QI Leaders Academy Kaizen Program: Distribution of Health Alert Network Messages

Summary

Impact Statement:

Health Alert Network (HAN) messages provide vital public health information to the community’s health care providers, schools, churches, day care centers, and so on. The RiverStone Health team used a 5-day Kaizen event to improve the HAN process, create job keys, involve more staff, and decrease processing time by 70%.

Summary:

The aim of this quality improvement (QI) initiative was to improve the process for expediently delivering tailored HAN messages to a target audience and to maintain accurate distribution lists. Staff at RiverStone Health in Montana employed a 5-day Kaizen event during which they used process flow maps, cause and effect analysis, the 5-Whys, prioritization matrices, and hypothesis testing. To test the new state process, staff created job keys such as roles and responsibilities, checklists, and standardized work templates. Four staff members are now capable of putting out HAN messages, allowing greater work distribution and backup; additionally, staff decreased work time without compromising internal brand standards. Staff are continuing to investigate proprietary products to manage the distribution lists and to increase the accuracy of dissemination. Two intangible benefits were recognized: (1) a decrease in staff frustration with the HAN process, and (2) the creation of a HAN distribution team with inherent collegiality and support.

Organization that conducted the QI initiative:

Yellowstone City-County Health Department (doing business as RiverStone Health)

Citation:

Tapia, M. Public Health Quality Improvement Exchange. QI Leaders Academy Kaizen Program: Distribution of Health Alert Network Messages. Thu, 11/16/2017 - 14:05. Available at https://www.phqix.org/content/qi-leaders-academy-kaizen-program-distribution-health-alert-network-messages. Accessed October 10, 2024.

Background and Aim

Aim statement:

By the end of the Kaizen event, improve the process for expediently delivering tailored HAN messages to a target audience so that • process time will be reduced by at least 50%, from an average of 254 minutes to less than 127 minutes; • a minimum of three staff members will be able to send HAN messages; and • a contact management system will be selected that will increase the accuracy of distribution lists so that at least 90% of HAN messages are successfully delivered upon first sending.

Need For The QI Initiative:

Because of staff turnover and technology challenges, RiverStone Health identified a need to make process flow changes and train more staff in being able to send out a HAN message on short notice. The HAN system had been riddled with concerns since 2012. The pre-existing system for distributing HAN messages was complicated, and only one person was able to accomplish the process. This project crosses the four Public Health Services divisions at RiverStone Health (Community, Environmental, Population, and Family Health Services).

Area for Improvement:

RiverStone Health, as a local health department, must ensure a robust electronic communications capacity to deliver a HAN message to community partners. The HAN messages contain vital public health information that originates at the Centers for Disease Control and Prevention, the Montana Department of Public Health and Human Services, or the local level. This information is transmitted through e-mail and fax and is the backbone for communication to health care providers, schools, churches, and daycare centers. The pre-existing process for distributing HAN messages could be performed by only one staff member and required up to 8 hours for reformatting to meet internal brand standards, and only 76% of messages were delivered correctly upon initial distribution.

Root Cause:

Root causes identified in planning the initiative included the following: • Methods for complying with internal brand standards are cumbersome and time consuming. • Contact lists from the state cannot be obtained, contact information changes frequently, there is a lack of defined roles and responsibilities to maintain lists, no staff time is allocated for list maintenance, lists are not tested, there is no budget, and there are software limitations. • The process is too complicated and has a lot of glitches, a single person sends out HAN messages and has no backup, and the culture of the organization is a limitation.

Planning and Execution Details

QI Implementation:

The two QI leaders and this project were selected for participation in the Public Health Accreditation Board (PHAB) QI Leaders Academy. The project was deemed appropriate for the 5-day Kaizen event model taught by the coaches. The two leaders prepared before the event by defining the problem, developing an aim statement, collecting data, and identifying team members for the event. Below is the day-by-day sequence of activities and tools that team members employed during the event. Those affected by this initiative include (1) contacts who need to act on information contained in HAN messages, such as childcare providers, physicians and other health care providers, pharmacies, faith communities, schools, and licensed food establishments; (2) the community at large; and (3) members of the Epi Team. Day 1: July 27, 2015 • Introduce the event and the team • Review ground rules • Review Kaizen and the improvement cycle • Align the team around the goal • Map the current state • Validate the current state • Virtual HAN—walk the process • Identify waste Day 2: July 28, 2015 • Share overnight thoughts • Identify issues and wastes in nonprocess areas • Prioritize wastes • Perform root cause analysis of priority issues • Develop solutions Day 3: July 29, 2015 • Map the new state process • Develop a rolling action item list (RAIL) and test the new state • Review standardized work and mistake proofing • Develop job aids Day 4: July 30, 2015 • Perform mistake proofing • Standardize work • Perform testing • Share and update job aids • Test job aids • Share lessons learned Day 5: July 31, 2015 • Share lessons learned on test 1 • Run test 2 • Share lessons learned on test 2 • Review continual improvement system and measures • Review training tools • Perform action planning for the rollout of the new HAN messaging process • Prepare report out

Focus activities

Other Environmental Health Services:

Disaster/Emergency Preparedness

Administration:

Communications

Other QI Focus Activities:

HAN

QI Methods:

QI Tools:

Prioritization Matrix

Process maps

Root cause analysis

Other QI tools:

Testing the current and new process

Hypothesis testing

QI Tool Documentation:

Pre-Kaizen HAN process map

Post-Kaizen HAN process map

HAN message template with drop-down selection

HAN messaging process: Test results

Checklist for HAN message distributor

HAN improvement hypothesis

Initiative Dates:

5/1/15 to 8/31/15

Initiative Duration:

Between 6-12 months

Methods of evaluation:

The following measures were identified to assess the impact of the initiative: • Process time—from taking a received HAN message, distribution, and final storage on the server. • Data were collected from direct observation before, during, and after the Kaizen event. The pre-event and post-event processes were tested during the Kaizen event. • Percentage of bounce-backs when the message is initially sent • Data were captured from bounce-back reports. • Staff frustration • Staff feedback was obtained. • Number of staff capable of sending timely HAN messages • Data were collected by direct observation.

QI Leaders Academy Kaizen Program: Distribution of Health Alert Network Messages

Summary

Background and Aim

Planning and Execution Details

Results

Training and Preparation

Information about the Community

Information about the Health Department

QI Staff Information

Collaborations

Contact Information of the Submitter

QI Spotlight

quality improvement together.

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QI Leaders Academy Kaizen Program: Distribution of Health Alert Network Messages

Summary

Background and Aim

Planning and Execution Details

Results

Training and Preparation

Information about the Community

Information about the Health Department

QI Staff Information

Collaborations

Contact Information of the Submitter

QI Spotlight