Time Reduction in Conducting Point of Sale Real Estate Septic and Well Inspections

The data collected were sufficient to conclude that the improvement test was effective. Twenty-four inspections were conducted within a 6-week test period. The time it takes from application for a septic and well real estate evaluation to when the inspection was conducted was reduced from 11.8 to 7.1 calendar days, a 40% decrease in time. This far exceeded the final aim statement goal of 10.0 days or a 15% decrease. Following is a summary of post-test data. • The average time it takes from application to scheduling is 2.7 days. • The average time it takes from application to inspection is 7.1 days. • The average time it takes from application to process completion is 13.8 days.

The initiative also resulted in: • self-moderated collaboration between the inspectors, and • the creation of a tracking mechanism for other wastewater programs.

Self-Assessment With regard to conducting the self-assessment, it was very advantageous to have the accreditation coordinator attend the Public Health Accreditation Board (PHAB) training beforehand. The accreditation team may not always consist of managers, but those who have a lot of knowledge about the many processes and services the health department provides. The process the team used in conducting meetings to conduct the assessment as a group worked out well. It may not be as easy to use this process for large or state health departments. The team also found that there were times that they did conduct certain activities but had little or no documentation to prove that they demonstrated the measure. The team had file folders set up on the network to the measure level. They found this worked very well to help keep all of the documentation organized and facilitated attaching documentation to PHAB’s online self-assessment documentation utility. Site Visit Preparation is important for the site visit. The Mahoning County District Board of Health should ensure that it acquires the further documentation that site visitors request in advance and should be prepared to address any questions on clarification of documentation that was submitted. The Mahoning County District Board of Health was prepared, and the site visitors were appreciative. The team’s self-assessment score proved to be lower than the score that the site visitors gave the Mahoning County District Board of Health. The visitors’ higher score was largely a result of having the further documentation that was requested. Quality Improvement (QI) Project With regard to the QI project, one of the things that benefitted the process was that many of the team members were familiar with the QI cycle. That cut down on the time needed to teach about PDCA specifically. If external stakeholders are involved in a project, the purpose for having them as a part of the team and the team’s expectations of them should be clear. Also, having a facilitator who knows and understands team dynamics is crucial to keep the process moving and on target. Caution should be used when interpreting data for short time frames. A study limitation could include the inspectors’ propensity to complete tasks that are being tracked first. Hence the nature of PDCA—always recheck the results.

This improvement will continue to be monitored, particularly in warmer months when home sales are more common. Gains will be monitored throughout the summer of 2011 to determine if there are seasonal fluctuations. As a result of the success with assigning more equitable workloads, it was appropriate to adopt the improvement. The three affected inspectors decided and agreed to the distribution; thus, no challenges or obstacles arose.