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Story of Measurable Improvement in Public Health

Name of Health Department/Agency: Central Valley Health District
State: ND
Contact Name: Robin Iszler
Contact Information:
Date Added: 6/27/2011
Program/Topic Area: Environmental health
QI techniques/tools:  5-whys, Affinity Diagram, Flowchart, Root Cause Analysis,
Description of the process and intervention: Deficiencies in documenting environmental health services caused the team to use an affinity diagram to identify potential areas for improvement. A QI effort was implemented with a goal of increasing documentation of sewer inspections from 14% to 100%. After developing a flowchart of the current documentation process and conducting a root cause analysis using the 5-Whys technique, it was determined that inspections weren’t consistently being documented due to two different types of inspections and no clear protocol to document each. The improvement theory was that if a form is started when the call is received and are completed during the sewer inspection, then the number of documented sewer inspections will increase. The intervention involved the integration of a hybrid filing method that included both paper and electronic filing of completed forms. Data collection consisted of the number of sewer inspections that were properly documented.
Result/outcome: As a result of the new filing system, the percentage of properly documented sewer inspections increased from 14% to 80%.
Next Steps: The team will continue to refine the current computer filing program, educate all team members on the new filing system, and update the electronic and paper files weekly. The team will also continue to improve data collection and documentation of other environmental health services, starting with food inspection.

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