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Case Study – Case Processes to Meet Mandated Targets

Case Study – Case Processes to Meet Mandated Targets. Sandra Whitley Ryals Director Virginia Department of Health Professions. October 2006. Governor Kaine, assigned the Department of Health Professions (DHP) the performance goal of 250 days to close 90% of all patient care cases.

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Case Study – Case Processes to Meet Mandated Targets

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  1. Case Study – Case Processes to MeetMandated Targets Sandra Whitley Ryals Director Virginia Department of Health Professions

  2. October 2006 • Governor Kaine, assigned the Department of Health Professions (DHP) the performance goal of 250 days to close 90% of all patient care cases. Performance on October 2006 • Closure by day: 734.4 days • Closure by percentage of cases:57% CLEAR 2008 Annual Conference Anchorage, Alaska

  3. Performance Toward Goal Made Visible to Public Quarterly reports on performance web site • Electronic Access for Citizen Review • Emphasis on Reaching the Right Results • Securing Virginia’s AAA Rating http://vaperforms.virginia.gov/ CLEAR 2008 Annual Conference Anchorage, Alaska

  4. Getting to Goal: 7 Steps • Rapid introduction to qualitative information • Solid strategies • Unique core strengths • Supporting structures • Consistent systems • Well connected culture • Inspired leadership CLEAR 2008 Annual Conference Anchorage, Alaska

  5. Rapid introduction to qualitative information • 13 Boards examined individually for closure performance baselines; • Trend analysis provided to each board, executives, disciplinary units, with periodic real-time snapshots of case information; • Closure performance reported weekly to boards, units. CLEAR 2008 Annual Conference Anchorage, Alaska

  6. Solid strategies • Examine “patient care” definitions • Determine how many cases (5259) currently open • Determine oldest cases for blitz in closing • Identify the bottlenecks (disciplinary caseload 59%; Intake/investigation 46%; Probable cause 33%) CLEAR 2008 Annual Conference Anchorage, Alaska

  7. Unique core strengths • DHP has a deep understanding of its processes due to stability of management; • DHP has a record of excellence in state government and wanted that branding to endure; • DHP’s cultural lifeblood is doing it well; now it had to be done well and more efficiently CLEAR 2008 Annual Conference Anchorage, Alaska

  8. Supporting structures • Establish multidisciplinary performance action teams: • Intake & Investigation; • Old Cases; • Probable Cause. • Network with specialist consultants (VRI) for data verification and reporting clarity. The company had worked with U.S. court systems for similar performance accountability. CLEAR 2008 Annual Conference Anchorage, Alaska

  9. example of team recommendations 250 Day Measure Recommendation 1. Create a tiered system for investigations where more work is done upfront “in-house” before a case is assigned to field • Tier 1 - Intake& preliminary investigation • Tier 2- Initial probable cause review • Tier 3 - Full investigation, either field or administrative CLEAR 2008 Annual Conference Anchorage, Alaska

  10. Consistent systems adopted Data reporting modified to separate into 3 measures, from the original 1 measure, to show a clearer, more balanced focus: • Added a Clearance Rate performance measure; • Added an Age of Active Pending Caseload performance measure; • Modified the Time to Disposition to incorporate a moving window. CLEAR 2008 Annual Conference Anchorage, Alaska

  11. Well connected culture * Changed approach from silo board mentality to agency wide consistency; * Actively partnered with other boards, discipline, adjudication to implement systems improvements & process efficiencies. A corporate culture that is well connected takes loads of time and effort. Culture is how people act everyday so you have to change behavior. This is one of the proudest things we accomplished! CLEAR 2008 Annual Conference Anchorage, Alaska

  12. Inspired leadership • Agency Director championed the effort; • Goal success considered a team sport; • Governor’s & Secretary’s Office encouraged improvement efforts; • Performance reported continuously; • Leaders identified early on; • Persons who added value openly recognized. CLEAR 2008 Annual Conference Anchorage, Alaska

  13. Here we are - today Today we can show the public a concise, balanced, and data-based way to measure DHP's disciplinary case processing: clearance rate = 200%; age of pending caseload = 29% time to disposition = 75%. CLEAR 2008 Annual Conference Anchorage, Alaska

  14. Conclusion: teamwork and data transparency translate purpose into action Thank you. Questions? Contact Sandra Whitley Ryals Department of Health Professions 804- 367-4648 sandra.ryals@dhp.virginia.gov CLEAR 2008 Annual Conference Anchorage, Alaska

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