received a flu, PCV13, or PPSV23 vaccine from September 1, 2017, through November 30, 2017, by CGCDPH and whether the 7-day data entry goal was achieved.
During the first team meeting, a representative from the Iowa Department of Public Health was shadowing the QI planning meeting and recommended that the aim statement be checked midway through with an obtainable goal.
Sample of materials produced