NNPHI Kaizen Program: Death Certificate Filing


Impact Statement: 
The DeKalb County Board of Health used a kaizen event to decrease the labor time and increase the accuracy of filing death certificate registrations. Improving the process resulted in labor savings, better cash flow and improved performance for customers in providing accurate and timely filing. The error rate on incoming information was reduced from 90% to 55%. Processing time was reduced by 56%. The team used a kaizen event to understand the problem; to identify issues and their root causes; and to develop, test, and begin installing the solutions in one week. The process was redesigned to eliminate redundant operations and waste, key process aids such as the filing form were redesigned, standardized steps were created to enable funeral directors to perform part of the process, standardized acceptance criteria for receipt of information were defined, team roles were clarified, office space and equipment were moved to follow the process flow, new equipment such as scanning hardware and software was installed, and the phone messaging system, prompts, and routing/rollover system were improved.

The goal of this quality improvement (QI) initiative was to reduce the time to complete county death certificate paper filings. The beneficiaries of the QI initiative are DeKalb County Board of Health staff, funeral directors, physicians, the public and public health officials. This QI initiative was implemented so that staff time is more efficiently used to achieve desired results, certified death records are accurate and available on a timely basis, and more time can be spent on education and training on the benefits of the state electronic registration system. The conditions of the QI initiative included improved process and data quality management, reduced filing time (by at least 30% for one full-time staff member), and achievement of targets within 4 weeks of kaizen event completion. The Office of Vital Records used two measures. The first measure was the average length of time for the data collection, validation, correction, input and printing for one paper filing. The target was to decrease the average by 30%. The second measure was the total number of weekly paper filings as a percentage of the total number of all death filings (paper and electronic). This measure will be tracked to assess funeral homes' and physicians' use of the state electronic registration system and to assist in future resource allocation.

Organization that conducted the QI initiative: 
DeKalb County Board of Health

McWethy, D. Public Health Quality Improvement Exchange. NNPHI Kaizen Program: Death Certificate Filing. Mon, 07/31/2017 - 10:56. Available at https://www.phqix.org/content/nnphi-kaizen-program-death-certificate-filing. Accessed July 25, 2024.

Submission Status: 
0 users have voted.


cgizzi's picture
Submitted by cgizzi on

I loved seeing this poster at the Open Forum conference, and it's a great PHQIX submission. Even though our death certificate filing process is very different in Washington state compared to your process in DeKalb County, I still learned a lot and am able to apply your improvement methods and learnings to our processes here. Thanks for providing so much detail (e.g., in Lessons Learned, Observations, and Insights) so that we can apply the info to our own programs.

Cindan Gizzi, MPH
Tacoma-Pierce County Health Dept.

0 users have voted.
Link to the resource where this submission is also published: