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Story of Measurable Improvement in Public Health

Name of Health Department/Agency: Miami-Dade County Health Department
State: FL
Contact Name: Rene Ynestroza
Contact Information:
Date Added: 6/26/2011
Program/Topic Area: Clinic wait times
QI techniques/tools:  5-whys, Control Chart, Fishbone Diagram, Flowchart, Multi-voting, Pareto Chart, Root Cause Analysis, Brainstorming, Before and After Line Graph
Description of the process and intervention: The goal of the effort was to reduce the percentage of clients in the Family Planning Clinic with a wait time greater than two hours from 37% to 19%. Root cause analysis revealed that long wait times were the result of client appointments not matching provider availability. The intervention involved the development of a client schedule that matched provider availability, updating the Health Management System (HMS) appointment scheduler, training staff on the HMS scheduler and serving clients based on their appointment times. Cycle time of clients was collected and compared to data collected before the intervention was implemented to determine whether an improvement was made.
Result/outcome: After four weeks of the new client scheduling system, the client cycle time greater than 2 hours dropped from 37% to 24%.
Next Steps: The team will continue to collect weekly data for 2 months to analyze if the trend in reducing client cycle time continues and to fine tune the processes through PDSA cycles. If the intervention continues to show improvement, the process will be applied to other programs and locations.

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